Fees and Insurance

 

 

     


Forms of Accepted Payments

-Major Credit Cards
(Visa, MasterCard, American Express, Discover)
-Flex Spending Accounts (FSA)
-Personal Check
-Cash


Insurance Coverage

Accepting the following Health Insurance Coverage Plans

 

-Harvard Pilgrim Healthcare

-Cigna

-United Healthcare

-Anthem NH BC/BS

-HealthNet Federal Services  (No longer providing authorizations as of 8/1/18 – Veterans must seek authorizations for care through their local VA Center)

-VA Community Care- All new VA authorizations must be through their local VA Medical Center PCP.

 

If your health insurance plan is not listed here but you have Acupuncture benefits combined with out of Network benefits, we can submit your claims as a courtesy. Payment for services will be due at time of service.

 

—Please check with your health plan for information about deductibles, co-pays and/or co-insurance.  Co-pays and Co-insurance is due at time of service.


 

Important!  Please contact your health insurance company prior to scheduling an appointment. The following are suggestions to check with your insurance plan:

1. Call the member services number on the back of your Health Insurance card and ask if Acupuncture Services are covered.

 

  •  Ask if there are any diagnostic code restrictions. Some insurance companies say they cover acupuncture but only for specific conditions. 

2. If covered, is it: in-network?  out-of-network?  is there a co-pay?  a deductible?  is there a limit to the number of visits? Write down this information and bring to your first appointment along with your medical card. 

  • If they tell you my office is out-of-network, you may have recourse to make it ‘in-network’ (which means less copay/deductible).
  • Tell them you wish to receive a gap exception to see Diane Chase, L.Ac. at ‘in-network’ rates. This is because there are no network providers within a ‘reasonable’ distance. They will usually prepare a form to set things up accordingly. This form should be mailed to you – and to my office as well.

 In-network provider for Cigna! 

 

NEW Coverage information from Cigna

 

If coverage for acupuncture services are available in the applicable benefit plan document,
acupuncture may be provided as treatment for ANY of the following conditions when medical
necessity and treatment planning /outcomes meet the criteria defined below:
• Tension-type Headache; Migraine Headache with or without Aura
• Musculoskeletal joint and soft tissue pain (e.g., hip, knee, spine) resulting in a functional deficit
(e.g., inability to perform household chores, interference with job functions, loss of range of motion)
• Nausea Associated with Pregnancy (only when co-managed)
• Post-Surgical Nausea (only when co-managed)
• Nausea Associated with Chemotherapy; (only when co-managed)


 Veterans!

If you have HealthNet Federal Services Veterans Choice Program, your Acupuncture services are typically covered at 100% with authorization from HealthNet. You can either get a referral from the VA or call the number for HealthNet VCP and request to receive acupuncture services from my facility.


Currently, the majority of insurance companies do not cover acupuncture. If you believe your health insurance plan does cover acupuncture, please call them before coming to your first appointment and ask the following questions:

 

1. Ask if Acupuncture Services are covered
2. Ask if there are diagnostic code restrictions to coverage
3. If covered, is it: in-network? out-of-network? is there a co-pay? a deductible? is there a limit to the number of visits?

As a courtesy, I am able to provide a form called “super bill”. This form will list the required medical coding needed by insurance for reimbursement. This would be the clients responsibility to submit to their insurance company for any potential reimbursement. If you have any other questions regarding insurance, please contact customer service on the back of your insurance card.


Also, if your insurance does not cover acupuncture, you may be able to use a Health Savings Account (HSA) or Flex Spending account which will allow you to save money tax free and use it for medical expenses outside of your coverage such as acupuncture, eye care, etc. You should contact your insurance company and/or banking institution with questions about these plans.

What are Medical Flexible Spending Accounts?

One of the few ways you can cut out of pocket medical expenses is through medical flexible spending accounts (aka, flex spending account or FSA). A medical flex account is an employer-provided benefit that allows you to contribute a set amount from your paycheck in order to cover out-of-pocket medical, dental, and vision expenses such as health insurance co-pays, uninsured treatments, or even over-the-counter drug purchases.

The funds are usually deducted through regular, equal payroll deductions. The good news is that money deposited in a flex account is exempt from federal, state, and payroll taxes. Because taxes are not calculated on your contribution, your paycheck is not reduced by the full amount you set aside. Using this concept of “pre-tax” dollars can reduce your medical costs by as much as 30% depending on your tax bracket. Let’s say for example, you have a $100 per pay period deduction….your actual check may only be $75 smaller because a smaller amount of taxes were withheld.