Forms of Payment and Insurance – FAQs

 
You may pay in cash, check, MasterCard, Discover and Visa.

Vitality Cards (prepaid cards) are available for purchase and can save you 5%, 10%, or 15% off all products.

If checks are denied at the bank due to insufficient funds then there is a $30 fee for reprocessing the payment. The credit card on file will be used to cover the amount on the check and the $30 fee.

It is customary to tip service providers 10-20% for EXCELLENT service. If tipping your therapist makes it difficult for you to afford the session, then please forgo your tip this session. We want you to be able to afford your wellness care!

The most important thing regarding tipping is that doing so SHOULD MAKE YOU FEEL BETTER. If you tip out of a sense of obligation and you leave the Tummy Temple feeling like you paid too much then it takes away from the goal of your sessions = feeling better. Know that if you do not tip that it is okay and there are no hard feelings.

Helping you feel your best is our 100% goal!

Most likely. Flexible spending accounts are designed for individuals to self-select their health care and use pretax dollars that have been set aside as part of employee benefits. All payments are due at time of service at the Tummy Temple.

If you have a credit card tied to your flexible spending account we encourage you to use it for payment. If you need to self-submit to your flexible spending account for reimbursement please tell your therapist at time of service and they will provide you with the necessary supporting documentation at check-out.

It depends on your insurance plan. The best success we have seen is with insurance plans that include a yearly stipend for alternative health care to be used at the subscriber’s discretion. These stipends are intended to cover health related therapies such as colon hydrotherapy, nutrition counseling, and massage.

Some folks are provided by their company with something called a “Flex Spending” account. Though not insurance, these accounts let you put aside pre-tax dollars from your income to spend as you like towards your health. This is a good use for those dollars and equates to almost a 20% discount! The Flex Spending account must be used by the end of the year or you lose the money. Be sure to check with your employer to see if you have access to a Flex Spending account.

Additionally we have seen success in insurance covering colon hydrotherapy when it is specifically prescribed as “medically necessary” by a referring ND or MD.

Please be aware, however, that the Tummy Temple does not submit insurance claims to insurance companies. We leave that to you, the subscriber. We will provide you with receipts, procedure codes and chart notes for you to use in the submission process.

When speaking with your insurance company we recommend using the appropriate CPT code, as follows:

COLONICS: Most customer service reps will not know the procedure as “colonics” or “colon hydrotherapy”. So, to speak in their terms, let them know that you are going in for a procedure that is coded as:

  • 74283: Therapeutic Enema
  • 97139c: Unlisted Therapeutic Procedure (Removal of Impaction)
  • 45915: Removal of Fecal Impaction of Foreign Body, or
  • 45999: Unlisted procedure, Rectum or Anus

MASSAGE: This procedure is coded as:

  • 97124

ASSUME you will be reimbursed and ask “How do I get reimbursed for receiving this procedure?”. From experience we have found that getting a diagnosis code from a doctor as part of a referral or prescription for this service puts you in the best place possible. If you need a referral to a colonic-friendly doctor please let us know.

When self-submitting to insurance companies for reimbursement we suggest the following approach:

GET CONFIRMATION:

  1. Contact your insurance company as ask them HOW do I (not CAN I) get reimbursed for procedure code [CPT]____? Use the CPT code vs. a description of the service as many call center operators will not know the service or how to look up the CPT code. E.g. Colonics are often covered under procedure code CPT 74283.
  2. Once you get the affirmative that it will be covered ask for it in writing (email is fine). Often times you will not get it in writing. Ask for the operators name, location and reference number for the call. Make sure to repeat back your understanding of what you need to do to get reimbursement.
  3. If you did not get an affirmative response, it is okay to hang up and call back. You will get another operator and they may answer differently AND/OR you may feel that a different approach will work better. Try it out. There are many examples where it has taken up to 4 calls before a person will get the affirmative response. And, to be fair, your plan may simply not cover the procedure regardless.

IMPROVE CHANCES:

  1. One of the biggest reasons for reimbursement denial (apart from it not being a part of the insurance plan) is that it is not clear why the service was done. For example, the insurance company may believe that the service was simply for relaxation or pleasure.
  2. If possible, get a diagnosis code from a doctor that lists the CPT code on the same piece of paper as a prescribed or recommended therapy to address the diagnosis. In this way the insurance company can totally relax into knowing that a medically licensed practitioner diagnosed you and that the service presented for reimbursement is relevant.

The Tummy Temple is not a preferred provider for any insurance company, does not engage with insurance companies or submit to insurance companies on behalf of customers. Services received at the Tummy Temple would be considered out of network. Some insurance plans have reimbursed 100% and others 0%. There is no guarantee of reimbursement AND if you follow the advice above you will position yourself for the highest level of reimbursement if it is possible.