At Pinnacle Wellness Center, we are committed to helping you get the most out of your care and that starts with understanding your insurance coverage. As a courtesy we verify insurance, however we encourage you to reach out to your insurance provider directly so you have an accurate assessment of your available benefits.  

Please note that your insurance plan is a contract between you and your insurance company. It is your responsibility to understand your coverage and to provide accurate, up-to-date insurance information. While we will do our best to verify your benefits, we cannot guarantee coverage or the accuracy of the information provided by your insurance company.

You are financially responsible for any portion of your care not covered by insurance. This includes co-pays, coinsurance, deductibles, and any non-covered services or treatments. Ultimately, you are responsible for the full payment of all services rendered.

Here’s a step-by-step guide on how to verify your benefits for acupuncture and/or chiropractic services.

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What You’ll Need Before You Call

Have the following handy before you call your insurance provider:

• Pen and paper to document all information provided by your insurance company
  • Or you can download and print out our blank ‘Insurance Benefits Verification Form’ below to keep all your answers organized

• Your full legal name as listed on your insurance card
• Your date of birth
• Policyholder details (all found on your insurance card)
  • Name of the primary insured if different than you (e.g., spouse or parent)
  • Insured date of birth (e.g., spouse or parent)
  • Member ID number/HRN
  • Group ID number  (if applicable) 
• Name of the clinic: Pinnacle Wellness Center
• Type of care: Acupuncture and/or Chiropractic

Step-by-Step: What to Ask

When you call the customer service number on the back of your insurance card, let them know you’d like to verify your outpatient benefits for acupuncture and/or chiropractic care. 

Taking good notes during your call is key. Be sure to ask the following questions and document the answers provided by your insurance company to help us, and you, stay on the same page in case there are discrepancies later.

Call Details: 

• Name of the representative you spoke with
• Date and time of the call
• Reference number for the call or inquiry (ask for this before you hang up)

Details of your benefits (including what’s covered, how many visits, and any limitations, if the provider you are seeing is in-network with your plan) 

1. Do I need a referral or authorization?
2. Do I have coverage for acupuncture and/or chiropractic services? (Specify both if you’re seeking both types of care.)
3. What is my co-pay or co-insurance for each visit?
4. Do I have a deductible? If so, how much have I met? 
5. Do I have an out of pocket maximum? (OOPM)
6. Are there any restrictions or limitations on coverage? (e.g., only for certain diagnoses, specific conditions, or limited duration of care)
7. How many visits are covered for each type of appointment per year or per benefit period? How many have I used?
8. Is the provider you are seeking care with an in-network provider?
   (If not, ask about out-of-network benefits.)

Why This Matters

Understanding your coverage ahead of time:

• Prevents surprise bills
  
• Helps you plan the frequency and type of care
  

We recommend verifying benefits at least 5 days before your first visit so everything can be processed smoothly. And remember — we’re here to help if you have any questions along the way!

Still Have Questions?

Give our office a call at 503-746-6095 or email us at info@pinnaclepdx.com. We’re happy to assist!