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Starting Feb 1st 2019, we will be an out-of-network practice

Starting February 1st 2019, we will be transitioning to become out-of-network providers for all insurance companies.

The background

We recently sat down to analyze our next 5 years, and realized that the in-network reimbursement rates do not allow us to create a sustainable clinic model. We value the amount of time we spend with you at each session, and we cannot make things work in the long term with in-network reimbursement rates unless we cut that time down by over 60%. This decision is our attempt to find a middle ground between the financial health of the clinic and the quality of care we provide for our clients.

The good news

If you have been using insurance to cover acupuncture at our clinic, it is very likely that your insurance policy includes out-of-network coverage for acupuncture. If you have not yet received an email from us about your out-of-network benefits, you will receive one soon. We also have suggestions on how to help make out-of-network acupuncture more accessible/affordable below.

How out-of-network coverage will work
  1. At the time of service, you will pay for the service in full. 
  2. If you have out-of-network acupuncture benefits, we will provide documentation which you submit to your insurance company. 
  3. Your insurance company reimburses you directly according to your policy.
Options to help make out-of-network acupuncture sessions more affordable
  1. Consider funding an HSA or FSA account for 2019: Acupuncture is a covered service according to the IRS, and you’ll be able to pay for your sessions with pre-tax dollars. 
  2. New at the clinic starting Feb 2019: Use the Paypal Credit option when paying for your appointment – for packages of 4 or more appointments, you have 6 months at 0% interest to pay for your sessions. This means you won’t have to pay anything out of pocket until you’ve received your reimbursement check from your insurance company.
Things to note if you decide to seek out-of-network coverage for acupuncture

If you do NOT currently have out-of-network acupuncture benefits and are discussing a new policy with your employer or researching any on the DC, Virginia or Maryland health exchanges, below are some key points to investigate.

  • Does the policy cover “in-office, therapeutic acupuncture”? (You want the answer to be YES.)
  • Does the policy contain an “anesthesia only” clause? (You want the answer to be NO. This is a common clause that only covers acupuncture when used as surgical anesthesia — which does NOT cover the therapeutic acupuncture we provide at our clinic).
  • If there is acupuncture coverage, are there any restrictions on the conditions covered? (Some plans will only cover acupuncture when used to treat certain conditions, like back pain and migraines.)
  • Is there a deductible for acupuncture? (If you have a deductible, you would have to pay out of pocket until the deductible is met.)
  • What would the copay or coinsurance be for acupuncture visits?
Effective date of transition to out-of-network

This will become effective for all dates of service February 1st 2019 and onward.

Questions?

We love our clientele, and we would like to make this transition as simple as possible for each and every one of you. If you have any questions, please do not hesitate to contact us via email.

Kind regards,
The Transformational Acupuncture Team

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HOURS
Open 7 days a week:
Monday 12 pm – 8 pm
Tuesday 12 pm – 8 pm
Wednesday
  9 am – 12:30 pm
  5 pm – 8:00 pm
Thursday 12 pm – 8 pm
Friday 10 am – 6 pm
Saturday 10 am – 6 pm
Sunday 10 am – 6 pm


LOCATION
1645 Connecticut Ave NW,
3rd floor
Washington, DC 20009
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