Patient Paperwork
Paris Family Chiropractic & Acupuncture wants to make it easier for you when you come to see us. All of our New Patient Paperwork is available for you to conveniently access before you walk through our doors.
Please click on the applicable form, print and fill out, and bring it with you on your first visit. If you have any questions, please call us for assistance.
Our HIPPA Policy
New Patient Paperwork—Medicare Patients
New Patient Paperwork—Patients Using Medical Insurance
New Patient Paperwork—Self-Pay Patients
Methods of Payment & Cost
Chiropractic Care
Insurance
Paris Family Chiropractic is in network with most insurance companies. If your insurance is not listed, please feel free to call the office to verify if chiropractic is a covered benefit.
- Blue Cross Blue Shield
- Cigna
- Medicare
- United Health Care
- UMR
- Medicare Supplemental
- VA Referrals
If you chose to use your insurance, we will file it on your behalf. You will be responsible for all co-pays at time of service and any other payments once we have heard back from your insurance company.
Medicare
When using Medicare, there are limitations as to what they will cover with regards to chiropractic treatment. They are as follows:
- Pays for 80% of the adjustment when on an active treatment plan (after yearly deductible has been met)
- MOST supplements will pick up the remaining 20%, if not, it becomes patient responsibility
- Does not pay for maintenance adjustments (i.e. monthly or infrequent appointments)
Medicare does not approve the following charges, and they are the patient’s responsibility:
- Exams
- X-rays
- Therapy (i.e. E-Stim, Ultrasound, Traction, etc.)
Paris Family Chiropractic tries to keep the cost for our patients low and as a result our fees are affordable for all patients.
Self-Pay
If you chose not to use your insurance, do not have chiropractic benefits or do not have insurance, you are responsible for paying for your treatment each visit. The cost varies from patient to patient depending on their health concerns and/or symptoms.
Workman’s Compensation
Paris Family Chiropractic accepts workman's comp patients from local businesses. If you have an injury which occurred at work, have your Human Resources representative call the office to verify employment and benefits and schedule an appointment.
Personal Injury
Paris Family Chiropractic will accept patients who have been involved in Motor Vehicle Accidents and have filed a claim with their insurance company. When you call to schedule your appointment, make sure to let us know that we will be filing with your car insurance. You must bring the following: insurance adjusters name, contact information and your claim number with you to your first appointment. Verification of chiropractic benefits will be done up on arrival to the office, prior to treatment.
Acupuncture
Very few insurance policies cover acupuncture treatment. If you have insurance which covers, we will file it on your behalf.
If we are filing your insurance for a chiropractic adjustment, and you are having acupuncture, the cost of acupuncture is $25.00.
Self-pay price is $45.00 without adjustment and $55.00 with adjustment.
Call Us Today!
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CONTACT INFORMATION
Address: 1203 E Wood Street Paris, TN 38242
Phone:
(731) 642-3761
Fax Number: 731-642-3762
BUSINESS HOURS
Monday - 8:00 am - 5:00 pm
Tuesday - 8:00 am - 1:30 pm
Wednesday - 8:00 am - 5:00 pm
Thursday - Closed
Friday - 8:00 am - 5:00 pm
Two Saturday a month 8:00 am - 12:00 pm