Not a Cigna Customer? Here’s Info on Filing a Health Insurance Claim Form

Energy Matters is in network with Cigna and will file claims for you if your Cigna plan covers acupuncture - if this is the case for you, go ahead and fill out our online Insurance Verification Form here. It takes 2 to 3 business days and we will email you your eligibility information which will include any deductibles you may need to meet, any co-pay or co-insurance obligations, as well as any visit/dollar limits or diagnosis exclusions.

If you are not currently insured with Cigna, but your plan does cover acupuncture, you can pay our prompt-pay, discounted rate (see fee schedule here) and we can provide you with a superbill which is a detailed invoice insurers use to reimburse for claims. Superbills are generated after the date of your treatment and upon receipt of payment. Are you enrolled in an HSA or FSA plan? If so, and your plan requires proof of purchase, you may use a superbill for that as well.

Should you decide to buy one of our treatment packages which further discount the prompt-pay rate, you will receive a superbill after each visit and the amount paid will reflect the per treatment rate of the package you purchased. You may email us at [email protected] and let us know that you would like to receive superbills for your visit. 

Filing Your Claim

Once you have received your superbill, review your plan information to find the steps you need to take to file your claim for reimbursement. Many plans allow you to file your claims online and those that don’t usually have a form available to print out and mail. You can also call your plan’s customer service if it is unclear how to file. 

It will usually take anywhere between 2 to 4 weeks from when you file your claim to be reimbursed. Anything longer than that and we recommend that you contact your plan to track the claim. At some point, you will receive an EOB (explanation of benefits) with a payment check. If there is no check attached, then your EOB will show whether this is only a notification that you will be receiving a check or if your claim has been rejected or denied. 

Claims can be rejected because of a mistake made on the form, a missing superbill, or some other error or oversight. Checking the reason provided on the EOB and correcting or providing the missing information usually resolves the issue. A claim that is denied, on the other hand, will require more advocacy on your part. Some denials can be reversed with a letter from a primary care physician prescribing acupuncture treatment. We can also provide medical documentation to support any diagnosis and acupuncture procedures that were on the superbill. Call your plan’s customer service line to get more information about their appeals process.

FAQs

• You will be reimbursed your “allowable amount” after any deductibles, co-pays or your co-insurance share. Review your plan information to determine all these factors.
• Your plan may not cover out-of-network services. Check your plan information or call your plan’s customer service number to find out if that is the case. If so, you may choose to find an acupuncturist within your plan’s network to get your payments covered.
• Some plans that cover out-of-network treatments may automatically pay the claim directly to Energy Matters. We do check every claim payment we receive and if we find that this has happened, we will deposit the payment and write out a check to you in the amount paid. We record claim payments 2 to 3 times a month so if you receive an EOB stating that the claim payment was made to the provider, i.e. Energy Matters, feel free to email the Insurance Admin at [email protected]. They will look into it for you and arrange the reimbursement when they find the claim payment.
• Should this occur, you will need to contact your insurance plan and request that future payments be made directly to you.
• If you are considering switching insurance providers during any open enrollment period and want to see if you can get your acupuncture treatments covered, please review our Open Enrollment letter here.

We understand that health insurance can be complicated to navigate and hope that this has been helpful information for you! Feel free to contact us if you have any questions about the information provided above at [email protected].