How Medical Insurance Works for Bodywork and Why It Helps to Think of It Like Dental Insurance

Medical insurance can be confusing, especially when it comes to chiropractic care, physical therapy, and hands-on bodywork. Many patients assume insurance is either “covered” or “not covered,” or that it determines what kind of care they receive.

In reality, insurance works very differently than most people realize.

A more accurate and far less frustrating way to think about medical insurance for bodywork is this:

It functions much more like dental insurance than full medical coverage.
In other words, it acts more like a cost-sharing benefit or coupon than a true reflection of the value of care.

Why Insurance Feels So Inconsistent for Bodywork

Most medical doctors and dentists are trained to diagnose disease, manage pathology, and intervene with medications or procedures. Musculoskeletal pain, especially pain involving the head, neck, jaw, shoulders, and upper back, often lives in a gray zone between specialties.

Chiropractic care, physical therapy, and clinical bodywork exist in that space. Insurance companies do recognize the value of this type of care, which is why many plans currently contribute toward treatment. But they do so cautiously, with strict limits, time caps, and frequent policy changes.

At the moment, many plans through Regence BlueCross BlueShield, MODA, and PacificSource cover a significant portion of comprehensive chiropractic and rehabilitative bodywork when it is deemed medically necessary.

However, this level of coverage is not guaranteed and historically, it does not last.

Insurance Coverage Changes (And Not in Your Favor)

Over the past several years, many insurance companies have steadily reduced benefits and reimbursements for hands-on care. This isn’t unique to chiropractic, it’s part of a broader cost-cutting strategy across healthcare.

We’ve already seen this happen with:

• Providence

• Cigna plans

• Aetna

In these cases, coverage that once supported meaningful care was reduced, capped, or eliminated altogether.

Other insurers, such as Kaiser Permanente and UnitedHealthcare, are often highly restrictive from the start by frequently denying services, downgrading billed care, or approving only the most minimal treatment regardless of clinical need.

These decisions are not based on what works best for patients. They are driven by internal policies, utilization algorithms, and profit margins.

So What Does This Mean for You as a Patient?

It means insurance should be viewed as a benefit that helps offset the cost of care, not the authority that defines it.

Just like dental insurance:

• It may cover a portion of each visit

• It may cap the number of visits per year

• It may change without warning

• It rarely reflects the true cost or value of the service

Dental patients intuitively understand this. Very few people expect dental insurance to “fully cover” comprehensive care. They expect it to help and they plan accordingly.

Bodywork and rehabilitative care function the same way.

Why This Reframing Matters

When insurance is treated as the primary decision-maker, care becomes rushed, fragmented, and frustrating for both patients and providers. Visit lengths shrink, treatment becomes formulaic, and the focus shifts from outcomes to compliance with billing rules.

By reframing insurance as a supporting benefit, several important things happen:

• Care can stay focused and intentional

• Visits can be structured efficiently

• Treatment decisions are based on your needs, not billing limits

• You retain more control over your healthcare choices

If your insurance contributes significantly? Great.
If it contributes partially? Still helpful.
When it changes in the future? Now you won’t be caught off guard!

The Bottom Line

Insurance is a tool, not a guarantee.

Right now, many plans do contribute meaningfully toward chiropractic care and bodywork and we apply those benefits whenever appropriate. But insurance companies continue to narrow coverage, reduce reimbursements, and shift costs onto patients.

Understanding this ahead of time allows you to make clearer, calmer decisions about your care without frustration or false expectations.

Our goal is to provide thoughtful, effective care that makes sense for your body while using insurance as a benefit when it helps, not a limitation when it doesn’t.

Why the name change?

Between the physical relocation of the practice to the Hollywood District in the same building as Haven Dental PDX combined with the evolution of my treatment style and interests, the name change felt like the logical next step.

The Work Changed Before the Name Did

From the beginning, I focused on hands-on, thoughtful care, not quick adjustments, rushed visits, or one-size-fits-all treatment plans. Over time, that approach became more refined and more specific.

The majority of patients I work with are dealing with pain or dysfunction involving the head, jaw, neck, shoulders, and upper back, often after trying multiple providers without lasting results. These cases require a combination of clinical reasoning, skilled manual work, and an understanding of how the nervous system, posture, breathing, and stress interact.

At the same time, it became clear that effective care in this area often overlaps with dentistry, particularly when jaw position, airway, bite mechanics, or oral appliances are part of the picture.

The name needed to reflect that reality.

Why Haven Dental and Haven Bodyworks Work Together

Even when not at “work”, Alex and I spend a lot time talking about health and life in general. We have a shared vision for a new model of healthcare that focuses on true preventative integrated care as opposed to “patch & repair” that we currently live in.

As a result, Haven Dental and Haven Bodyworks share a common philosophy:
the body doesn’t function in isolated systems, and care shouldn’t either.

Traditionally, pain in the face, head, and neck falls into a gap between professions. Medical doctors and dentists are essential for diagnosing disease and addressing structural or medical issues, but they are not typically trained to manage musculoskeletal pain patterns. Chiropractors and bodyworkers are trained to treat those patterns, but are limited when deeper structural, orthodontic, pharmaceutical, or surgical intervention is required.

By working in closer coordination, we’re able to:

• Address pain conservatively when appropriate

• Recognize when additional intervention is needed

• Communicate clearly across disciplines

• Avoid fragmented or redundant care

This doesn’t mean every patient needs dental and bodywork care. It means your care is informed by a broader clinical context when it matters.

A Shift Toward Focused, Sustainable Care

The new name also reflects a shift in how care is delivered.

Rather than offering generalized sessions, visits are now structured to be focused, efficient, and goal-oriented. While I am still happy to address other areas of pain/dysfunction, my primary focus will be pain causing conditions of the head, neck, shoulder, and upper back. This allows me to:

• Be more consistent

• Reduce burnout

• Stay available long-term

• Provide care that makes sense within real-world constraints

Longer, more comprehensive sessions are still available when appropriate, but the default approach is intentional rather than expansive.

This change supports better outcomes for patients and a healthier practice overall.

What Stayed the Same

While the name and structure evolved, the core values did not.

• Care is still hands-on and individualized

• Sessions are calm, unrushed, and thoughtful

• Treatment plans are explained clearly

• Decisions are made collaboratively

• No one is pushed into unnecessary care

The name change simply brings the outside of the practice into alignment with what’s been happening inside it for a long time.

Looking Forward

This marks a commitment to clarity in scope, communication, and care.

It allows us to better serve the patients we’re best equipped to help, collaborate more effectively across disciplines, and build a practice that is sustainable for the long term.

As always, the goal remains the same:
care that’s grounded, honest, and actually helps people feel better.

How to use out-of-network medical insurance benefits?

Some medical insurance plans through PPOs like Regence, MODA, and Providence reimburse up to 70% of out-of-network “medically necessary” services such as chiropractic, acupuncture, massage therapy, and physiotherapy.

This reimbursement is paid directly to you through your out-of-network medical insurance benefits. 

How to use these benefits?

Step 1: Book + Pay at the time of your session

You pay the regular session fee at the time of service (just like normal). Because I’m not in-network with insurance companies, my fees are SIGNIFICANTLY lower than many other chiropractic clinics simply because I don’t have to play haggling games with insurance companies. This ultimately means a lower out-of-pocket cost to both you and your insurance.

Step 2: Request a Superbill

During your session, ask me for a superbill. This is a special receipt that includes:

• Date of service

• (CPT) Treatment codes: Exams [99202-99204 & 99212-99214] Soft Tissue/Stretching [97140, 97530, 97124], Spinal Manipulation [98940-98942] Extremity Manipulation [98943], Strengthening/Stretching/Stabilizing Exercise [97110, 97112]

• (ICD-10)Diagnosis codes: For example [M54.50 Low back pain], [G44.219 Episodic tension-type headache, not intractable], [M62.838 Muscle Spasm], etc.)

• My NPI number and business info

Because I’m trained and licensed in the state of Oregon to use chiropractic, physiotherapy, and massage therapy codes, your insurance has a better chance of approving it.

Step 3: Submit It to Your Insurance

You submit the superbill to your insurance company’s claims department (usually via their website, portal, or mail).
Within a few weeks, they’ll send you a reimbursement check based on your plan.

Unsure if you have out-of-network benefits?

1) Login to your medical insurance online portal and read through your benefits section to see what your coverage entails.

2) If you’re still unsure what your insurance covers, feel free to call your insurance company and ask:
“Do I have out-of-network benefits for chiropractic (98940–98943), physiotherapy (97110, 97112, 97530, 97140), and/or massage therapy (97124)?” Then let me know either in your intake forms or during your session what your insurance covers and I will code accordingly!

I’m happy to help you interpret your coverage or walk you through the process.

What’s up with Medicare Coverage?

I do not bill out to Medicare as it does not pay for the following services performed by chiropractors:

• Health history reviews/physical exams

• Soft tissue and myofascial release

• Stretching

• Nervous system calming techniques

• Strengthening/stretching/stabilizing exercises (ie weight training, stretches, fall prevention)

• Diet/general lifestyle counseling

• Over-the-counter medication/supplement recommendations

Even though we are licensed and trained to do what is listed above, the only chiropractic service Medicare covers is spinal manipulation. I rarely perform traditional chiropractic high-velocity spinal adjustments (“cracking”) and even less frequently on aging spines. This is because most of my older patients coming in for headaches, stiffness, jaw tension, hip pain, posture fatigue, back pain, and balance issues respond better to the slower low-force soft tissue and rehabilitation focused treatments as opposed to a quick crackin’ session.

Hopefully this helps you better understand your insurance benefits! As always, feel free to email me with any questions you may have at info@longevitychiropdx.com.

See you soon!

- Dr. Andy

To the patients of Jasmar Reddin DC

To the patients of Jasmar Reddin DC,

I’ve had the privilege of meeting many of you and look forward to spending some quality time with the rest of you! For those of you I haven’t met yet, my name is Dr. Andrew Carper D.C. I am a chiropractor and have been working with Jasmar for a few months now. Please just call me Andy! And if we must entertain the whole doctor thing, then “Doc” will do. Fair enough? 

After working and studying with Jasmar for the last few months, I have some exciting news to share! As of April 4, 2024, my practice, Longevity Chiropractic, has taken over patient care for Jasmar Reddin D.C., P.C. You will see the same familiar faces as Jasmar and Terria have both agreed to stick around for a little while to help me get my bearings before they fully embrace and enjoy their well-deserved retired lives. 

I know I don’t need to tell you how much Jasmar cares about each one of you, because I know you feel it when you come in. It’s not possible to be around her and not feel it. That’s a rare thing these days and is becoming increasingly hard to find in a healthcare provider. I know I will never fully fill her shoes, but I will do my best to continue to learn, grow, and always be working toward the highest standard of care. I work hard to create a safe space in my office and I will do everything I can to help you make the best informed health decisions for your life.  

My approach to health is simple: find the root of the problem rather than chasing the symptoms. 

I treat the aches, pains, and injuries that affect us all from head to toe, with my major focus being on conditions of the head and neck. I’ve struggled with headaches and migraines my entire life and will be the first one to say “They suck.” which is why I have spent quite a bit of time honing my skills to understand and treat headaches. I also have a special interest in treating temporomandibular joint (TMJ) disorders that cause jaw pain as I work closely with my wife Alex, who is a brilliant dentist in NE Portland. If you have a headache and jawache that you can’t shake, I’m your guy.

My treatment consists of releasing tense and painful muscles with a combination of different massage and stretch techniques, chiropractic adjustments, and embedding rehabilitative movement into your daily life activities to help you return to pain-free function. I also believe in an integrated approach to healthcare, meaning a team of multiple providers with varying specialties and educations. I recognize my own limitations and if I believe a problem is beyond my abilities, I will do my best to help you find the right provider for your problem whether they are a medical doctor, nurse practitioner, physician’s assistant, dentist, podiatrist, physical therapist, orthopedist, or any other area of training. I look forward to helping you find your longevity!

A bit about me outside the office: I grew up in a small town in Northwestern Ohio, Tiffin, before getting a communication degree at Wright State University in Dayton, Ohio. Dayton was where I ultimately met my wife, Alex. After a few years working in various unfulfilling corporate jobs, I decided it was time to follow my interests back into the sciences which led me to the University of Western States here in Portland, Oregon. After graduating with my bachelor’s in human biology and doctor of chiropractic, we settled into a life that we love here in NE Portland. 

In my free time, you can find me spending quality time with Alex and our dog, Otter. I’ll either be concocting something in the kitchen, working on the house, making music, listening to podcasts, paddling on the water, or adventuring in the wilderness of Oregon and Washington. Feel free to shoot me an email, give me a call, or come see me at the office! 

I look forward to seeing you soon!

Dr. Andrew Carper D.C. “Andy”

Owner and Chiropractic Physician, Longevity Chiropractic