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INSURANCE BILLING & NETWORK DISCOUNTS
Reimbursement for acupuncture treatments by health insurance companies and HMO's is changing rapidly. A small but growing number of health insurance policies provide coverage which includes acupuncture and other holistic health modalites. K. J. Gardner Singleton, Dipl.Ac. is a preferred provider with most insurance companies (that provide acupuncture benefits in the state of Oklahoma).
INSURANCE COVERAGE
At present, only a few health insurance plans cover acupuncture in the state of Oklahoma. Please note that although (at the time of this writing) K. J. Gardner Singleton, Dipl.Ac. is a qualified provider for all of the network plans (included below), individual policies may not cover all services; it all depends on each patient's particular coverage.
Blue Cross, Blue Shield and other like companies are like umbrellas. Under the umbrella is every type of plan one can imagine, and depending on which plan the employer has bought, the coverage for acupuncture is different. For instance, some individual plans may include PPOs and HMOs that won't cover you unless you are part of their network; however other policies include coverage for "out of network" benefits". Even if you are covered, there may only be eligible reimbursements for a covered diagnosis.
We suggest you check your policy for current coverage and monitor it for changes. In conclusion, nothing is concrete until you check with the insurance company about your specific policy for coverage and benefit eligibility.
- We ask that you pay in full at the time of each visit. We accept personal checks, VISA and MasterCard.
- We will provide the necessary documentation for you to submit the claim and receive reimbursement directly from the insurance company if your insurer will cover some (or all) of the cost of your acupuncture visits.
- Visits missed or canceled with less than 24 hours notice will be billed at 100% of the cost of the scheduled visit.
The following types of insurance coverage may be available to you:
Currently, in the state of Oklahoma, policies with acupuncture coverage include the Mail Handlers Benefit Plan (for federal government employees, such as those of the FAA) and many CIGNA PPO policies.
Personal injury protection (primarily care insurance) will sometimes cover acupuncture to help recovery from an accident.
Worker's Compensation plans may cover acupuncture for on-the-job injuries with a prescription from your primary care provider.
In addition, some insurance companies provide a percentage of coverage (typically a fixed discount of approximately 25% to 60% off regular fees) for acupuncture treatments:
Blue Cross, Blue Shield
HealthNet
PacificCare
Aetna
United HealthCare
American Specialty (they have their own network and manage others including Blue Cross and Aetna)
ACN Group (works with Great West and Secure Horizons).
More are insurers are adding acupuncture benefits all the time.
FLEXIBLE SPENDING (FLEX PLAN) ACCOUNTS
In addition to the network discounts mentioned above for acupuncture services, those enrolled in a qualified high-deductible health plan (HDHP) may also enroll in a Health Savings Account (HSA), also often called a "Flex plan" medical expenses account. Out-of-pocket medical expenses like acupuncture treatments satisfy the requirements of flex plans, and can save you money.
What Do To If Your Insurance Coverage Doesn't Include
Acupuncture or Massage Therapy:
If you are shopping for health insurance, let the agent know you are interested in a plan that covers complementary therapies such as acupuncture.
If you work for a company, inform human resources or the benefits department that they can purchase a holistic health care rider that can include acupuncture, massage therapy, dietary and nutritional counseling.
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