Verifying Insurance
lab vials amh
lab vials amh by martin lopez

Date

Verifying insurance should be done by both parties – You and I, before you come into the office if you plan on paying only your copay on your first visit.  Unfortunately, insurance is increasingly confusing and often if you try to look up your benefits online, they are INCORRECT.  For this reason, if you plan on having insurance pay for some of your acupuncture visit, you will need to call them first to verify your coverage. See guidelines below for what to ask when you call your insurance company. 

After you call your insurance company and verify that you have coverage with Dorothy Pang, L.Ac. as directed below, please call my office at 650-588-0888 to ask us how to submit your information so that we may call to double verify your coverage for you.  Please note this can take several days as some companies have extended hold times. 

Both parties will need to call and verify if you would like to pay only your copay.  Otherwise, you will pay the full rate for acupuncture, and we will submit an insurance claim on your behalf for reimbursement. 

Questions to ask your insurance company

Please CALL to verify as this is the best way to get an accurate answer. (Although sometimes this still is inaccurate and this is why we have a double verification process in office.) 

1. Do I have Acupuncture Coverage? 

2. For what conditions? 

3. Do I have coverage with Dorothy Pang, L.Ac., Provider number 123-521-3877? 

4. Do I have a deductible? How much has been met? 

5. Do I have a limit on the number of visits? 

6. What is my copay or coinsurance?  

7. May I get a reference number? (record this for your records.)

8. Call our office at 650-588-0888 to give us the details given to you, and to arrange for us to double verify that the info given was correct. 

After you have called to verify your coverage, we will call them to verify again.  We have found in the past that Customer Service representatives can be wrong when talking to either party. This double verification process reduces mistakes on the part of the insurance agent. However, we have found that many plans do not cover acupuncture at our office so we require that our patients take the initiative to call their insurance first.  

Dorothy Pang, L.Ac. is in network with Cigna and Hill Physicians. Medicare will not pay us, we do not accept Medicare, even if it’s Medicare with Hill Physicians. 

Out of Network: 

We do provide out of network billing services, however the patient is expected to pay for services on day of treatment. Reimbursements will be sent to the patient when they are received from the insurance company.  Processing can take 30 days or more by your insurance company.   Dorothy Pang is out of network with any company not listed. There has been a problem with being mistakenly listed as in network with Blue Cross, Blue Shield and Anthem. This is not correct. We are out of network for these companies.

Medicare:

We do not get paid by Medicare and do not submit claims to Medicare. You would pay for services out of pocket at time of service and submit for reimbursement yourself. 

More
articles