I accept the following insurance

Selected HMO, PPO health insurance
                 Worker's compensation
                 Auto accident insurance

I am the provider for the following management company:
                 American Specialty Health Network
                 Landmark Healthcare
                 Optum Health (ACN group)

There are two ways to check your acupuncture benefit.  Either by you or by me.
When you do the checking, make sure you obtain the following information:

    1. Ask if you have acupuncture benefit.
    2. If you do, your deductible. You must pay out of pocket to meet the  deductible before your insurance pay for  your treatment.
    3.  Number of visit you will have per calendar year.
    4. What is your co-pay or co-insurance.
    5. Ask if your acupuncture benefit is paid to the licensed acupuncturist does acupuncture.  Some insurance only pay to the M.D. does acupuncture but not to the licensed acupuncturist does acupuncture.

When you decided to let me do the checking, please provide the following information:
        1.  Subscriber's full name as appear on the card
        2.  Subscriber's date of birth
        3.  Subscriber's ID number on the card
        4.  Group number
        5.  Customer service phone number (toll free #), or provider toll free #
           6.  Your contact phone number