Financial Policy & Fees

What are your self-pay fees?

If your insurance plan doesn’t cover acupuncture or we do not participate in your network, you will never pay more than

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72 dollars

for an all-inclusive

Point of Cure Session.

 

This is our guarantee!

 

What's included in your Point of Cure Session?

All-inclusive Point of Cure Session takes between 20 and 40 minutes and consists of 4 vital steps:

 

• Reading:  Consultation, diagnostic meridian palpation, & skin resistance testing

• Opening:  Cupping, acupressure, ultrasound, and/or infrared therapy

• Balancing:  Acupuncture with or without electrostimulation

• Firming:  Auriculotherapy (needle or laser)

                                                                                               $72 (after 55% self-pay discount)

 

Will I receive a superbill?

Absolutely! Upon your request (within two business days), you will be provided with a “superbill” (an itemized receipt) in case you decide to seek reimbursement from your insurance plan.

 

Do you take Insurance?

We do accept many PPO and HMO plans. Before your initial appointment, we will attempt to verify your coverage.

 

What if you are in my network?

That makes things somewhat easier. Your financial responsibility (and our reimbursement) is governed by the contract we have signed with your insurance plan. You pay the mandatory copay and deductible; your insurance pays the rest.

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How good is the insurance coverage?

While more and more insurance plans will pay for acupuncture, the degree of coverage varies. Some cover only certain acupuncture modalities. Others limit the number of sessions or have a cap on the maximum yearly amount. In rare cases, insurers may require documentation of a specific medical condition (such as chronic back pain).

 

Hence, having insurance does not mean “free healthcare.” You are still personally responsible for any deductibles, co-insurance, co-payments, and all noncovered charges. Also, most additional services (prescriptions, injections, etc.) are not covered by insurance. If you decide to add them to your acupuncture session, you will be required to pay at the time of service.

 

All self-pay amounts, copayments, deductibles, and past-due balances are due at the time of service unless previous arrangements have been made. We accept credit cards, Venmo, and Zelle.

 

What information is needed from the insurance company?

It may also be a good idea for you personally to call your insurance carrier and ask the following questions:

 

• Do you cover acupuncture?

• What specific conditions are covered?

• How many treatments will be covered?

• Is Dr. Lu a participating provider?

• What is my responsibility (deductible, copay, or coinsurance)?

• Do I need a referral from a PCP?

• Is there a cap on coverage?

 

Do I need a referral?

Only in rare cases.

 

Do I need prior authorization?

Usually, no. That said, some plans (and Medicare) may require evidence that either a) one or more of the preferred treatments has failed and/or caused severe side effects or b) you suffer from a condition that precludes the use of a preferred treatment.

 

Once we get an OK from the insurance company, am I good to go?

Here is the thing. Regardless of what we/you hear back from your insurance, it’s never a guarantee. The final determination is made after the bill is submitted for payment. There is always some risk that your insurance company will cover only a small portion of the charges or even outright refuse to pay.

 

But worry NOT! In either case, you will never have to pay out of pocket more than $72 dollars per Point of Cure Session (as explained above).

 

What if you can’t determine my coverage?

If we are unable to verify your coverage, you will be considered a self-pay patient and pay $72.

 

What if I am out-of-network?

Trying to use insurance out-of-network is messy: it complicates billing and may end up costing you more than simply choosing the self-pay option:

 

• Your insurance may cover only a small portion of the provider’s (non-discounted) charges, making you responsible for a high coinsurance.

• You may have to wait for the insurance to mail you the payment before forwarding it to the provider.

• Your insurance may simply not cover the services, leaving you on the hook for the full (non-discounted) balance.

 

For these reasons, we try not to bill out-of-network. Instead, we suggest you go self-pay and never worry about paying more than $72 per Point of Cure Session.

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Can you waive my copay?

Can't. Neither can we “adjust” a diagnosis or symptom to convince an insurer to pay. These are considered a violation of insurance rules.

 

If I have secondary insurance, will that help?

Secondary insurance policies typically pay according to a coordination of benefits with the primary insurance. Being a small practice, we simply can’t navigate these complicated billing arrangements. Frankly, considering our modest fees, it doesn’t make much sense to even try. If you want to avoid the billing headaches, we strongly suggest you simply go self-pay.

 

Can I use HSA or HFA to pay for acupuncture?

Certainly! Acupuncture is a “qualified medical expense” under HSA and FSA. We’ll gladly swipe your card.

 

Do you accept liability payments?

We do not bill motor vehicle (PIP) insurance and we do not accept attorney letters or contingency payments.

 

Do you bill workers compensation?

We do take some Florida and Federal workers’ compensation plans. Once we have verified the claim, no payment is required on your part. If the claim is denied, we will try to re-submit it to your primary medical insurance carrier. If your primary medical insurance denies the claim as well, you will be responsible for payment in full.

 

Do you charge a penalty for returned payments?

Credit card chargebacks or returned payments will attract a minimum $35 penalty in addition to the balance owed. Accounts with returned payments will be expected to make payments via money order or cashier’s checks only.

 

Do you charge for completing forms?

Completing disability, FMLA, and other medico-legal forms requires significant time to a) review your medical records, and b) navigate through these (often convoluted and lengthy) forms. Additionally, there is a certain degree of liability attached to this “small favor.” Potentially, years after completing a form, a physician may be called to testify in court. So, definitely, we do charge to complete forms. Please see our Fee Schedule for details.

 

What if acupuncture doesn’t work, can I get my money back?

Healing is an inherently unpredictable and inexact process. For some patients, acupuncture provides almost an immediate (they say miraculous) relief. For others, it may take a couple of days or even several treatments to notice improvement. Yet there still are patients for whom acupuncture does absolutely nothing. Finally, once in a big while, we even encounter a patient whose symptoms have gotten worse after our treatment. We never know upfront. We always suggest trying acupuncture once or twice before deciding if this is for you. Regardless of the outcome (or your satisfaction with our service), all fees are non-refundable.

 

Further Questions

So, to sum things up, the insurance business is complicated. Paying out of pocket may be a better option for some patients. Please contact us to ask questions and/or make payment arrangements prior to your appointment. During the visit, Dr. Lu prefers not to discuss financial matters.