Payment Policies    Health Insurance    Self-Pay    Workers Compensation    Personal Injuries



O’Connor Chiropractic, SC accepts most insurance plans. Our dedicated and knowledgeable insurance
staff will file your insurance claims
for you and work with the payers to assist them in paying your claims correctly.

We ask that you provide your insurance information before your appointment so that we can verify your
benefits with your insurance carrier. Please note, however, that an insurance company will never
guarantee coverage or benefits until the actual claim is processed.

Regardless of any potential insurance coverage you may have, any and all charges on your account are
the responsibility of you, the patient, or your legal guardian. Though we will file your claims for you and
work with your insurance company on your behalf, please understand that ultimate responsibility lies
with you, the patient.

If you have specific questions regarding your insurance plan, insurance coverage, or our payment
policies, please contact our Patient Accounts Department at (920) 735-2828.


Payment Policies ...

Our general payment policy is that payment is due at the time of service for any anticipated patient out-of
-pocket amounts due under your insurance plan(s).

However, if you have financial hardship that you would like us to consider, or if you expect the costs of
your care to exceed your current ability to pay, please contact our Patient Accounts Department before
your appointment to make alternative payment arrangements. If authorized, we will ask you to sign a
Payment Plan agreement and to make a good-faith payment at your first visit.

For your convenience, we accept cash, checks, debit cards, and MasterCard & Visa credit cards.
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Health Insurance ...
Following is a list of the most common insurance plans and PPOs (Preferred Provider Organizations)
that we participate with in the Fox Valley. If you do not see your insurance plan listed, please contact our
office at (920) 735-2828 for more information. We participate with and accept many insurance plans, but
are unable to list them all.  Additionally, state and federal government insurance plans prohibit us from
advertising whether or not we accept them, so please call (920) 735-2828 for more information.

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Self-Pay / No Insurance/ Non-Covered Services ...
If you do not have health insurance coverage available, or if your health insurance does not cover
chiropractic or certain services, we offer a discount if you are able to pay at the time of service.

Additionally, you can receive a discount for paying at the time of service if you choose to not have
O'Connor Chiropractic, SC submit certain health insurance claims on your behalf by signing a Waiver of
Insurance form.  Please call for details.  Some exclusions apply (Ref MC & MA covered services, ACC, PI, WC). 
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Workers Compensation ...
If you are involved in a work-related injury, immediately report your injury to your supervisor and continue
to keep your employer informed about any changes to your condition. Any delays in reporting your injury
can affect not only your health, but also possible compensation benefits.

Your employer has the responsibility to report your injury to its insurance company (or internal claims
office if your employer is self-insured), who will then report it to the Worker’s Compensation Division.

Please have any information relating to your claim available when you schedule your appointment. We
especially need a name and contact number for your employer’s Human Resources Department, and a
claim number if available, so that we may contact them to obtain information on how to file your workers
compensation insurance claim.

If there is any dispute between you and your employer relating to a workers compensation claim, you
should contact the Wisconsin Department of Workforce Development Worker's Compensation Division
for help with your claim at or by calling (608) 266-1340.

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Automobile and Other Personal Injuries ...
Automobile and other personal injury claims can become quite complicated. If you have retained an
attorney to assist you with your injury claim, please provide our office with your attorney’s contact
information so that we may work with him / her on your behalf.

If you have medical payments available (either through an automobile, homeowners, or other policy), this
coverage will be billed first. Please have any information relating to your claim available when you
schedule your appointment. We especially need the name of your insurance company,
a contact phone number, and a claim number if available.

We will also ask for a copy of your accident report (if available) and any third party liability information
(i.e. party(ies) at fault) so that we may assist you in filing claims with all involved parties.

If you have medical payments coverage available and choose not to file a claim, payment will be due in
full at the time of service.

If there is no medical payments coverage available or if it has been exhausted, we may (in some
circumstances) file claims with your health insurance carrier, in which case you would be responsible for
any out-of-pocket due under your health insurance plan. Alternatively, we may ask you to set up
a payment plan or you may be eligible for our "date of service" discount. You may be able to recover these
out of pocket amounts from any settlement you receive from any other responsible third party.
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Members of the Wisconsin Chiropractic Association

O’Connor Chiropractic, SC
2021 Oneida Street • Appleton, WI 54915
Phone: (920) 735-2828 • Fax: (920) 735-2981
O'Connor Chiropractic Facebook


The staff at O'Connor Chiropractic SC offers experienced chiropractic and great patient services in Appleton, WI. 920-735-2828.



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