I just had a patient ask about insurance coverage for acupuncture. We need more demand for policies to cover our services!

Some patients do in fact have coverage:

  • nationwide companies tend to the ones likely to carry coverage: Fidelity Investments, Procter & Gamble…
  • a few supplemental policies to Medicare cover (e.g.: Horizon Blue Cross Blue Shield)
    • Medicare NEVER covers acupuncture. Supplemental coverages may cover anything that is not covered by Medicare though!
  • a couple of the federal health insurance options cover acupuncture

Traditional acupuncture “Blooming Lotus Acupuncture” is the way to go if you have insurance coverage. We do require prepayment, but will put together a superbill that will break down all services rendered and the fees that you have paid. (Alternatively, the  community acupuncture model is geared to those who do not have acupuncture insurance coverage. Making acupuncture affordable.)

To submit the superbill for reimbursement, the patient needs to enter their information: insurance company, member ID, and policy number. Then a signature is needed on the form as permission to release this personal information to the insurance company.

Why do we go about it this way with prepayment and superbills?

  • Insurance is a monumental waste of time for a provider.
    • An additional full time employee would be needed to cover all the work involved
    • In my experience, insurance declines coverage as often as it can.
      • they claim not to have the member
      • they claim not to have received the claim
      • they deny services for a particular issue
      • they say the claim form isn’t “legible”
      • you name it! They’ll deny it.
    • Due to these issues listed above, it is often necessary for the provider to submit claims many times over for just a single visit.
  • Insurance has a relationship with the patient. They will respond more quickly and in better correspondence with you, their member.
  • There have been occurrences where providers, years later, are being billed by the insurance companies for thousands of dollars because their payments are claimed to be made in “error”. I have never heard of such a claim made to the patient. (Thank goodness!)

We can provide treatment notes as well. If when the superbill is submitted, the insurance company requests treatment notes to support the claim, please let us know.

Happy covered health and wellness!

-Kristin Gundrum L.Ac. NCCAOM