Forms

Complete the Health Questionnaire below and bring it to your first visit accompanied by the Insurance forms if you intend to bill insurance for your visits.

Health Questionnaire (pdf)

 

Health Insurance

In Washington State, most health insurance plans cover acupuncture treatment. Contact your insurance company and complete the form included in the Health Questionnaire before your first visit to clearly determine the details of your acupuncture benefit. For insurance companies with whom Amy is not contracted, she can bill out of network or you can pay for each visit, as with the HSAs, and submit the receipt to your insurance company for reimbursement.

Amy is contracted as a preferred provider with most insurance companies including;

  • – Aetna
  • – Cigna (withdrew due to merger with ASH network, can bill out of network)
  • – First Choice Health Network
  • – Kaiser Permanente FCH (PPO, not HMO plans)
  • – Lifewise
  • – Premera Blue Cross
  • – Regence Blue Shield
  • – United

 

Payment

Cash Rates, when paid at time of Service

  • $150 – Initial consultation & treatment (includes herbal consultation, dietary and other counsel, Mindfulness or other awareness practices, handouts etc.) (1.5 hours).
  • $120 – Follow-up treatment (includes herbal consultation) – (45-75 minutes).

Elders over the age of 63 pay full fee for initial visit. For follow up visits, those on a fixed income may choose to pay sliding scale rate from $120 down to $108/session.

 

Health Savings Accounts (HSAs)

Amy accepts cash and checks in clinic.  She does not accept credit or debit cards.  For patients with a HSA debit card, payment is collected by cash or check at the time of treatment. Amy will issue a receipt which can be submitted to your HSA for reimbursement.

If you have additional questions about insurance coverage, please contact Amy or her billing company Diversified Medical Billing at 206. 772.5315.