What to do about some shady acupuncture?

January 28, 2019 4:39 PM

I was seeing an acupuncturist and I believe that they are doing some shady insurance stuff. How do I proceed?

My insurance covers acupuncture. This is mandated by my jurisdiction.

I went to an acupuncturist and began treatment. They put in needles and left the room for 45 minutes. The bill to insurance was $35-60, depending on the code. The needles were never changed in the session. They never checked in on me. Multiple people were in the office, in different rooms. The needles were places the same each week, despite what I was feeling. I also have to admit that I did not like this person very much. They had a weird vibe. The scheduling emails were oddly scolding. "I've been waiting for a reply from you for 1 hour. If you don't take this appointment, I will have to deprioritize you to get a spot next week."

After a couple of months, I changed acupuncturists and my new person is with me for the entire time, changes the needles often, also does massage, and is all-around great.

Meanwhile, I went for a therapeutic massage (lots of practioners for this injury) who also happens to be an acupuncturist. We were broadly discussing body work and massage therapist person mentioned that acupuncturists are supposed to bill in 15 minute increments and that there needed to be significant contact to count another 15. I told him about the previous acupuncturist and we agreed that all of those patients at once and being left alone might be a little shady.

So today I brought it up with my current acupuncturist. They said that a lot of practioners do not understand insurance billing, they're not taught in school, etc. They told me about someone they knew in school that saw 20 people a day in 6 hours and eventually they were audited. Current acupuncturist also confirmed the 15 minute rule but said that it is possible that old acupuncturist was confused. Current acupuncturist encouraged me to assume the best that old acupuncturist was mistaken, maybe isn't committing fraud. Current acupuncturist said that I could look closely at my EOBs to see and perhaps call old acupuncturist to find out. Current acupuncturist also said that a lot of body work practioners are pretty stressed out about insurance.

Regardless of what happens, I was unhappy with the situation. If a friend/neighbor asked me, I'd give old acupuncturist a bad review - for the overall vibe and the questionable billing practices. But should I go further? Maybe give a bad review on some website? Maybe give a bad review on my insurance company's site? Tip off the insurance company? Honestly, I don't want to call old acupuncturist because I disliked them so much.

posted by k8t to Health & Fitness (9 answers total)

I would just move on. If the first acupuncturist is ripping off insurance companies, that's not your problem and not something I can get really excited about (which I guess makes me a bad person). You didn't like the tone of their e-mails, but that's a personal opinion. You expected the needles to be moved around during a session and for the acupuncturist to stay in the room with you, but that's not how everybody does it (or wants it to be done to them). There are better things to do with your time, especially if you're busy recovering from an injury.
posted by The corpse in the library at 6:09 PM on January 28, 2019

thisnisnjudt a function of finding the licensing board that oversees this person. Find board, email complaint, maybe have to answer some follow up questions. Then you get to move on and not worrry about it.
posted by furnace.heart at 6:20 PM on January 28, 2019

Honestly it sounds like this person rubbed you the wrong way and you want to get that off your chest.

But you don’t have much to go on really. Write a bad review and let it go.
posted by St. Peepsburg at 7:45 PM on January 28, 2019

I wouldn't do anything with this previous situation. If you encounter it again, call your insurance company and ask what you should reasonably be able to expect of your acupuncturist. They'll tell you, and that will also tip them off to keep a close eye on them.
posted by summerstorm at 8:30 PM on January 28, 2019

All my acupuncture sessions sound similar to the first one: consultation, needles go in, chill out for ~45 minutes, needles come out, shorter consultation. The chilling out solo was part of the therapy, and I would have been weirded out had the practitioner stayed in the room. If I think of it in 15-minute increments, it’s probably two: one for the needles going in, one for them coming out. Was your practitioner billing for more than that?

All that to say — alternative therapies are very very much YMMV. If this is an insurance issue, talk to the insurer. If it’s just a gut-check, this random person on the internet says it’s pretty normal.
posted by third word on a random page at 1:44 AM on January 29, 2019

Would you consider reporting if you had liked the practitioner? That's your answer.
posted by juniperesque at 6:03 AM on January 29, 2019

+1 for your first description—needles in, long rest, needles out—being normal for the appointments from four different practitioners I've seen over the years (minus the unhappy vibe). None of them were billed under insurance. $35-60 is within the range of the rack rate I'd pay out of pocket. My needle points may have been the same over the course of treatment, but some type of assesment (my best practitioner did pulses and tounge) and charting was done each time.
posted by Rube R. Nekker at 7:18 AM on January 29, 2019

I've seen 3 different accupuncturists over the course of my life. I never had one stay in the room with me, there was always a period of time where I was left to "chill" with the needles in. On the occasions I was seeing the acupuncturist for insomnia, I would actually fall asleep while left alone. It was bliss. Also, most often I would only have the needles placed once per session, although in one case we did front side of the body then back side of the body placements in each session. There were never more than one or two other patients being seen at the same time I was, however. That's the part of your experience that sounds a bit dicey. I'd leave an honest, non emotional review on Yelp or similar site so that people could decide what they're comfortable with before they're on the table with needles in. I personally, as a person looking for an acupuncturist, would appreciate your leaving a head's up.
posted by WalkerWestridge at 10:39 AM on January 29, 2019

My acupuncturist also leaves me in the room alone almost the whole time. He will come back in after ~5 mins to check on me but that's it. I can't imagine him staying in the room. I usually fall asleep! He definitely does a checkin at the beginning of the session and changes the placement based on how I'm feeling. If I had to guess, he is seeing 4 patients per hour, so 20/day doesn't sound outrageous.

My gut is that there's nothing to *report*, the person you saw was just not that great. Which, I get, is annoying. I agree that you should write a factual Yelp review, consider it flagged, and move on.
posted by radioamy at 1:11 PM on January 29, 2019