INSURANCE COVERAGE CHECKLIST

Call the customer service phone number on the back of your insurance card, and ask the following questions:

Is Ariel Touchet N.D., L.Ac in-network with my plan?

ND Office Visits

• Do I have a deductible? (Yes/No)  How much? ________________ 
• How much of my deductable has already been met? ____________

• Out of pocket maximum? (Yes/No) How much? ______________
• Office visits subject to deductible? (Yes/No)
• Naturopathic medical coverage? (Yes/No)
• Prior authorization required? (Yes/No)
• Limits to coverage?  Number of visits or dollar amount?
• Co-pay or co-insurance? How much? _____________
• Is CPT code 99354 covered?

Labs

• What percentage of labs are covered?

• Subject to deductible?
• In-network labs? Quest, Labcorp, etc?

Acupuncture

• Acupuncture coverage? (Yes/No)
• Prior authorization required? (Yes/No)
• Limits to coverage?  Number of visits or dollar amount?
• Co-pay or co-insurance? How much?_____________

Holistic Pelvic Care or Massage


• CPT code 97140 covered? (Yes/No)