Heart of Healing Acupuncture & Chinese Medicine

 

230 Second Street, #102
Encinitas, CA 92024

ph: 858-699-3015

Becoming a New Patient/Insurance

 Welcome to Heart of Healing Acupuncture & Chinese Medicine

 In an effort to better serve you, below is a checklist of things to prepare before your first visit.

  • Fill out and sign all downloadable forms before your appointment.
  • An original Consent form will be given to you sign a the time of your appointment.
  • Payment in the form of Visa, Mastercard, Discover, Check, ITEX Barter or Cash is expected at the time service is rendered.
  • Please allow an hour and a half to two hours for your first visit and one hour for subsequent visits.
  • Please bring all forms completed and signed for your first appointment.  Feel free to contact us if you have any questions or concerns.
  • Wear something very comfortable and loose fitting.

 

     Patient Record                                           Patient Health History

     Patient Health Information Privacy              Informed Consent

     Patient Acknowledgement of Privacy Information

Questionnaire for Herbal Consultation Only

Cosmetic Facial Acupuncture Renewal

 Insurance/Superbill

Any patient wishing to have insurance cover all or  portion of their treatment costs should contact their insurance provider to verify the coverage of their policy with respect to Traditional Chinese Medicine, including acupuncture.

I am able to work with a variety of insurance providers by providing my patients with a Superbill upon request.  A Superbill is an invoice for your visit that uses standardized codes for all the treatments performed.  The process requires the patient to cover the full cost of the treatment at the time of service.  The Superbill can then be submitted to your insurance carrier for full or partial reimbursement depending on the policy coverage.  Patients wishing to use this service are advised to check with their insurance provider to be sure Superbills are accepted.



 

debbie@heartofhealingacupuncture.com

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Copyright Heart of Healing Acupuncture & Chinese Medicine 2006-2009. All rights reserved.

 

 

 

 

 

 

230 Second Street, #102
Encinitas, CA 92024

ph: 858-699-3015