Payment
Insurance Accepted
Kaiser, American Specialty Health, United Healthcare, Sharp, Aetna, Blue Cross, Anthem, …and others.
Insurance Information
At Ocean Beach Acupuncture and Ocean Beach Therapeutic Massage your health has always been my top priority. There is a reason I received 2010 Talk of the Town for customer satisfaction, and 2009 Readers Choice for medical services. Unfortunately your insurance carrier is not so concerned with your health, it is only their bottom line that concerns them. Reimbursement has dropped by 50%, the cost of doing business in San Diego has doubled.
The information provided below has been gathered for over 17 years. I hope it is helpful. It may not be what you want to hear, but after dealing with these companies for 17 years, I can tell you it is pretty accurate.
Listen very closely when you call to get any information from your insurance carrier, they have a disclaimer at the very beginning that will say something like, “the information given is just a suggestion of coverage and we are under no obligation to pay for what ever service you receive.” They will have it worded different ways, but the short answer is even if your insurance tells you you are covered for services, the bottom line is you the patient are responsible for all payments of service you receive. At Ocean Beach Acupuncture, that fee will be my cash price listed.
Most carriers will tell you they pay some percentage of your treatment, the truth is they cover 15 minutes. To date, United HealthCare is the only company that actually reimburses for up to 45 minutes.
Insurance companies look at Acupuncture like a regular Dr.’s appt. You usually are in and out with a medical Dr. in 10 or 15 minutes. For Acupuncture to be effective you need at least 45 minutes for needles to circulate the qi.
As of August 1st, 2010 I will have each patient sign a contract stating that if your insurance does not cover, you, the patient are responsible for my cash price. Most insurance companies reimburse about $25. I now will be adding what is called co – insurance, that is different from your co-pay. Any addition services are payable at my cash price.
This may or may not have to do with Acupuncture, these are just two things I have learned over the years that will save you thousands of dollars. If you ever have a problem with coverage you can do what is called an appeal. You usually have to write a letter, get turned down again, write another letter, but on the third turn down you can request what is called an IMR. Independent Medical Review, this information is priceless, they HAVE to give you an IMR on the third try. Most insurance companies will not let it go this far as they need to get 3 doctors to write reports on why or why not what ever your request is should or should not be covered. It may take a few months, but if there is a treatment out there, any treatment, surgery, chemo, certain drugs, anything that you think will help with whatever condition you have, you are entitled by law for an IMR.
The second tip is called a warm transfer, this will ensure the person you are talking to will stay on the line with you until another person answers the phone, so no more waiting for 45 minutes on hold. If you need to be transferred for whatever reason, just simply ask for a warm transfer. The person you are talking to has to stay on the line until you get to the right person. This will save you hours………..
Hope this information helps. Again, this is only for information purposes, each plan is different and you may be the one in a million patient who actually is covered 100%.
