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Insurance for Acupuncture Treatments
We are able to bill your insurance company for your acupuncture treatments if you have coverage that is approved for acupuncture as performed by a Licensed Acupuncturist (L.Ac.). Please read this entire page first as there may be some differences from your other medical practitioners. We are posting this information here with the intention of being as transparent and straightforward as possible, so there are no unpleasant surprises when it comes to your bill.
Pre-Visit Insurance Verification
Ideally, please provide us with your insurance information with plenty of notice so that we can verify your coverage before your first visit. If you have coverage, we can submit claim forms on your behalf. We will need to know:
- The name and phone number of the insurance company
- The patient’s name and date of birth
- The name of the insured, if different from the patient
- The name of the employer of the insured
- Policy number, ID number, Group number, etc
- The condition(s) being treated
Please allow up to 3 business days for verification.
Out of Network
We are considered Out of Network for all insurance plans.
All patients regardless of insurance are required to pay for the first treatment at the first appointment. If you have insurance coverage for acupuncture, we will then submit the claim for the first treatment to insurance and require them to send the first reimbursement check directly to you. Insurance will not guarantee payment until the first claim is sent in, and there have been issues of them denying a claim while debating whether or not acupuncture is a medical necessity for the patient. We have no control over this but we will do what we can to make sure insurance has all of the necessary information to support your coverage.
For follow-up visits, insurance patients will be responsible for paying a portion at the time of service and we will submit the claim to the insurance company for reimbursement. This amount will vary per person based on the information given to us by the insurance company. Payment is typically one of the following:
- Copay, if required by the insurance plan, or…
- Full amount if still during the deductible period, up until the deductible has been met, or…
- Coinsurance percentage, e.g. if 20% then you would pay $15 for a $75 visit, and…
- The amount above the allowed amount (also known as “usual and customary fee”) that insurance does not cover.
No insurance discounts or write-offs are given, which means that any amount that insurance does NOT cover will be your responsibility to pay. Sometimes even when we verify the coverage beforehand, insurance companies may end up not paying us for various reasons. They might also change the allowed number of visits or conditions treated. We will communicate with you along the way, again to hopefully limit any unpleasant surprises.
Medicare currently does NOT provide insurance coverage for acupuncture. However, some secondary insurance companies do. If your secondary card says “Medicare Supplement” or “SUPPL PLAN”, the secondary insurance will also NOT cover acupuncture. If you do not see this indication on the secondary insurance card, you may call the clinic and we can verify if there is coverage.
Please call us with any questions. Every insurance plan (even within the same insurance company) has different rules and regulations regarding coverage. Our goal is to help you as much as possible. Although we are not able to anticipate every curveball, we will do what we can to investigate any issues. These clinic policies may be updated and revised without notice based on the ever changing insurance world.