Linda answered this question or a similar question in the past but I couldn’t quite grasp the concept. This patient has a med-advantage plan, so unless the provider is a Medicare Provider claims are going to process out-of-network. But this begs the question, if Medicare does not recognize the specialty, in this case acupuncture, then how can the patient see an in network provider? The answer is the patient needs to see an MD who is a Medicare Provider and also has a DO or LAc credential allowing him or her to perform acupuncture.
I knew I’d get it eventually.