HOW TO SELF-BILL YOUR INSURANCE
Please be aware of the following:
• NOT all plans allow self-billing, and Medicare does NOT permit patients to self-bill.
• It is the responsibility of the patient to consult their insurance plan for instructions and appropriate forms for self-billing.
•Contact Alisa at firstname.lastname@example.org if you are planning to bill your insurance and she will prepare the itemized receipt with necessary insurance codes to facilitate self-billing. Include your diagnosis code that must be included on your itemized receipt. You can take a picture of your prescription and email it as well.
• It is advised to make copies of all forms prior to submitting insurance claims.
• Alisa Popova LMT is an Out-of-Network Provider/Non-Preferred Provider who is not contracted with any insurance companies.