Medical bills and dealing with insurance companies can often be quite stressful, to say the least. When trying to find a holistic treatment that can help solve an array of. Different maladies and symptoms, it can be even more frustrating. To help, here are some helpful tips that can make navigating the process a bit easier, and hopefully lead to a resolution.
Know The Terms
This may sound simple, but so many people are not aware of what. Is considered a covered expense, and what is not. Terms like “in network”, “out of network”, “deductible” and “out of pocket max,” are also enough to make your head spin.
This might help:
In-Network: A provider has agreed to join the network of providers for your specific insurer, and accept their rates/amounts for services.
Out of Network: A provider who does not accept the plan or insurer and often is not covered, or is covered at a lesser amount that is reimbursable.
Deductible: A deductible is a specific dollar amount that your health insurance company may require that you pay (of your own money) each year before your plan starts to make payments for claims. But, not all health plans require a deductible. Most of the. Time, HMO plans typically do not require a deductible, while most Indemnity and PPO plans do. (So it’s important to know which one you have.)
Out of Pocket Max: A set figure that once. You have met, you no longer have to pay your own money for any covered services within that specific year.
Ask Your Provider & Insurer
Next, what’s most important is to first ask your desired acupuncture provider if they, in fact, even accept insurance. (NJ Acupuncture Center does!) Then, ask if they “take” and are “in or out of network” with your specific plan. If they are out of network, it is then important to call your insurance company (or check your coverage online) to see if they provide any coverage or reimbursement for out of network services. If not, it can never hurt to ask your preferred provider if they offer any special rates or discount specifically for cash-pay, or uninsured patients.
It’s also really important to know where you stand with your deductible. If it has been met, then your coverage has kicked in. If it hasn’t yet, you might be responsible to pay in full for services until it is met. What’s even better, is if by chance your out of pocket maximum has been met, then you may not have to pay anything for the remainder of the calendar year.
For any insurance questions or concerns, we are always more than happy to help navigate and find out your coverage for you!