Frequently Asked Questions About Insurance for Acupuncture Treatment
1. Do you take insurance?
Yes, we do. Depending on your plan and whether or not we are “in-network” with your insurance provider, we can either bill your insurance company directly or issue you a “superbill” that you will need to submit for reimbursement.
As of 10/1/2016 we will no longer be accepting Anthem BlueCross insurance, billing for Anthem BlueCross insurance, or providing any type of progress notes to Anthem BlueCross.
This is due to the change on the part of Anthem BlueCross to have their plans administered by American Specialty Health (ASH). If your insurance is through Anthem, you should have received a letter directly from Anthem regarding this change.
We can provide you with a super bill, which you can submit for direct reimbursement, although we suspect there will be limited coverage.
2. How do I know if Acupuncture is covered by my insurance?
The first thing to do is to call our office and provide all your insurance information so that we can verify your benefits.
3. Are you contracted with any insurance providers?
We are currently contracted with two insurance companies - Cigna and Valley Health Plan. In other words, we are “in-network” with these insurance companies, and you will only be responsible for the co-pay amount designated in your plan
4. How much of my treatments will be covered by insurance?
Between 20-80% for most PPO’s. Herbs and supplements are typically not covered by insurance. If you have a Health Savings Account (HSA), then it will cover all of your treatment, and any herbs you may choose to take.
5. What is a Health Savings Account (HSA)?
A HSA is a tax-deductible health savings account which is set up by your employer. Usually you decide at the beginning of the year how much you think you are going to need for the year – this can include acupuncture, herbs, nutritional supplements, massage, whatever you choose – and then the amount comes off your pay check. The benefit of this system is that the amount you choose to deduct from your pay reduces your taxable income.
6. How do I use my HSA?
You will be given a special HSA credit card that works the same as any other credit card – give it to your health care provider at the time of treatment. You may also receive a checkbook that is linked to your HSA account.
7. How do I get reimbursement for my treatments?
The easiest way is to go to the website of your insurance provider (see the links below for a list of the most common providers). Print out the claim form. Fill it in and send it along with the superbill to your insurance company.
8. Why am I being charged on my first visit to your clinic?
Despite our best efforts, sometimes an insurance company will say they cover acupuncture and even tell us a percentage, but then once we have billed we find out that the amount they deemed fair and reasonable was less than the cost of the treatment. For that reason, until we know what the insurance company actually covers, we ask that you pay the first treatment at the cash price. We will then bill the insurance company and reimburse you or credit your account as soon as we receive payment from them. We don’t like having to chase money owed as much as you don’t like receiving a bill after the fact, so this way, we know it is covered.
9. What is a superbill?
A superbill is a receipt of services that includes a diagnosis code and a practice code. It is used for patients to submit to insurance companies themselves for direct reimbursement.