I bill insurance as a joint partnership with you
I am happy to provide the service of billing your insurance for you, but need you to join in on the work. So, first verify your coverage. This requires a phone call to your plan as the information is not provided online. Some plans I know; others I do not know. I list the ones I have information about below; however there is no guarantee this is accurate, as plans are always changing.
Copayments are due at the time of service. If your insurance ends up not paying for any reason within 30 days, my office manager Meghan will notify you by email so that you can have time (like 2 weeks) to investigate. If you discover the claim is denied, we charge your credit card on file. We charge the discounted cash rate and will let you know the day we charge your card so that it’s not a surprise.
This joint partnership allows me to be able to continue providing this service
I would like to provide this service! But, I am a small solo-practitioner operation and I don’t have professional billers. I need your help and cooperation. Feel free to check in with Meghan or I to ask if we’ve received payment from your insurance. If not you can always call to push them along or find out if there’s a problem.
Here are the plans we have some knowledge of:
- MCSIG Anthem has full coverage except apparently the EPO plan has no coverage.
- Cal Pers Anthem PPO has coverage with a copay after your $500 deductible.
- CHOMP employees have a copay of $110 initial/$60 followup.
- Salinas Valley Memorial employees have full coverage with a co-pay and 24 visits per year, more visits with a referral.
- Aspire with Medicare plans have full coverage with a co-pay; two plans have 6 visits and one has 12; may get more with prior authorization.
- Blue Shield plans likely have coverage for out of network acupuncture, and your plan reimburses you directly. So, you pay at the time of service, we bill for you, and you receive the reimbursement directly.
- We are not able to bill Medicare and Tricare, because these are federal programs that don’t include acupuncture at this time.
- We are not able to bill Medi-Cal.
- Monterey Institute of International Studies (MIIS) employees have full and unlimited coverage, there may be a deductible.
These are the questions you will need to provide answers for on your intake form:
- Does my plan cover out of network acupuncture?
- Is coverage limited to certain conditions?
- Does a deductible apply? If so how much is the deductible? How much has been met?
- Is there a maximum dollar amount allowed per visit?
- Are there a maximum number of visits per year? Or per condition?