acupuncture insurance reimbursement

[Guest guest]

Hi - does anyone know of any legal way to file acupuncture insurance

claims, when the patients insurance does not cover acupuncture?

 

The organization I work for is challenging me to find this suspected

pathway in order to move my services from the retail only " spa " to a

patient care area within the hospital network.

 

Thanks in advance -

 

Janis

[Guest guest]

I have been looking for an answer to this myself. After talking to

some of my colleagues they have told me that a lot of people will have

coverage for manual manipulations (massage) and they bill for that and

for office visits. I don't know if this is acceptable. Any comments

from others would be appreciated.

 

Kimberly Marin AP, RD

Sunrise, FL

 

Chinese Medicine , " Janis3934 "

<janis3934 wrote:

>

> Hi - does anyone know of any legal way to file acupuncture insurance

> claims, when the patients insurance does not cover acupuncture?

>

> The organization I work for is challenging me to find this suspected

> pathway in order to move my services from the retail only " spa " to a

> patient care area within the hospital network.

>

> Thanks in advance -

>

> Janis

>

[Guest guest]

only if a chiro or md also works there and files for you, (for

instance, cigna often will pay for acu if done by an md or dc but not

an LAc) but you still have to make sure the insurance will cover the

acu codes. In essence you'd become an employee of the dr's

corporation. I think it's still a grey area but at least it's gray and

not illegal, as I understand it...

[Guest guest]

You can legally bill for any procedure that you actually performed.

But billing for a procedure that you didn't perform is fraud, is

illegal, and can get you in hot water with the carrier, law

enforcement, and your state licensing board.

 

Acupuncture is not included in the manual therapy or massage codes,

so if you're not performing these procedures, you shouldn't be

billing them.

 

To protect yourself... If you didn't do it, don't chart it. If you

didn't chart it, don't bill it.

 

--Bill.

 

--

Bill Mosca, LAc

San Francisco CA

mosca

 

 

On Mar 2, 2008, at 7:51 AM, kimmymarin wrote:

 

> I have been looking for an answer to this myself. After talking to

> some of my colleagues they have told me that a lot of people will have

> coverage for manual manipulations (massage) and they bill for that and

> for office visits. I don't know if this is acceptable. Any comments

> from others would be appreciated.

>

> Kimberly Marin AP, RD

> Sunrise, FL

>

> --- , " Janis3934 "

> <janis3934 wrote:

>>

>> Hi - does anyone know of any legal way to file acupuncture insurance

>> claims, when the patients insurance does not cover acupuncture?

>>

>>

>

>

[Guest guest]

That's my take on it too, Bill. I welcome any other

commentary on this subject.

 

Janis

--- Bill Mosca <mosca wrote:

 

> You can legally bill for any procedure that you

> actually performed.

> But billing for a procedure that you didn't perform

> is fraud, is

> illegal, and can get you in hot water with the

> carrier, law

> enforcement, and your state licensing board.

>

> Acupuncture is not included in the manual therapy or

> massage codes,

> so if you're not performing these procedures, you

> shouldn't be

> billing them.

>

> To protect yourself... If you didn't do it, don't

> chart it. If you

> didn't chart it, don't bill it.

>

> --Bill.

>

> --

> Bill Mosca, LAc

> San Francisco CA

> mosca

>

>

> On Mar 2, 2008, at 7:51 AM, kimmymarin wrote:

>

> > I have been looking for an answer to this myself.

> After talking to

> > some of my colleagues they have told me that a lot

> of people will have

> > coverage for manual manipulations (massage) and

> they bill for that and

> > for office visits. I don't know if this is

> acceptable. Any comments

> > from others would be appreciated.

> >

> > Kimberly Marin AP, RD

> > Sunrise, FL

> >

> > --- In

> Chinese Medicine ,

> " Janis3934 "

> > <janis3934 wrote:

> >>

> >> Hi - does anyone know of any legal way to file

> acupuncture insurance

> >> claims, when the patients insurance does not

> cover acupuncture?

> >>

> >>

> >

> >

>

>

> Subscribe to the free online journal for TCM at

> Times

> http://www.chinesemedicinetimes.com

>

> Help build the world's largest online encyclopedia

> for Chinese medicine and acupuncture, click,

> http://www.chinesemedicinetimes.com/wiki/CMTpedia

>

>

>

 

> and adjust accordingly.

>

> Messages are the property of the author. Any

> duplication outside the group requires prior

> permission from the author.

>

> Please consider the environment and only print this

> message if absolutely necessary.

>

[Guest guest]

Janis:

 

Allow them to pay cash and obtain any due reimbursement. After all,

they " own the policy " . Let your success direct the insurance companies

desire to assist their insured. When you fix things people notice.

 

Then call up a claims adjuster and talk with them. Excite them with

yor success. They can be more than helpful in this regard. They may

even suggest billing codes and refer patients to you.

 

Yes, this works. Know your own value and allow others to assit you in

achieving your desired worth.

 

Bill

 

P.S. And the sooner you get out of your patients' pocketbook, the

better for both of you!