INSURANCE

Many insurance plans in Maine have some acupuncture coverage for certain conditions. If your plan covers acupuncture for your condition, Six Branches Family Acupuncture may be able to bill your insurance company. We are in network with many major insurance companies, including:

• Aetna **

• Anthem/Blue Cross Blue Shield

• Community Health Options

• Harvard Pilgrim

• Optum/United Healthcare

We are out of network with Cigna. We ask you to pay out of pocket and we will provide you with a superbill to submit to your Cigna plan for reimbursement. This is an easy process and we are happy to provide you with instructions.

Mainecare does not cover acupuncture, however, we do offer a discount to pregnant people with Mainecare.

Standard Medicare only covers acupuncture for chronic low back pain while some Medicare Advantage plans cover more than just low back pain. We are not able to bill Medicare directly, but we are able to bill some Medicare Advantage or secondary plans directly. Here are two questions to ask your Medicare plan to determine how and if we can bill your plan directly:

1) Can an acupuncturist submit claims to my plan directly, without getting a Medicare denial first?

2) Does my plan only cover acupuncture for low back pain or will it also cover other conditions like neck pain or headaches?

If the answer to the first question is 'yes', then we can bill your plan for your appointments here. If it is 'no' then we cannot and would ask you to pay out of pocket.

Our Billing Process

When you schedule an appointment with us, you will be asked to complete your new patient paperwork where we will collect your insurance information. We will do our best to verify your benefits before your first appointment, but we can only do that if you complete your forms at least a week beforehand.  You should also contact your insurance company to verify your coverage and understand your benefits before you begin treatment. We offer a list of suggested questions to ask here.

Some plans require a referral for acupuncture. If your plan requires a referral, in most cases it will need to be for a musculoskeletal pain condition like back pain, neck pain or headaches. You will need to have the referral ordered before the first appointment date. We do not need to receive it before the first appointment, as long as the referral is dated by the first appointment.

If your insurance plan covers acupuncture for your condition, we handle the insurance billing for your treatments.  You will be responsible for payment of copays, co-insurance, or balances applied towards a deductible. We do our best to know what these charges will be ahead of time but it is also your responsibility to understand your plan and potential costs.

We are able to accept HSA/FSA cards. If you use an HSA/FSA or if we are not able to bill your plan directly, we can provide you with a superbill receipt so that you can provide documentation or seek reimbursement through your plan. 

Please note: Most insurance plans cover acupuncture for pain conditions only, and some are restricted to particular types of pain. It is a good idea for you to speak with your insurance company about which conditions are covered by your plan. For more information on insurance billing, please see our FAQ page.

** Aetna has a very limited list of conditions they will cover acupuncture for. Even if they say you have acupuncture coverage, they will only cover for chronic neck pain (not shoulder pain), chronic headaches, low back pain, osteoarthritic pain of the knee or hip (needs an "osteoarthritis" diagnosis), nausea and vomiting of pregnancy, chemotherapy, or after an operation, post-operative dental pain, TMJ-related jaw pain. Also, please verify that your acupuncture coverage applies to these conditions and is not solely "in lieu of anesthesia".

FORMS OF PAYMENT

For those not using insurance, we accept cash, check or credit card payment at the time of treatment. A “time of service” discount applies to rates for un-insured and under-insured patients who pay at the time of their appointment. It does not apply to patients paying to meet their deductible as we still do a considerable amount of work to submit, process, and follow up on claims.

CANCELLATION POLICY

If you miss an appointment or cancel less than 24 hours before your appointment, you will be charged a $75 late cancellation fee. Please understand that we cannot bill insurance for a missed appointment, so this fee will also apply for insurance patients who miss an appointment as well as self-pay patients.