We are pleased that you are interested in joining ACU-CARE, the only network owned and operated by Acupuncturists, where you’ll get fair reimbursement rates and supplier and merchant discounts and caring customer service.

We have tried to make the application process straightforward and clear, but if you have any questions about joining our network please feel free to contact us at our toll-free number (888) 510-CARE (2273).

To get started just follow the steps below.

Please read and follow these FIVE STEPS below to submit a complete application for membership in the ACU-CARE network.  To avoid a delay in processing your application, print out this ACUCARE APPLICATION CHECKLIST 1-2017 to use as a guide for documentation we need from you.

Acu-Care will NOT accept any form of electronic signature.

1.  Documents you will need to print and complete.

CLICK for Additional IMPORTANT Information

APPLICATION: Make sure the application is signed and dated. If you make any errors make sure you initial any changes. W9: Use the Name and or Business name you use on your tax returns. Use either your EIN or your Social Security number–NOT BOTH. PROFESSIONAL LIABILITY:  Professional Liability must provide coverage of 1 Million each occurrence and 3 Million aggregate. GENERAL OFFICE LIABILITY: General Office Liability must provide coverage of 1 Million each occurrence and 2 Million aggregate and must show the address covered. CV/RESUME’: CV/Resumé must show employment back five years and indicated by “From Month/Year and To Month/Year”. If you are a recently approved acupuncturist and have not been practicing for 5 years include your internship or other activities and employment you were involved with at that time. OTHER: If you make any errors on any of the documents and correct the error, remember to initial the change to indicate it was authorized by you.

2.  Document copies you will need to provide.

  • Professional Liability Certificate of Insurance declarations page
  • General Liability Insurance declarations page (for your office)
  • Curriculum Vitae or Resume’

3. Our contracted Payors/Insurance Companies/Networks—it’s YOUR CHOICE.

Listed below are the ACU-CARE contracted Payors/Insurance Companies/Networks. Click on the name to access general information about that company and contract.  If you want to participate as an in-network provider with a particular company, click on the link described as “Contract Summary”, print it and sign and date the document before submitting along with your application.   If you are not familiar with some of the companies, you can learn more about them by going to their individual websites by clicking on the link below.  You can add a contracted company or drop a contracted company via ACU-CARE at any time—but remember, to add or delete a company will each take time and the change will not be effective immediately.

Payor Name: Connecticut General Life Insurance Company (CGLIC)

Product: Group Health, CIGNA PPO

Cigna Medical Coverage Policy

Rates:

  • 97810 Acupuncture, first 15 minutes $57.00
  • 97811 Acupuncture, Reinsertion $38.00
  • 97813 Acupuncture with elecrtical stimulation, first 15 min. $66.00
  • 97814 Acupuncture with electrical stimulation, reinsertion $44.00

If you wish to participate with Cigna PPO please click on the Contract Summary below, complete the document and return it with your Application.

CIGNA PPO Contract Summary

www.cigna.com 

Payor Name: Cigna HealthCare of California (“Cigna”)

Product: Group Health, CIGNA HMO

Cigna Medical Coverage Policy

Rates:

  • 97810 Acupuncture, first 15 minutes $57.00
  • 97811 Acupuncture, Reinsertion $38.00
  • 97813 Acupuncture with elecrtical stimulation, first 15 min. $66.00
  • 97814 Acupuncture with electrical stimulation, reinsertion $44.00

If you wish to participate with Cigna HMO please click on the Contract Summary below, complete the document and return it with your Application.

CIGNA HMO Contract Summary

www.cigna.com 

PPO Name: ClarisPointe

Product: Workers’ Compensation

Claims: Provider shall submit bills within sixty (60) days following the date of service.

Rates: For acupuncture services provider shall be reimbursed at 85% of California state Workers’ Compensation Official Medicial Fee Schedule.

If you wish to participate with Clarispointe please click on the Contract Summary below, complete the document and return it with your Application.

CLARISPOINTE Contract Summary

www.clarispointe.com 

PPO Name: CorVel

Product: Workers’ Compensation

Rates: Provider agrees to accept as payment in full, reimbursement for covered health care services, the lesser of 90% of usual charges, 90% of usual and customary prevailing rates or 90% of amounts based on the current state applicable Workers’ Compensation Medical Fee Schedule as amended from time to time.

If you wish to participate with Corvel please click on the Contract Summary below, complete the document and return it with your Application.

CORVEL Contract Summary

www.corvel.com 

PPO Name: Coventry Health Care

Products:  (Offerings exclude Auto and P.I.)

  • Coventry National – Group Health, Commercial Product
  • Coventry Worker’s Comp Services – Worker’s Comp Product
  • First Health (A Coventry Health Care Company) – Group Health, Network Access Product.

Rates: Applicable for Group Health and other Payment Programs other than Workers’ Compensation: Services shall be reimbursed at 90% of Current Year CMS RBRVS, with GPCI gap filled, for all services, except for those services defined below.

Procedure Carve Out Codes

  • 99203 Initial Office Visit $97.74
  • 99213 Office Visit $65.83
  • 97810 Acupuncture, first 15 min. $33.12
  • 97811 Acupuncture reinsertion $24.83
  • 97813 Acupuncture Electro Stim $35.35
  • 97814 Acupuncture Electro Stim reinsertion $28.22
  • 97010 Hot/Cold $4.50
  • 97026 Heat Lamp $6.00
  • 97110 Therapeutic Exercise $32.00
  • 97140 Tui-na, Massage $30.00

For Workers’ Compensation:

90% of the official California Workers’ Compensation medical fee schedule.

If you wish to participate with Coventry Healthcare please click on the Contract Summary below, complete the document—make sure you check the boxes only for the Coventry products you wish to participate with—and return it with your Application.

COVENTRY HEALTHCARE Contract Summary

www.coventrywcs.com 

PPO Name: HealthSmart Network

Products:  (Offerings exclude Auto and P.I.)

  • Group Health
  • Workers’ Compensation
  • Other payment programs

Rates: Applicable for Group Health and other Payment Programs other than Workers’ Compensation: Services shall be reimbursed at 90% of Current Year CMS RBRVS, with GPCI gap filled, for all services, except for those services defined below.

Procedure Carve Out Codes

  • 99203 Initial Office Visit $121.90
  • 99213 Office Visit $79.12
  • 97810 Acupuncture, first 15 min. $49.01
  • 97811 Acupuncture reinsertion $37.81
  • 97813 Acupuncture Electro Stim $52.52
  • 97814 Acupuncture Electro Stim reinsertion $42.37
  • 97010 Hot/Cold $6.45
  • 97112 Neuromuscular Re-education $36.28
  • 97139 Unlisted Therapeutic Procedure $21.08

For Workers’ Compensation:

85% of the official California Workers’ Compensation medical fee schedule.

HealthSmart is not a payor.

If you wish to participate with HealthSmart please click on the Contract Summary below, complete the document and return it with your Application.

HEALTHSMART Contract Summary

www.healthsmart.com 

PPO Name: MultiPlan, Inc.

Products: Primary PPO (Excluding Workers’ Compensation, Auto and P.I.)

Rates: Practitioner shall accept as payment in full the lesser of practitioner billed charge or the amount set forth as follows:  % Medicare current year RBRVS: Evaluation and Management 110%.  For non-medicare & non-listed codes: 50% off billed charges

The following CPT codes are reimbursed as follows:

  • 97810 Acupuncture, first 15 min. $50.57
  • 97811 Acupuncture, reinsertion $38.86
  • 97813 Acupuncture, Electro Stim $54.08
  • 97814 Acupuncture, Electro Stim reinsertion $43.93

If you wish to participate with Multiplan please click on the Contract Summary below, complete the document and return it with your Application.

MultiPlan Contract Summary

www.multiplan.com 

PPO Name: Prime Health Services

Products: Workers’ Compensation, Group Health, and Auto Liability

Rates:

Provider agrees to accept reimbursement for Covered Services rendered to Covered Persons at the following tiered rates for each of the product lines described in 4.0 of the PHS Provider Terms and Conditions Booklet.

For all applicable Payor Programs Provider will be paid the lesser of the schedule below:

  • 90% of the Submitted Billed Charge

OR

  • 90% of any maximum allowable rate specified by federal or state schedule or law.

Standard Terms & Conditions: Before signing the payor summary, provider agrees to go on line to access the Booklet by logging into the secure provider portal www.primehealthservices.com. The Booklet found at: www.primehealthservices.com/media/219938/phs-provider-agreement-booklet-v130.pdf is incorporated into this Agreement by reference and its terms and conditions are non-negotiable in regards to this Agreement and the relationship with PHS. Provider is also responsible for logging into the site to review PHS’s Client Directory as it may change periodically.

If you wish to participate with Prime Health Services, please click on the Contract Summary below, complete the document and return it with your Application.

PRIME HEALTH SERVICES Contract Summary

www.primehealthservices.com 

4.  Fees to send along with your application.

  • $50 Application processing fee.
  • $300 Annual Membership fee.
  • $60 Site inspection fee — for each location.  (For details about the site inspection click on this link… SITE INSPECTION FORM.)

5.  Mail the completed package to…

ACU-CARE
2500 E. Foothill Blvd. Ste. 401A
Pasadena CA 91107

PLEASE READ the “Additional IMPORTANT Information” above before submitting your application!