Insurance Reimbursement

 

Our office does not file insurance claims or pursue payment from insurance companies. Our focus is the therapeutic relationship with the clients, not with his/her insurer. Clients are encouraged to consider all of the options available to help pay for his/her health care, including health savings accounts, flexible spending accounts and insurance coverage to obtain reimbursement for fees paid for  integrative healthcare consultations.

STEP 1: Contact insurance company to determine coverage
Call the insurance company and ask if they cover homeopathic consultation or integrative healthcare consults (some have this coverage) and to what extent they reimburse expenditures for each of these categories.  If they cover this, request a form so that a claim can be filed for this.

STEP 2: Document the consult you want reimbursed
Photocopy the consult statement form provided to you showing consult arrangements and  payment for our work together. The insurance company will need: practitioner name, date, client name, amount paid, CPT code – all of these are on the consult statement from our office.

STEP 3:  Get the primary care physician’s diagnosis code
This is an ICD9 code which is used by insurance companies to process your claim. It is likely to be on a recent consult statement from your physician’s office.  You can also contact your physician’s office and ask the front desk for the diagnosis code related to your chief complaint. This would have been assigned during either a special visit to consult about this complaint, or possibly during a routine check up and should be part of the medical record there.  Let them know that you need this for insurance documentation. Write the name/phone/office details of the physician, and the diagnosis code on the consult statement form you received from me, or on the insurance company’s submission form.

STEP 4: Submit and follow up
Fill out the form from the insurance company to request reimbursement, and attach the consult statement form from me and send it in. After a week, call to make sure it has been received.  Call to check on it a few weeks later.  If it is denied, resubmit it. Be persistent. Some companies are great about paying up front easily, others require that you persist diplomatically until the payment to which you are entitled has been paid to you.

 

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