An increasing number of insurance companies are covering complementary and alternative medicine, fueled by consumer demand and a growing body of scientific evidence demonstrating the benefits and cost-effectiveness.
We do not bill insurance directly, however we can provide you with the proper detailed receipts so you can submits claims yourself. Payment is always due at the time of service.
We encourage you to write to your local government representative to express a demand for acupuncture services.
Flexible Spending Accounts (FSA) and Health Spending Accounts (HSA)
At Isthmus Wellness many of our clients use FSAs or HSAs that use pre-tax dollars to pay for covered services including acupuncture, therapeutic massage, consultations, Chinese herbal medicine and other prescribed therapies. We are happy to provide “Superbill” receipts if they are necessary for you to submit to a Flexible or Heath Spending Account. Please let a Wellness Coordinator know if you need to be on the “Superbill List”.
Which Insurance Plans Cover Acupuncture?
Many plans from Aetna, Blue Cross Blue Shield, UnitedHealthcare, and some union-sponsored health plans may include acupuncture benefits. Coverage varies significantly by plan. Since we do not bill insurance directly, we are considered an out-of-network provider. We recommend checking with your insurance company to determine whether your plan includes acupuncture coverage and whether out-of-network services are eligible for reimbursement.
Please call your insurance carrier and ask these specific questions
- Does my plan cover acupuncture services?
- Does acupuncture need to be pre-authorized or pre-approved?
- Do I need a referral from my primary care provider?
- Which CPT codes for acupuncture and consultations will be covered?
- How many visits are covered and over what period of time (for example, 6-10 visits a year of acupuncture)?
- Is there a co-payment or deductible for out-of-network providers?
- Will the therapy be covered for any condition or only for certain conditions? Please obtain covered ICD-10 codes.
- Will any additional costs be covered, such as nutritional consultations and lab work?
- Are there any dollar or calendar limits to my coverage?
- If I use a provider who is not part of your network, do you provide any coverage? Are there any additional out-of-pocket costs?
- Check to see if your policy has a “clinical gap or geographic gap exception.” This is typically this done with a care coordination specialist at your insurance company. These exceptions allow coverage at in-network rates for out-of-network providers. If this is approved, you will receive a letter from your insurance carrier.
Helpful tips when dealing with insurance companies
It is helpful to keep organized records about all interactions with your insurance company. Keep copies of letters, bills, and claims. Make notes about calls, including the date, time, customer service representative’s name, and what you were told. If you are not satisfied with a representative’s explanations, ask to speak to someone else.
If the insurance company requires you to have a referral, be sure to obtain it and bring it with to your first appointment at Isthmus Wellness. It’s a good idea to keep a copy for your own records.
Accident Liability and Medical Payments Insurance Coverage
If you have been involved in an accident with medical payments coverage we can provide you with the proper detailed receipts so you can submits claims yourself. Payment is due at the time of service.
If you have been involved in an accident and are filing a liability claim we will provide copies of your medical records as requested. We can provide you with the proper detailed receipts so you can submit claims yourself. Payment is due at the time of service.
