ESEMA Healing Arts | Acupuncture, Herbal medicine and Doula services » Insurance

Good News! Now Accepting Insurance

Erin — Mon, 16 May 2011 16:55:30 +0000

Many insurance companies are beginning to cover for acupuncture treatments more and more these days, and we are proud to be a part of a vast collection of out-of-network providers. Thanks to our new billing partner, Jenn, we are able to verify coverage for patients within 48 hours and bill for services in the event that acupuncture is a covered benefit.

Find Out All the Details after the jump..

What this Means for You

No more super-bills and self-submitting receipts! This step takes out the work that you, the patient, had previously done in an attempt to get reimbursed for treatments. We take the hassle of calling insurance companies, understanding denied claims and resubmitting with accurate billing codes.

How This Affects Payment

In the event that you have acupuncture as a covered benefit on your insurance plan, it is likely that you will be able to continue receiving treatments for the cost of your office co-pay (usually ranging from $15-$30) once your deductible is met. While your herbal consultation is included in the office visit fee, herbal formulas are unlikely to be covered by your insurance.

Information Needed

A copy of your health insurance card, date of birth and updated contact information is all we need to check your coverage. Once verified, we need little else from the patient to submit claims.

Is There A Catch?

No catch! Well…not, really. Insurance companies can be slippery entities to work with, and try their best to find their way out of denying payment wherever they can. In the event that your insurance company fails to compensate for services you’ve rendered, you will be responsible for any remaining fees unpaid. This, of course, can be placed on a payment plan if needed and is upheld only in the event that all other avenues for reimbursement have been exhausted.

A Brief History of Medicine

Erin — Mon, 28 Jun 2010 14:07:13 +0000

“Doctor, I have an earache…”

2000 BC ~ “Here, eat this root.”

1000 AD ~ “That root is heathen; say this prayer”

1850 AD ~ “That prayer is superstition, drink this potion”

1940 AD ~ “That potion is snake oil, swallow this pill.”

1985 AD ~ “That pill is ineffective, take this antibiotic.”

2000 AD ~ “That antibiotic is artificial – here, eat this root!”

~author, unknown

Going around full circle, I wanted to share this enlightening, humorous and fun short poem sent to me by one of my patients. A lot of today’s movements are going back to the beginning for useful advice on health, medicine, nutrition and body care. As we become more conscious of the impact our decisions have on our health and the planet – organic, “green” and natural are coming back into fashion. Food is another great example, as we move out of the grocery shelves (while less money up-front and quick in preparation) and back to the farmers market (what you’ll save in health care bills far compensates the cost up-front, and promotes sustainable agriculture for farms just like our ancestors).

The same is true for acupuncture, herbs and other complimentary medicine practices – which may seem like a luxury, but are actually more like insurance. We are a clinical practice, focused on the medical needs of our patients through detailed health history discussions and sending them home after treatment with, well, roots (like the ginseng root pictured above). While there is no question that modern technology has given us incredible tools, stepping back – in some cases – is more like taking a step forward.

Some of my favorite resources for stepping back and staying modern:

Gorgeously Green – Do it yourself (and from the garden!) skin and beauty-care products

Suncoat Cosmetics – Formaldehyde, Toluene & Phthaletes Free (aka: Toxin-Free) Nail Polish

Sara Snow – Advice on Green Living for all areas of your life, from the family of Eden Organics

Erba Organics – Organic & natural body products for baby and mom

Healthy Bitch Daily – On the front-lines of hip and healthy, this daily email will keep you in the know

“In Defense of Food” - One of many wonderful books on healthy eating by Michael Pollan

Will My Insurance Cover Acupuncture?

Erin — Thu, 13 May 2010 13:32:08 +0000

Ah, the common question: Do you take my insurance? Is acupuncture covered by my insurance? While I’d like to answer an easy ‘yes’ to both of those questions, the decision is not actually up to me. Since you are most likely seeking out an acupuncturist to help with a condition you are experiencing, it would only make sense that your health care coverage recognize the treatment modality – right?

Truth be told, while there are many insurance companies out there who do cover acupuncture services, there are still many plans who do not. To avoid confusion here at ESEMA we do not accept or “take” any particular insurance and have not made any agreements with specific insurance carriers. As limiting as this may sound, you actually still have a likely chance at getting some sort of return on your investment – and no corners cut on treatment quality or time.

The Super Bill

In exchange for patronage up-front, we provide our patients with the proper insurance receipts (including diagnosis codes) for submission to their individual insurance carrier. These receipts are known in the medical world as “Super Bills,” and if your insurance company covers out-of-network acupuncture treatments, then you will most likely receive full to partial reimbursement for your treatments. If your insurance company will not reimburse you for the services rendered, the receipts may be able to be applied to your deductible or accepted into a flex-spending account. Many of our patients find these receipts to be quite useful in saving them money throughout the course of their care.

Check It Out In The New York Times

The New York Times recently wrote a wonderful article about the benefits of acupuncture, and how even though paying out of pocket for such services may cost you more up-front, that you may be saving money in the long run preventing illness and avoiding other more costly medical procedures. To read the full well-researched article, click here.

Other Options

Perhaps paying full-cost out of pocket is not in your feasible budget. While we try to help as many people as we can through payment plans and package options, we have a network of referrals to other resources in the city who operate under different models and who therefore are able to reduce up-front costs to patients. There are some acupuncturists out there who do form alliances with insurance companies so that the only cost up-front is the cost your traditional copay. Such clinics often hire a staff to handle their billing, to ensure proper and timely payment, much like a traditional doctor’s office. Depending on the clinic, this model may also speed up patient care to churn out more clients to make up for insufficient reimbursements (depending on the clinic).

Another option to save money on treatments up-front are community acupuncture clinics. ESEMA Healing Arts is a fan of two different community style clinics in New York City wherein the office visit and treatment are based on a sliding scale. To make up for the lower cost, the patient-practitioner intake is often shortened and your resting period with the needles is often shared in a room with other patients (as opposed to the private rooms offered at ESEMA Healing Arts.

Navigating Your Way

We are happy to connect you with the resources you need so that you can get the care that you deserve. Please contact us directly with questions, as we are happy to provide useful tips for navigating the often complex web of insurance carriers.