Updates Regarding Health Insurance Plan Changes

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Teresa Lau's picture

Due to recent changes to health insurance plans that affect acupuncture coverage, I regret to announce that the treatment sessions for TLC Medicine patients may be affected in the near future. The details are as follows.

Starting in July, Anthem Blue Cross PPO, will be cutting benefits and allow for only a 15-minute session of acupuncture per visit. Previously, Anthem Blue Cross allowed for acupuncturists to bill for an hour-long visit as intended. In addition to the reduced coverage, insurance claims will require significant paperwork by the provider, further cutting into provider-patient time. Other plans including Blue Shield HMO, Kaiser, and Health Net PPO/HMO have already implemented this change.

If you have visited TLC Medicine before, you’ll know and appreciate that a typical visit takes about an hour. This time allows adequate time to review patient status and needs, diagnosis, discuss treatment options, and perform acupuncture and other therapies as necessary. However, as insurance pays only for the 15 minutes of acupuncture itself and nothing else, the new coverage is highly insufficient to compensate for the current hour-long visit.

How this affects patients is that the length of an office visit will be reduced from an hour to 30 minutes if billed through these insurance plans. We feel that 30 minutes is the minimum amount of time required to provide effective care, even though the insurance insists that 15 minutes is adequate by way of their compensation.

It is not our choice nor desire to implement this change and cut your visits short. If you do wish to continue to receive hour-long treatments, please do let me know when you book your next appointment and we can discuss further options. Until then, we will be writing to the plans to appeal this change. We urge you to speak to your HR, benefits administrator, or directly with your insurance representative as well about the negative impact of this change in coverage and how it affects you.

Thank you for your support and understanding.

In health,
Teresa Lau