Health Insurance for Acupuncture

Many acupuncturists accept health insurance reimbursement for their services.  Many don’t.  I come down on the side of those who don’t.  I’d like to lay out my reasons for not accepting health insurance, because in the long run, I feel that it actually benefits my patients.

First of all, let’s talk about…me.  The reality is that health insurance companies do not pay me or any other acupuncturist adequately for their time.  They typically will determine what they think is “appropriate and reasonable” and only reimburse that amount, which is often about half of my usual fee.  (My fees are in line with and often lower than other acupuncturists in my metro area.)

In addition, the insurance companies take months to get the check in the mail.  And they do it shamelessly.  I have had numerous letters from one insurer offering to send the check right away if I would take even less money than I’m entitled to! (The patient paid for the treatment, so they were barking up the wrong tree.) The inference is that if I don’t agree, they’ll take much longer to send the payment.  This begs two questions:  One, why can’t they just send the payment right away? And two, isn’t this blackmail?  Okay, three and four:  Who does business this way?  And, what would happen if you tried to pay your bills in this manner?

Furthermore, if I accepted health insurance, much of the time I now spend treating my patients would instead go to filling out documentation and paperwork to satisfy the insurance companies.  Or I would have to hire someone to do it.

So let me recap—I get paid less, they take forever to pay,  and it takes more of my time.  Where do I sign up?

How does my not taking health insurance benefit my patients?  I’ll answer that with a story:  Two weeks ago, I saw a new patient—a lovely, vital woman in her 90’s with some back pain.  She had been to another acupuncturist who accepted health insurance.  My patient’s experience with this provider is what brought her to me.  She complained that the other acupuncturist didn’t even talk to her to explain her condition or how the acupuncture would work.  He just plopped the needles in (her words), and left her.  His office assistant came take the needles out, and she never saw the acupuncturist again during that treatment.

This acupuncturist may be an excellent practitioner, but because he’s being paid less for each patient, he needs to see two, three, or four patients in an hour just to make a living.  One of the strengths of Chinese medicine is that listening to your patient is part of the diagnostic process.  However, if your practitioner is racing from patient to patient, that listening component is compromised.

My patients benefit from my non-participation in insurance reimbursements because I choose to see only one person at a time.  If I were dealing with health insurance companies, I couldn’t do that.  My patients get my full attention and intention, which enhances their treatment and the healing process. Isn’t that what it’s all about?

My patients who have insurance that covers acupuncture aren’t completely out of luck. I do offer my patients is a receipt that has been formatted with all my practitioner information, diagnosis and treatment codes, dates, amounts, etc., so they can submit it to their insurance for reimbursement. This type of receipt also works perfectly for patients who have Health Savings Accounts or Flex Plans.

Many would argue that acupuncture treatments should be accessible to everyone.  I agree.  However, MRI’s, doctor’s visits, and medications should also be within everyone’s financial reach, but they are not. Some acupuncturists have chosen to open community-style acupuncture clinics, with the cost of treatments determined by a sliding scale.  These clinics are a fabulous solution to working outside of the health insurance system.  However, many of my patients who are familiar with the community-style clinics still choose to come to me; to pay a little bit more and be seen one-to-one; a choice they should also have.

More and more providers of all kinds are opting out of the health insurance system.  Last month there was an article in our local paper about a family practice MD who opened his own fee for service clinic.  Many psychiatrists have also opted out of the system because the insurance companies want them only to prescribe medications and will not reimburse them adequately or at all for talk therapy.

To accept insurance payments or not is a personal and business choice for many practitioners, especially those who work with complementary therapies.  My personal choice is to practice in a way that most benefits both me and my patients, and to do so excludes intervention on the part of health insurers.

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