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Accepting Acupuncture Coverage for UPMC Members

12/28/2015

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On January 1, 2016, UPMC started offering acupuncture coverage for its commercial plans which include most PPO, HMO, and EPO plans. At this time, Medicare plans are not covered. 

​Life Balance Acupuncture is proud to be an In-Network provider with UPMC.

Details and Requirements: 
  • Eligible members are covered for up to 12 acupuncture visits per benefit year.
    • You must have a Physician's Order for acupuncture to use your UPMC coverage.(NOTE: UPMC customer service or your doctor's office may tell you that an order is not required, but they may not be yet aware of the change.)
    • The Doctor's order should have the condition/code for that condition you are seeking care for.
    • It's easy! The doctor's office may fax the order to 855-296-7125 or bring it with you to your first appointment. Generally no doctor visit required, just a phone call!
       
      NOTE: patients not using their coverage, those with non-UPMC plans, or those who pay cash for treatment do NOT require a doctor's order to receive care.
  • UPMC covers acupuncture treatment for the following conditions:
    • ​back pain (lumbar, thoracic)
    • neck pain/ spondylolysis in the neck 
    • sciatica/radiculopathy (pinched nerve causing pain)
    • knee osteoarthritis 
    • migraines (Symptoms experienced for 15 days or more per month and lasting four hours a day or longer) 
    • Sacroiliac Joint (SI) Sprain/ Sacrococcygeal disorders (sacrum/coccyx)
    • nausea/vomiting (generally in pregnancy, patients on chemotherapy, following gastrointestinal surgery, but not limited to)
    • NOTE: to ensure coverage follow these UPMC guidelines for coverage before seeking acupuncture care: For acupuncture treatment of migraine headaches, chronic pain in the lower back or neck or caused by knee osteoarthritis to be covered all of the following must exist and be documented: a. Diagnosis with supporting medical testing or evaluations b. Duration, intensity, and frequency of the pain c. Failure of standard treatments for a period of three months or more 
    • Please call or email if you have questions about covered conditions.This list is not exhaustive and covers only the most commonly treated conditions. 
    • Members must be 18 years or older to be eligible for treatment. 
    • Copays/Coinsurance vary from plan to plan. And must be paid at time of service and cannot be waived.
    • If you exceed your 12 covered visits, you must pay our regular fee out of pocket at time of service. Click HERE to see our services and fees.
Members can call UPMC to check their eligibility and benefits at 1-888-876-2756 or call their UPMC Healthcare Concierge before scheduling. Click below to schedule!

Feel free to email us with any questions. 
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PGH Fitness Expo Memorial Day Weekend

4/28/2015

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Join Life Balance Acupuncture at the 16th Annual Pittsburgh Fitness Expo. We will be offering acupuncture treatments, mini consultations, and Emily's Skin Soother products. 

In addition to the wonderful health, nutrition, and fitness vendors, there will be tons of martial arts, talent, and body building competitions. It will definitely be a busy show with something for everyone to enjoy! Check out the Expo's link above for more vendor and event info. 

Where: Monroeville Convention Center
When: Friday, May 22 from 4-10pm and Saturday, May 23 from 9am-5pm
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Low Back Pain and Acupuncture 

4/10/2015

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According to a 1994 study found in the New England Journal of Medicine, 31 million Americans are experiencing back pain at any given time. That's a lot! Low back pain is the single leading cause of disability world wide. 

There are many causes for low back pain, but acupuncture can help in most cases unless there is severe structural deformity or degeneration (and even then it still may help with the pain). 

I have heard that some people are under the impression that acupuncture just 'masks' the pain temporarily. This is not the case at all. While acupuncture does decrease the pain response in the body, it also works to correct and heal the back so that the pain is reduced or gone for good. 

With that said, it is never advised to do strenuous exercise or activity right away (it's so tempting to go full force at the gym or in a sport once the pain is finally gone, but you still have to heal and prepare the area for that activity again!) 

The way we treat low back pain at Life Balance Acupuncture may be a bit different than other acupuncture or direct back treatments you've had before. In fact, we will not put needles into your sore, tight, back at all! 

The idea of not directly treating the affected area turns many heads and leads to many looks of confusion. However, the answer is simple. Everything in our body is connected. Acupuncturists will treat points on meridian pathways that travel throughout the body. Now, these meridians and points serve as longitude and latitude lines and landmarks superimposed as a map onto our bodies. 

Point A connects to Point B, even if there is some distance in between. Now, if you were to peer inside you won't see this perfectly drawn lines. However, there is some evidence that the classic meridians do follow a pathway along the fascia and connective tissues in the body. 

Therefore, we may treat your hand, arm, or leg to treat your back. The back can be moved gently to see if the intensity and location of the pain has shifted within seconds of putting the needles in. 

This treatment technique works quickly and brings relief to the majority of patients within 24 hours. 

Several follow ups may be necessary depending on the severity of the pain and if it is more chronic or acute in nature. Why keep suffering? We're here to help!
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    Author

    Sarah is the owner of Life Balance Acupuncture in Pittsburgh, Pennsylvania.

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