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Insurance Questions

Insurance Questions

 

Comprehensive Natural Medicine accepts several major insurance plans.  We provide insurance billing for your convenience.

 

Our In-Network (they accept us and we accept them)  Insurance carriers include:

 

  • Aetna – ND and Acup
  • First Choice PPO plans – not Core (HMO) plans – ND  and Acup
  • Premera & Lifewise – ND and partial Acup
  • Regence – ND and Acup

 

Just because we are “In-network” with a particular insurance carrier does NOT mean that you have:

  • Met your deductible (either individual or family) for the year at the time of service.  If you have not met said deductible, you will be responsible for the out-of-pocket expense for your visits until you do meet your annual deductible.
  • Particular desired benefits or full coverage by your insurance plan.  You must call your insurance company or go online to verify and understand your policy.  Sometimes your plan has specific restrictions around care:
    • Do you need a referral to have care be covered?
    • Is there a pre-authorization requirement for care?
    • Does your plan cover particular medical conditions (i.e. Aetna covers acupuncture ONLY for neck and back pain)?
    • Does your plan require you to pay a co-pay or co-insurance once you have met your annual deductible?

 

You – as the patient –  are ultimately responsible for understanding your insurance benefits, and are financially responsible for any mutual agreed to therapies that are not covered by your insurance.  You will be provided information and an opportunity to opt-in or out of treatment, potential costs, and alternative options.

 

Insurance verification questions please call your health insurance company on the back of your insurance card.

 

We encourage every patient to call their specific insurance company as coverage and benefits can vary from plan to plan for every insurance and patient.

 

It is ultimately the patient’s responsibility to understand and be clear on their insurance benefits.

 

Always record the date, time, details, and the name/s of insurance personnel who give you information on your benefits.

 

We are currently NOT accepting Medicare, Medicaid, Medicare Related plans, or Medicaid Related Plans.

 

We follow policies outlined by the No Surprises Act:  https://www.insurance.wa.gov/sites/default/files/documents/1688-consumer-notice-updated.pdf

 

You will be provided with a summary of the proposed treatment, the potential costs of said treatment if insurance denies, and potential alternative treatments each time the treatment plan changes significantly.

 

We can provide a super-bill to those who have out-of-network insurance plans, but payment for your services will be due on the day of service.

 

Cash services are paid at a 20% time-of-service discount – on the day of service.  If they are not paid on the day of service and we are required to invoice you later, they will be paid at our regular fee-schedule price.

 

We do have package options for those who are out-of-network or have exhausted their benefits, but are still seeking regular repetitive care for acupuncture wellness services.  if your acupuncture treatments are not what your insurance company will deem “medically necessary”, you have the option of securing care with us by utilizing such a package option.  Please inquire with Kristin as to current pricing.

 

 

Our current biller (all billing related questions should be fielded through him.  He prefers that you do not ask us billing questions in the office.)

 

Byron White 

phone:  425-825-8674

Email:  info@eastsidebilling.com

 

Response time for email contacts is within 48 hours.

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