RATES & INSURANCE

Most insurance plans cover acupuncture and massage; however, your specific coverage depends on the specific plan that your employer chooses for you. 

To find out how much your plan covers, you can check your policy booklet, contact your company’s HR person, or phone your insurance company directly.

Typically, you will receive a certain dollar amount (i.e. $300 – 500) toward a particular service. Amounts are decided on by each company and may be negotiated by unions. Some plans also have a separate “health spending account” that are discretionary fund to use however you like.

To find out your specific plan coverage, you can check your policy booklet, contact your company’s HR person, or phone your insurance company directly.

Many insurance companies now allow us to bill them directly on your behalf- it’s easy and the response is instant. There are situations where we aren’t able to direct bill, or where you will have to pay out of pocket:

• If your plan doesn’t allow us to direct bill on your behalf, you will be required to pay for the services up front and submit to your insurance company for reimbursement.

• If your plan only covers a portion of the visit (i.e. 80%) you will have to pay the difference to the clinic.

• If you have reached your annual maximum coverage for the service.

• If your plan requires additional information, such as a doctor’s referral.

• If you have 2 plans, and the plan we are billing is a secondary plan.

• If it’s the first time using direct billing services for your plan, the insurance company sometimes blocks the first transaction to verify that it’s a legitimate claim. Once the insurance company has verified the claim, future claims can usually be submitted.

• Some policies have a deductible that you must pay once a year.

There is a 1-800 number on the back of your insurance card. To find out if your insurance plan includes acupuncture benefits, ask them:

• Does your insurance policy cover acupuncture?

• Do you need a doctor’s referral? If yes, does it need to be submitted to the insurance company first?

• What is the dollar limit for acupuncture per year?

• Is there a limit to the number of visits allowed per year? If so, how many?

• Is there an annual deductible on your plan? If yes, how much? Has it been met for this year?

• Does your plan have “health spending account”?

We can only direct bill to one plan at a time. If your plan does not cover the full amount, you will pay the remainder and a receipt will be sent to you that you can then submit to your secondary plan.

Check with your plan. Most plans do not cover herbal medicine or supplements.

Your direct billing information can be entered into your intake form.

If the plan is through your spouse or family member: the full name and date of birth of the plan holder is required.