Get a receipt
Even if you can’t get a prescription from a physician, you should get a detailed receipt whenever you pay out-of-pocket for an alternative treatment. This will increase your chances of being reimbursed. “The receipt should include more than ‘XYZ Acupuncturist, $65,’” Rubin advises. “You need to put it in the insurance company’s language, which is ICD and CPT codes.” The International Classification of Diseases (ICD) is an internationally standardized system of codes for medical diagnoses, while Current Procedural Terminology (CPT) codes are five-digit numbers assigned to specific treatments by the American Medical Association (AMA) in order to facilitate communication between (and among) medical specialists and insurers. CPT codes exist for alternative treatments such as acupuncture, therapeutic massage, and biofeedback, and you can search for other codes by keyword on the AMA’s website.

In addition to the official diagnosis and CPT codes, ask the practitioner to outline the treatment plan (the duration and frequency of visits, for example). If you do have a prescription, make sure the treatment on the receipt falls within the plan that was prescribed. Indeed, when you are choosing a practitioner, it’s always a good idea to ask if they have experience submitting insurance claims for alternative therapies.

If your insurance claim for an alternative treatment is denied, try appealing the decision. Sometimes the insurer can be convinced with additional documentation, such as medical notes from the CAM practitioner. “The carriers don’t want to spend their money unless it’s helping,” says Jennifer Gibbons, the office manager at Wall Street Physical Medicine & Rehabilitation, a New York City facility that offers acupuncture and therapeutic massage, among other treatments. “They want to see improvement. They want medical notes that show that pain has gotten better, or that impediments to acts of daily living—such as not being able to put on your shirt because you have a frozen shoulder—are improving.”

Limiting out-of-pocket expenses
If you have to pay your own way for all or part of your treatment, you should explain your circumstances to the CAM practitioner. “It is always beneficial if the patient discusses the financial issues with the practitioner prior to the first appointment,” says Janet Borges, a licensed acupuncturist and spokesperson for the American Association of Acupuncture Oriental Medicine. “Often they will negotiate a fee for service that may be even more beneficial for both parties than insurance coverage, such as a sliding-scale fee structure.”

You may also be able to save on CAM treatments by using pretax money from a health savings account (HSA) or flexible spending arrangement (FSA). If you have a high deductible health plan ($1,100 or more), sometimes known as a “catastrophic” insurance plan, you are probably eligible to open a tax-free health savings account (HSA). As with an IRA, contributions to HSAs are tax-deductible and the money is tax-exempt upon withdrawal if used for a qualified health expense. Offered by many employers, FSAs allow you to set aside an annual amount of pretax dollars for health care that must be used by year’s end. Depending on your tax bracket, the tax savings from these vehicles can add up to a substantial discount on treatments. Eligible expenses may include therapeutic massage, acupuncture, and more (check your plan’s language for details). Even travel expenses—such as bus, taxi, and train fare—that are used primarily to get to essential medical care are eligible.

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