We have prepared a document to help you know what to ask your insurance company about your coverage.
We will assist you by verifying acupuncture benefits for all insurance plans.
How our office will bill your insurance for Acupuncture treatments
We are in network with UnitedHealthcare/Optum only. The following is the health plans we participate in through UHC:
- Health Allies
- UHC of Colorado
- UHC Navigate
- Nexus ACO-R
- Nexus ACO-NR
- UHC Dual Complete (Supplemental Benefit)
There are many variations of plans within the same insurance company. For example, you may or may not have a copayment, variations in copayment amount, high or low individual/family deductibles, limitations on benefit for in/out of network, and treatment procedure codes exclusions, etc.
Once you have received treatment by me, we will bill your insurance carrier at our insurance treatment rates. It can take anywhere from 4-12 weeks for insurance carries to pay out.
The following are some reasons why Touch of the East Acupuncture might NOT receive payments from your insurance:
- If your individual/family deductible has not been met for the year, we will receive no payment, it will all go to your deductible and you will be responsible for the payment for those appointments at the non-insurance price.
- If you have more than one insurance, there may be complications with payments and a delay in processing for up to 1 year is possible.
- If you change your insurance plan from PPO to EPO or PPO to HMO in the beginning of the year and if we are no longer in network with your insurance carrier.
- If you are late in paying your insurance premium.
- Some insurance companies only pay for a very specific condition or situation, such as, acupuncture anesthesia and performed in the hospital by MD only.
Please note that even if your insurance carrier states that you have acupuncture coverage, both your insurance company and our office cannot guarantee that they will pay for Acupuncture treatments until the claim is submitted and processed by your insurance.
Many people assume that insurance pays for all acupuncture treatments. Unfortunately, it is not designed that way. Your insurance policy is a contract between you and your insurance company. Ultimately, you are the one who is responsible for any payments that your insurance will not cover. Each insurance plan is different and we encourage you to review your insurance benefits prior to your appointment and become familiar with the specific stipulations of your plan.
At your appointment we will ask for your estimated copayment at time of your appointment. This is an appropriate amount based on the limited information provided by your insurance company, and represents our best estimate of what your insurance will cover and what you may need to pay out-of-pocket. We will file your claim for you in our office, and bill you if a further amount is required. Please expect an invoice from us if we receive no payment from your Insurance carrier to cover our cost. We appreciate your prompt payment and response.
You are always welcome to ask us questions by contacting us directly. Thank you for your time and understanding.