Insurance Coverage | Quantum Breakthroughs

Some insurance plans offer holistic stress-reduction options. As an example, Oxford Health Plan, based in Norwalk, CT and serving CT, NY and NJ, offers access to 4,400 holistic providers without prior approval of a ‘gatekeeper’, at a contracted rate added to the premium.¹

Biofeedback coverage terms for vary from one plan to another. A call to your insurance company will help you verify whether biofeedback is covered under your plan, the terms of coverage, and what procedure to follow to secure coverage.

In some cases, insurance coverage for biofeedback requires either a primary care doctor’s referral or a request for ‘prior authorization’.

For example, for in-network biofeedback providers, some Oxford plans do not require a referral by the primary care doctor. But some plans do, and this depends on the location of where biofeedback service is provided — in an office, a clinic or at the client’s home.
For out-of-network biofeedback providers, Oxford never requires a referral from a primary care doctor.
Depending on the location of service (office, clinic or home), Oxford may require a prior authorization request from your doctor. Once Oxford has issued a prior authorization, you, as the insured, can submit a claim to Oxford for reimbursement of your out-of-pocket biofeedback expenses.

Some people may find it empowering to discuss their holistic stress-reduction interests with a doctor. While every doctor is different, many are familiar with biofeedback as a relaxation technique and support the decision to try it. In a national survey of referral patterns conducted in 1996 by the Alternative Therapies journal, 85% of U.S. board-certified family physicians and internists were willing to refer people for biofeedback.² In 2012, Biofeedback with S.C.I.O. legally won the approval of a mainstream U.S. insurance company for making it possible for people to better able to integrate orthodox medical approaches.

The Association for Applied Psychophysiology and Biofeedback, Inc. provides guidelines and an extensive list of procedural or “CPT” codes for mind and body conditions doctors can use to help people interested in pursuing insurance coverage for biofeedback services.³

1
Oxford Health Plans. (2014, August). Complementary & Alternative Medicine. Retrieved from https://www.oxhp.com/altmed/ Further, biofeedback services are covered by Oxford.
2
Blumberg D.L., Grant W.D., Hendricks S.R., Kamps C.A. & Dewan M.J. (1996). The Physician and Unconventional Medicine. Alternative Therapies. 1, 31 – 35.
3
Association for Applied Psycho-Physiology and Biofeedback, Inc. (2014, August). New Guidelines for Third Party Reimbursement for Biofeedback. Retrieved from http://www.aapb.org/i4a/pages/index.cfm?pageid=3387