No Insurance Part 2 – The Provider

** This blog was written before FL Blue’s invitation to join their commercial network in Dec 2022. We have resumed to accept insurance on 3/15/2023. Your insurance will still need to be verified for coverage.

This blog is from the perspective of the provider.

When we were still taking insurance, many behind the scene work needed to be done.

First, it starts with verifying the insurance coverage by calling the insurance company. About 15% of the verification having some acupuncture coverage. But a lot of those are not feasible to use (example as in the previous blog). Therefore, we are the bearer of the bad news if the patient’s insurance doesn’t cover acupuncture or coverage not feasible to use.

For the treatment, we have to conform to what is allowed even we know it may not be in the patient’s best interest.

We have to keep good medical record, file the claims, wait for payment, reconcile payment etc.

So, it sounds simple, isn’t it ? No ! We have to first learn medical billing. Different insurance companies have their own system and do things in different ways. They make mistakes too (and a lot) ! Their mistakes are usually incorrect claims denial.

When there is a problem, we have to call them. Every call takes a lot of time and usually do not get resolved easily. This is partly due to “off shore” call centers being used by the insurer with a huge language barrier. The other is due to a huge gap in knowledge of the “off shore” support. Most of them are only trained to “read from the screen” without any understanding what we are trying to resolve. Many times, things do not get resolved even with repeated calls.

Sometimes, the insurer asked for medical record. We would have to upload to their system. This will delayed payment or sometimes not paying for no good reasons.

We average for one hour of treatment time we spend on an insurance patient, we spend an additional 30 mins of administrative work. We handled some of the insurance in-house and also used a billing service for some other cases in which a fee will be assessed.

All of the above are very time consuming in which most patients do not understand.

We believe our time should be better spent on providing quality care and treatment to our patients. A lot of unnecessary hours were wasted dealing with insurance issues. This is the main reason for the “no insurance” policy.