The Department of Veterans Affairs (VA) classifies acupuncture as a complementary and integrative health (CIH) approach within the innovative VA’s Whole Health system of care. This is great news for acupuncture practices because it means they can be reimbursed for providing services to veterans when acupuncture care is deemed clinically necessary by the patient’s care team.
Acupuncture can be a great treatment for veterans suffering from a variety of complications. Besides its benefits as a pain reliever, acupuncture treatments are also a safer method than opioids for pain management. As an acupuncture insurance billing company, we know many acupuncture providers are interested in providing services to military veterans. However, it seems most providers still are not familiar with the process of enrolling with the VA. If you’re looking for how to optimize your VA medical billing, or have questions about the billing process in general, then follow this guide for billing the VA for acupuncture in six easy steps!
Acupuncture has been growing in popularity as an effective and minimally invasive pain relief method, as opposed to conventional pain relievers. Besides their minimal burden on the patient, acupuncture treatments have been shown to be sufficient in treating veterans for a wide range of conditions.
Acupuncture treatments have been increasingly gaining traction as an integrative therapy method for effective pain relief. As a minimally invasive procedure, acupuncture is considered generally very safe when administered by a trained provider. While ongoing studies are finding that acupuncture may offer more benefits than for pain management alone, the VA considers acupuncture effective for veterans who suffer from:
Acupuncture for veterans may be effective as a stand-alone treatment or adjunctive with other medical treatments.
Acupuncture has the potential to become a front-line treatment for pain management as an alternative to opioid drug prescriptions. Acupuncture and other holistic practices have been helping reduce the number of active service members prescribed opioids. In 2011, 26 percent of all service members were prescribed at least one type of opioid medication. That number has since gone down due to the armed forces offering alternatives, such as acupuncture, for conventional pain killers.
Veterans can take advantage of the health benefits of acupuncture without the need to subscribe to painkillers. As an opioid drug alternative, acupuncture can be used in place of the prescriptions for acute to chronic pain for the same effects with none of the side effects.
Although more research needs to be done, acupuncture holds promise to help treat PTSD and stress-related conditions. The prevalence of PTSD among veterans ranges widely throughout different eras and wars. While one major study of 60,000 Iraq and Afghanistan veterans found that over 13% of them tested positive for PTSD, other studies have found the rate to be as high as 20% to 30%.
According to the American Massage Therapy Association (AMTA), over 40 percent of adults suffer adverse health conditions due to stress and 70 to 90 percent of visits to primary care physicians are for stress-related problems. Studies show that acupuncture, as well as other holistic practices, can significantly help reduce stress, anxiety and depression — which all contribute to PTSD. Acupuncture for veterans and active military members can have a significant impact on their well-being of life and overall wellness.
While the VA may hire licensed acupuncturists to provide direct care at VA Medical Centers, this is not always a convenient solution for patients or for acupuncture practices. Fortunately, the VA’s Community Care Network (CCN) allows you to become credentialed as a VA healthcare provider, which makes it possible for your practice to deliver acupuncture for veterans outside of the VA Medical Center system. Working through your VA region’s CCN is a great opportunity to grow your practice due to the unique patient population, reasonable reimbursement rates, and patient visit pre-authorization
If a VA beneficiary lives too far away from a VA location or the facility isn’t able to treat a patient within 30 days, the VA refers them to registered community providers. Depending on which region of the country you’re located in, one of two companies, TriWest or Optum, will be responsible for credentialing, administering, and processing CCN payments. Given the high level of organization, the CCN is a great opportunity for licensed acupuncture practices that are just starting out accepting insurance payments.
The team at Holistic Billing highly recommends that practices get involved with their regional CCN. It’s a great way to help grow your patient pipeline and while also contributing to the strengthening relationship between the VA and holistic healthcare providers like acupuncturists, massage therapists, and chiropractors.
Before you can start receiving VA patients at your practice, there are some VA billing guidelines you must follow. Make sure you complete this checklist before receiving patients so you can bill the VA for acupuncture treatments.
We recommend you use a web-based application for NPI applications. To complete the process, you can visit the National Plan and Provider Enumeration System (NPPES) website (https://nppes.cms.hhs.gov/#/).
You need a CAQH ID and a login and password for the website to build an online profile so that healthcare entities can access your credentials. A CAQH ID can be obtained straight from the website with the new CAQH Proview. https://proview.caqh.org/PR/Registration. We recommend authorizing access to “any organization that requests access” to avoid future changes.
The VA Community Care Network is divided into six regions covering the continental United States and Hawaii, the Caribbean, and the Pacific Islands. TriWest manages the Western networks, while Optum handles the Eastern regions. You can visit the VA website to determine which region your practice resides in.
Before the network will refer patients to your practices, you must be credentialed. In most circumstances, completing the credentialing process takes at least three months. You can start the process by contacting Optum or Triwest directly.
Region 1: 888-901-7407 (Optum)
Region 2: 844-839-6108 (Optum)
Region 3: 888-901-6613 (Optum)
Region 4: 866-286-4174 (Triwest)
After the preliminary credentialing process, you must sign the necessary paperwork to become fully registered with the network. Forms are typically submitted electronically through DocuSign and will stipulate any final requirements that must be met to complete the credentialing.
Once your practice has been accepted into the network, you will receive referrals for VA patients authorized to receive acupuncture or massage treatments. Your CCN administrator will email the patient’s authorization letters before their initial visits.
After you’ve received a VA patient’s authorization letters, you’re able to begin treatment. In most cases, the VA will authorize a certain number of visits. While you are certainly free to schedule additional visits, keep in mind that you will not be able to bill the VA for these visits. Make sure patients understand which treatments will be covered by the VA and which will be out-of-pocket or require another source of insurance.
When submitting a VA insurance claim for the first time, you will need to submit all the authorization letter pages together with the claim. Make sure that you transmit all the following information with your claim to avoid a denial:
By following this checklist, you can ensure your Veterans Administration insurance claim will have all the accurate information it needs for a smooth billing process.
Find the answers to some of the more common VA medical billing questions.
The VA does not currently bill Medicare or Medicaid. However, there is information for veterans about the new Medicare prescription drug benefits.
Clinical massage therapy is one of the complementary integrative health (CIH) approaches covered by the VA’s Whole Health system of care. The provider must have passed requirements for basic or advanced training and maintains the required licenses and credentials to practice massage therapy.
Credentialed acupuncturists must be properly licensed and meet the proper training requirements based on the scope of their practice to ensure veterans are receiving the highest quality of care.
Besides traditional acupuncture, providers may be eligible to become certified providers for Battlefield Acupuncture (BFA). BFA is an acupuncture protocol where needles are placed in the ear to reduce pain. Since BFA believes the entire body is represented in the ear, inserting small needles in the ear alone can affect pain throughout the whole body.
As a medical billing provider with a special focus on holistic and integrative health practices, Holistic Billing Services can help you get credentialed by your region’s CCN and help you start treating veterans right away. We have plenty of experience navigating the unique VA billing guidelines, which allows us to maximize your reimbursements and keep your practice’s revenue flowing.
To learn more about how you can get started providing acupuncture for veterans and active service members without worrying about having your VA claims denied, talk to our acupuncture billing and coding experts today!