Request a Superbill Form
Jade & Cinnabar is a fee-for-service practice and does not accept or bill insurance. If your plan includes out-of-network acupuncture coverage, I am happy to provide you with a superbill — an itemized, coded receipt — for submission directly to your insurance company, FSA, or HSA for potential reimbursement.
Please complete the form below to request your superbill. As insurance companies and FSA/HSA plans require different formats, kindly indicate where you plan to submit your receipt so that I can prepare it accordingly.
