NIHA does not file or coordinate insurance reimbursements although we do provide information on the services rendered for you to submit. The information below should assist you with filing for insurance reimbursement.

Visit Check-Out-

For Drs. Beals, Garzon, Mines, Rind, and Solomon:
Services are provided on a fee-for-service basis and insurance support will not be provided. A bill describing services will be provided, but will only use procedural codes at the discretion of the practitioner. You may complete your insurance company's claim form and submit a request for coverage, but NIHA does not provide a claim form (HCFA 1500), nor will it respond to requests for additional information. Patients may request a copy of their records and personally respond to requests by their insurer for additional information. At check-out, you may request a copy of your practitioner’s notes for that date of service. Future requests for another copy will be available at a cost of $25.

For all other NIHA Practitioners:
NIHA will provide claim forms for submission to insurance; submission is the patient's responsibility. Claim submissions may or may not be for covered services and may or may not include procedural codes or other data sufficient to support your insurer's determination as to what services it will reimburse.

For Dental Practitioners:
Patients will receive an ADA (dental claim form), that will include all necessary information that is needed to file for reimbursement, along with a receipt for the services rendered.

Filing for Reimbursement- Methods for filing vary by company, but generally you will need to mail the bill provided at check-out (we suggest keeping a copy for yourself) to the address or post office box provided by the insurer or your employer. All of our practitioners have opted-out of Medicare. For secondary payers to Medicare, we will provide a copy of the practitioner’s opt-out affidavit.

Insurance Requests- If we get requests for additional information, we will forward the request to you along with copies of the requested notes, x-rays, etc. for submission to the insurer. If your insurer requires their form be filled out and submitted, you will need to fill it out and in the section where your practitioner’s signature or specific information is needed write, “see attachment.” Then attach the claim form, notes, x-rays, etc. we provided you and mail them to the insurer. As always, we urge you to make a copy of the information before submitting.

Not Recognized Care- Some of the care provided may not be recognized by your insurance company. Often these claim forms will be returned to you or us with a message like, “in order to process your claim we must have a correct CPT code” or “CPT code not valid”. Some of the services we provide do not have CPT codes, as the codes are set by the conventional medical community. Insurers rarely pay for services without a CPT code. We can provide you with a brief description of these services that you can submit for claim review, in the event you still wish to pursue payment.

Reimbursement Problems- Securing payments for insurance companies can be difficult, whether the services rendered were conventional or alternative. Your best bet is to keep close track of what and when you submit to your insurer and challenge or appeal any decision they make which is not explained to your satisfaction. If you are still dissatisfied and believe the insurer has not properly reimbursed you, you have two other options that are occasionally effective:

1. Contact your employer and ask them to intervene on your behalf. They often have more clout with the insurer, since they hire the insurer and pay the bill.

2. Contact your state’s insurance department. They will typically take your complaint directly back to your insurer, asking them to explain why (based on the contract) that something was not covered.

Insurance Billing Services- There are individuals and companies which, for a fee, can assist you with claims filing and reimbursement from insurance or flexible spending account administrators. A list of firms offering these services is available upon request.

[ Back ]