Spokane Acupuncture, LLC
Health insurance: No referral is required from your primary care physician. Call your insurance company to verify that your policy covers acupuncture.
Auto accidents: Motor vehicle injuries are generally covered by the auto insurance policy's P.I.P. (personal injury) component. Call your insurance agent to verify what your P.I.P. coverage is. No referral is required. Our office will submit billing to your auto insurance if you have P.I.P. coverage, and in most cases there is no cost to the insured patient until the P.I.P. coverage is exhausted.
In-Network Insurance Companies: Dr. Running is a preferred provider (in-network) with:
- Blue Cross Blue Shield
- First Choice Health
- MacKay Mfg (First Choice Health)
- Premera Blue Cross
- Providence Health Plan (Via Premera or First Choice Health)
- Regence Blue Shield of Washington
- Uniform Medical Plan
- Washington Idaho Operating Engineers (BCBS)
- Most insurance companies provide coverage for out-of-network providers. Please check your benefit details or call your insurance customer service number to verify your cost for out-of-network treatment.
- Kaiser Permanente HMO - formerly Group Health HMO
Excluded Companies: Our office will not bill AmeriBen, Ambetter, Asuris Northwest Health, Coordinated Care, or any company that requires pre-authorization or pre-approval. We can provide you a standardized receipt to assist you in self-billing these companies.
Excluded Services: Pre-Authorization / Pre-approval Our office will not obtain "pre-authorization, or pre-approval" from your insurance company prior to providing evaluation and treatment, or during your treatment. The pre-authorization / pre-approval process is very time consuming, unreimbursed, and may be required prior to each patient visit. The process makes it difficult if not impossible to maintain patient appointment times, and dictates that patients may not receive services from the provider until the insurance company is reached and provides their approval. Approval is frequently denied or unobtainable during an appointment time, wasting the appointment time for both the patient and provider. We opine that pre-authorization requirements are unethical administrative barriers designed to prevent people from being able to use the insurance benefits they are paying for.
Medicare: Medicare does not cover acupuncture. Secondary policies to Medicare may cover acupuncture if it is billed by a medicare provider (M.D., D.O., N.P., etc.). Secondary insurance requires a claim denial from medicare before they will provide secondary coverage. It is not possible for our office to obtain a claim denial from medicare in order to bill a secondary insurance, because medicare will not accept a claim from our provider type (L.Ac., E.A.M.P.). In our opinion, this leads to a "catch-22", where medicare recipients, in the vast majority of cases, must choose an acupuncture provider with little or no training in acupuncture to provide acupuncture services if those services are to be covered by their insurance.
Medicaid: Medicaid does not cover acupuncture.
Tricare: Tricare does not cover acupuncture.
Cost / Co-pays / Coverage: All health insurance purchased in Washington provides acupuncture coverage. Some Washington residents may not have acupuncture coverage if their insurance plan is from a different state. Call the customer service number on the back of your insurance card to get the details. Ask them if you have acupuncture coverage, and if the condition you wish to have treated will be covered. Headaches, neck pain, low back pain, and nausea are almost always covered, and it is possible to address other conditions simultaneously. Ask them if you have to meet your deductible before coverage starts, or if you have a flat rate co-pay. Many plans have a flat rate co-pay ranging from $20 to $30 per acupuncture treatment. Some plans have co-insurance ranging from 70% to 90% coverage after you meet your yearly deductible. Some insurance providers may require pre-approval for acupuncture and other benefits.
What does it mean to be "In-Network" with an insurance company? This means that a health care provider or facility has chosen to be included in a "Network", and has agreed to the Network's contracted rates for services.
What does it mean to be "Out-of-Network" with an insurance company? This means that a health care provider or facility has not chosen to be included in the insurance company's Network.
Insurance coverage denials: Patients should interact directly with their insurance company if they have a denial of coverage. A healthcare provider's office cannot mediate between a patient and their insurance company. The state office of the insurance commissioner may be helpful when insurance companies do not honor coverage obligations. http://www.insurance.wa.gov/