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Related
LINKS
INSURANCE U.S. BASED
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INSURANCE RELATED PUBLICATIONS:
- Acupuncture
Front Office Procedure: The Training and Reference Manual,
307 page book by Cynthia Bestani –Includes the day to day
operations of the practice, including handling insurance step
by step, ie.how to fill out insurance forms, talk with insurance
companies, prevent delays and optimize payment, handle collections,
and the steps to implement a good financial policy on insurance.
- The
Art of Practice Management for Acupuncture Health Care Practices
includes ”How to Implement an Office Policy on Insurance”
step by step. Procedures to optimize getting paid by insurance
carriers, the why and how of creating different types of financial
policies with insurance, Understanding Managed Care and Managed
Care contracts. Book also has five star rated reviews, endorsed
by David Maloney, Pres. of AAOM and other instructors and administrators.
Used by a number of acupuncture and Oriental Medicine schools.
- Insurance
coverage for acupuncture & how you can become a insurance
provider
- Most
commonly used current CPT
Codes
and ICD-9 Pain
Management Diagnostic Codes
in the US for Acupuncturists, Chiropractors, Osteopaths, Massage
therapists. Only print, photocopy or purchase enough superbills
or HCFA-1500 Forms to last a year. Codes
can change as often as yearly. Check in Oct preceding the new
year.
- The
Acupuncturist's Insurance Forms Packet.
There are
50 different master forms on 24# laser paper that can be photocopied
for use for acupuncture practices, or a combination of acupuncture
with chiropractic, massage, osteopathy, etc. Forms can be customized
with name, address, provider #, license number, phone number
for an additional nominal charge or the forms can be stamped
with this information. ICD-9 codes must be added and are not
placed on the forms to protect practitioner scope of practice
use. Please read criteria for ICD-9 coding use prior to using
these codes.
- American
Medical Association CPT Code Book and ICD-9 Diagnostic Code
Book
from the American Medical Association at 1-800-AMA-3211.
- Managed
Care Section on Acupuncture Today
- Should
I sign up for an HMO?
- Worker's
Compensation Issues
~ See Worker's Compensation by state in the next section on
US Organizations, Health Care Networks and Agencies.
- What
To Do When An Insurer Won't Cover Acupuncture - Appropriate
for patients and practitioners, this publication provides steps
to take to encourage coverage. Provides facts about acupuncture
to support coverage.
- Health
Care Insurance Carriers of Acupuncture
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UNITED STATES ORGANIZATIONS,
HEALTH CARE NETWORKS AND AGENCIES:
- Acu-Care Managed Care Company. Ilan Migdali, LAc. is president of this company and has given
evidence that his company protects both the rights of patients
and acupuncturists in negotiating with insurers. Email
- Acupuncture Plus Network California based. See article on this network.
- American Association of Health Plans -Trade organization representing health maintenance organizations
(HMOs), preferred provider organizations (PPOs), andother similar
health plans.
- American Health Care Alliance – for acupuncture and Oriental Medicine as well as collective
bargaining for access to patient referrals.
- American Specialty Health Networks - One of the largest Acupuncture networks.
- Health Care Finance Administration HCFA Medicare & Medicaid
- Info on Medicare for Acupuncture
- The Major Health Care Insurance Carriers. This is on a chiropractic site. However, it's easily used by
other professions, including acupuncture & Oriental medicine to
obtain what you need from the carriers websites.
- Landmark Healthcare
- Workers Compensation Agencies By State. This is on a chiropractic site and is well organized by state.
However, you should be able to access what you need for acupuncture
& Oriental Medicine. Not all states cover acupuncture & Oriental
medicine.
- JCAHO The Joint Commission evaluates and accredits nearly 17,000 health
care organizations and programs in the United States. An independent,
not-for-profit organization, JCAHO is the nation's predominant
standards-setting and accrediting body in health care.
- FCQU First Credentialing Quality Assurance. A national credentialing verification organization CVO). Functions as an Independent Practice Association (IPA) and a
national credentiality agency. Credentiality is provided for all
types of health care practitioners, including traditional medicine
and alternative health care providers. Claim to deliver objective
credentialing certification, which is used by payors to select
provider networks. FCQA also functions as an Independent Practice
Association (IPA).
- National Guild for Acupuncture and Oriental Medicine. Their purpose is to demonstrate the profession's benefits to
medical providers, insurance plans and the public, provide testimony
before the government commission on complementary and alternative
medicine and present information on the status of acupuncture
in the US. which may impact both greater state and national insurance
coverage, and inclusion in Medicare. They met with representatives
of state and national labor organizations with the goal of establishing
relations and expanding acupuncture services to federal employees
and their families, establishing unionization for acupuncturists
which would allow for greater power in negotiating standard health
benefits and giving employee access to acupuncture. To participate
in the Guild or find out more about the results of this project.
Tel: (310) 325-8054 Email
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OTHER INFORMATION
- Insurance Coding Information for reimbursement
- Criteria for hospital privileges by the American Academy of Medical Acupuncture.
- Acupuncturist (physician and non-physician) positioning in hospital
settings, contact consultants David Kailin, Convergent Medical Systems, or consultant, Jason
Stein, D.O.M. (former Medical Dirctor of Health South, Albuquerque,
NM)
- Quan Yin Insurance Billing Seminars and Insurance Billing Consulting for Acupuncturist and Acupuncture Physicians. Homebased in Florida.
By phone or email nationally.
- What is HIPAA, and how does it affect me? HIPAA is the acronym for the Health Insurance Portability and
Accountability Act of 1996, a law that required the U.S. Department
of Health and Human Services (DHHS) to insure the privacy and
security of patient information. The two provisions of HIPAA
that are most relevant to practitioners in private practice are
those that pertain to the electronic transmittal of and the privacy
of protected health information. To learn more, check out any
of the following links... The DHHS Site; The Center for Medicare and Medicaid Services; The American Medical Association's HIPPA site; the Health Privacy Project's site; or the Workgroup for Electronic Data Interchange. Fred Lerner has also written a couple of excellent articles
on HIPAA. Click here for Part One, and here for Part Two of his article.
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