For new patients - please arrive on time, during the initial visit there is evaluation, as well as, mandatory arbitration consent paperwork to be filled out.
Acupuncture Initial 75 -85 minute Evaluation with Treatment visit: I require a patient responsibility deposit of $200 at the time of service for the initial appointment. After your claim is processed, should your patient responsibility amount be less than $200, I will immediately Venmo you the difference. I will send a claim in to your insurance company for the services rendered during the initial 85 minute visit. Every insurance policy has a percentage the patient pays the provider depending on whether their policy is 60%/40%, 70%/30%, or 80%/20% For example, the insurance company pays 60% of the services billed and the patient pays 40% This is called fair and equal billing.
Acupuncture follow-up sessions: $160 deposit for patient responsibility per hour treatment due at the time of service. I will send an electronic claim directly to your insurance company for the service codes rendered during the visit.
After the first few sessions, we are able to determine the lesser patient responsibility amount for each follow-up session.
I will re-imburse you as soon as I receive the (EOB) Explanation of Benefits and the check from your health insurance company; Aetna takes two weeks to process, Cigna three weeks, United and BCBS four weeks to send out their checks to the provider. United Healthcare Shared Services (UHSS) takes five weeks to process.
In order for me to check your individual Out-of-Network deductible, I must have the following information:
Date of Birth
Member ID number
Health care company (e.g. Aetna)
Group number, if applicable
Your billing address
Provider Customer Service 800 number
1). Your In-Network deductible and your Out-of-Network deductibles are different.
2). HMO and EPO plans do not include Out-of-Network specialist evaluation visits within their policies and will not be reimbursable to the patient. HMO and EPO plans are In-Network only.
I am an Out-of-Network provider writing claims for PPO policies only (Preferred Provider Option policies).
Please have your insurance ID card with you for your initial visit or take a picture of front and back and email it to me. If you have any change of insurance plan, home address, or phone number, let me know so I do not bill with incorrect information which will delay your reimbursement unnecessarily by one month.
The companies with a PPO policy that reimburse an Out-of-Network acupuncture physician are:
1) Aetna Choice Plus Open Access PPO
and Choice POS II PPO (Out-of-Network) policies, Aetna Managed Choice pays at a lower % rate
2) Cigna Choice Plus Open Access
and Open Access Plus PPO (Out-of-Network) - offers a partial payment.
3) UnitedHealthcare Choice Plus PPO, UnitedHealthcare Shared Services (UHSS) policies
4) United Oxford PPO (Preferred Provider Option) out-of-network policies - make sure it is not an EPO policy, which is limited to In-Network providers.
5) Automated Group Administration (AGA) PPO (Out-of-Network) policies
6) Anthem Blue Shield of CA
7) Empire BCBS and some other state BCBS policies (not including Horizon NJ) - checks are sent directly to the patient.
Direct Payment Options:
- Cash, please have exact bills $160.00 as I may not have change.
- Health Spending Account (HSA)
- Flexible Spending Account (FSA)
- Venmo (firstname.lastname@example.org)
- Chase Zelle Quickpay: (email@example.com)
- PayPal: (firstname.lastname@example.org)
- Google Wallet: (email@example.com)
- American Express
- Diner's Club International
- Apple Pay
- Android Pay