Insurance thread - Feb 2014

"We don't bill insurance"

jasonbarkernd

Message 1 of 15 , Feb 24[-- Image:
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Dear Colleagues,

My practice is in Colorado and ND's are not part of the
insurance system as far as office visits go.

I get a lot of calls from potential patients who want to know,
first thing, if I "take insurance".

I'm looking for a more eloquent way of stating that, no we don't
take insurance but here's why we want you to come in, so to
speak. I'm looking for a better way to let them know that we
don't take insurance, but that shouldn't matter in your seeking
care with  me. Does that make sense?

Does anyone have a good 'line' that they use in similar practice
situations?

We've tried a few different lines but I'm wondering if any of
you have something more eloquent than we have.

Thanks,

Jason Barker, ND

Fort Collins, Colorado.

Michael W Whitney NMD DC FABNO

Message 2 of 15 , Feb 25[-- Image: Frame1 --]



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Hi Jason,



That question can be managed by getting additional information.
Do you take insurance?  reply:  What is the nature of your
problem?  What have you tried that has not worked?  Many of our
patients come to us because they are tired of the problem and
lack of results.   Dr Jason has been very successful treating
this condition.  Although your insurance is not accepted in
Colorado by Naturopathic Physicians many of our patients
believe they will spend more in copays attempting
to cover  their symptoms  than what you would spend with Dr
Jason getting to the cause.  Would you like to schedule an appt
to see the Doctor?  We can see you ..  Some folks it will be
money and that is too bad but most are wanting to get rid of
the problem and use their insurance.  Many will settle for
getting rid of the problem...  The take home is that because a
prospective patient says they want to consider you only if you
take insurance is a false filter for many prospective patients
and they can be scheduled. Cash plans are also useful to have
in place for these folks.



all my best,



Mike

Michael W Whitney NMD DC FABNO

c bye

Message 3 of 15 , Feb 25[-- Image: Frame2 --]



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I am a cash practice, when they ask if I take insurance I say,
(I think I have shared this before).

no, because I want to spend more time with my patients, not the
insurance companies trying to get paid. I say...thank goodness
they have insurance in case God forbid something bad should
happen like a car accident or they get cancer and need $350K in
care, and the US is the best in the world for that type of
care.  However health insurance is like car insurance..... it
is for a wreck. It does not pay to keep you well.  Just like
car insurance it does not pay for tune ups, oil changes or new
tires.... yet we are willing to pay out of pocket to take care
of our car... and your car is a replaceable item.... your
health is not, not even Steve Jobs could buy his health back.
Your body is the vehicle through which you experience your life
and you need to keep it well to experience as much in your life
as possible... isn't that why we are here.  When they ask what
I charge, I say the same as an initial visit with the MD but
instead of 20 minutes they will get 2 hours and  my goal is to
connect the dots and to teach them (doctor as teacher) how to
take care of themselves.  All of that takes time for which
insurance will not pay.

I have a pretty good success rate at helping them to understand
why they need to spend the money to come see me.  Frankly, I
personally do not want those that are not committed enough to
value their health enough to prioritize the money.  I know
there are some that truly can't afford my care and I will see
them for free. I want that commitment that they are willing to
take charge of their health and that includes finding the time
and the money to take care of themselves

My practice is successful and I am looking for an associate to
mentor to take over my practice within the next 5 years if
anyone is interested.

Cynthia Bye, ND, FABNO
Board Certified in Naturopathic Oncology

Vancouver, WA
www.cynthiabye.com

debepstein

Message 4 of 15 , Feb 25[-- Image: Frame3 --]



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I totally love that analogy to car insurance. Nice!
Here's my version of the
story:http://www.lumina-health.com/feesinsuranceseattlenaturopathdeborahepstein/.
Note that it won't totally work for you in Colorado, but there
might be parts of if that would be useful in crafting your
answer.
Deborah Epstein, ND
Seattle

docerin1

Message 5 of 15 , Feb 25[-- Image: Frame4 --]



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Cynthia,
I love what you have written here.  Do you talk to the people
yourself/screen calls.  I cannot imagine training my office
manager to do this...she is too shy?, well, she withholds and
will not push back.  It's a cultural thing.  Anyway, do you
have a written version of this?  Would you mind if I edited it
and put in on my website!?

Love it,
Thanks!
Erin Holston Singh, ND
Cleveland

Dr. DeeAnn Saber

Message 6 of 15 , Feb 25[-- Image:
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Dear Colleagues,

I too run a cash based practice, and feel that seeing ~10-12
folks a week is ok. And everyone else I know in Tucson is also
cash-based. That being said, here's my conversation: "No I do
not take insurance as they don't pay for my office visits
however they will cover your labs and that is a much larger
expense overall. What issues are you dealing with now?" Also I
let them know that my first office visits are 2 hours with
followups being 30-60 minutes long. Then I ask if they have
ever seen a doctor for 2 hours and been able to tell their
whole story. I also let them know that I am treating them, the
whole person and will get to the underlying cause so they won't
need to see me very often. That usually leads into them starting
to tell me about some of their issues and then we get them
scheduled. I also have a few folks who are sliding scale but I
don't advertise that - its done on a case-to-case basis.

That's the beauty of working for yourself!!

Dr. DeeAnn G. Saber, NMD is part of Wellness First!, a
collaborative, holistic community of practitioners in Tucson,
AZ, dedicated to personal integrity, professionalism, and
service.

Transformational Medicine, PLLC

3861 North First Avenue

Tucson, AZ 85719

Office# 520-209-1755

Cell# 520-668-0039

DrDeeAnnND@...

www.3861WellnessFirst.com



weyrich_comp

Message 7 of 15 , Feb 25[-- Image: Frame5 --]



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You probably want to add some sugar-coating, but the bottom line
for me is that if I took their insurance, I would become a slave
to the insurance companies and ObamaCare mandates, and my
allowed treatment protocols would be the same as what the MDs
provide who take insurance.  Patients who want that standard of
care are best advised to go to an MD - they have better training
in complying with insurance and federal mandates. :-)

Orville Weyrich, Jr PhD NMD

Phoenix, AZ (SCNM 2007)

Michael Uzick, N.D.

Message 8 of 15 , Feb 27[-- Image: Frame6 --]



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Hi All,

I've not read this entire thread, so my apologies if I'm
repeating what's been stated.

Currently we connect patients with a medical billing coder and
she assists patients in successful reimbursement for a fee. Of
course patients can try this on their own, which is what most
ND's recommend to their patients. I have patients with cancer
who are getting 80% of their high dose IVC covered. Then there
are patients with Bluecross/BlueShield of AZ who specifically
exclude Naturopathic care. So all of those patients with cancer
who would like to do IVC 3 times a week have to pay 100% out of
pocket.

I have other cancer patients who have successfully billed
medicare and received payment for 50% of their IV's. While this
sounds illegal, some of these patients are simply sending a
letter stating what's going on and submitting it with their
bills - i.e. the letter states that their primary care
physician is a Naturopath and not covered by Medicare. These
patient get their IV's and office visits covered by medicare,
often, but not always.

Regardless if this is a mistake or something illegal that's
occurred with medicare, the point I'm making is that it is
wrong to discriminate against Naturopathic doctors. It is our
patients who have paid for their insurance or have paid into
the medicare system who are also being discriminated against.
The consequences of this discrimination endangers the health of
our patients and are essentially theft in my oppinion. Just
because they signed these discriminatory contracts does not
make it right, certainly not in our current legal system.

Because I can't even run diagnostic lab work, imaging, prescribe
medications etc. in the medicare and state medical system, this
puts all of my patients with medicare and state insurance at
risk. These patients have chosen Naturopathic medical care. And
in AZ we are licensed primary care providers. But these
patients, these citizens, many with serious heath issues, like
cancer, have delays in getting their labwork done because they
want to get their other doctor to order it for us.. Yesterday
an advanced colon cancer patient who is in his 80's and is in
the dying process was in for treatment and it's clear he now
needs assistance. He and his family can not effectively care
for him now. Proper transport and bathing etc. are needed. The
insurance is medicare. If I order hospice or home care,
technically medicare could take back their reimbursement or
refuse to cover my orders. This is wrong. They need help now
without delays. These patients should sue the government.

The Affordable Care Act's section 2706 protects the citizens of
the US against private insurance companies that are
discriminating against some state licence health care
providers. The insurance companies are already folding and we
have not officially launched the campaign that is coming. Dr.
Traub showed me a letter from BCBS of Hawaii, who just like AZ,
perviously did not cover ND services. They sent out a letter on
their own specifically referencing this non-discrimination
clause 2706 and saying that would now cover Naturopathic,
acupuncture, etc. There are more examples and I believe this
will be an easy win for Naturopathic medicine and the patients
who chose our care. I also believe this will ultimately result
in a much quicker federal recognition of Naturopathic
medicine.

We don't want our care dictated by insurance companies or the
government. We are always at risk for such things. But these
are separate issues and stopping discrimination against our
medicine does not mean we are forced to change our practices.
In other words, my patients are paying me out of pocket for all
of my services and some of them are getting a check back from
their insurance companies for 50-80% of their services. I have
not had to change the way I practice for the insurance
companies that do recognize my services and apparently some
medicare employees who interpret on their own that US citizens
should be reimbursed for services their state licensed primary
care physician has provided.

Michael Uzick, ND
Tucson

Mike Whitney

Message 9 of 15 , Feb 27[-- Image: Frame7 --]



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Well done Michael!

Mike

Sent from my iPad

Michael W. Whitney NMD DC FABNO

Fellow of the American Board of Naturopathic Oncology

Board of Directors Oncology Association of Naturopathic
Physicians

Riy Chi

Message 10 of 15 , Feb 28[-- Image: Frame8 --]



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I rarely comment or ask questions on natchat. I learn so much
from the on-going posts that I rarely feel the need.

This past post, from Dr. Uzick has compelled me to come out from
the shadows. Lol.

I so totally agree with Dr. Uzick!!

This would be beneficial for our profession overall to be
recognized nationally and federally as 'real' physicians. Plus,
so many more patients could potentially benefit from our
medicine.

We don't have to change our philosophies and treatments just
because the insurance companies recognize us and cover our
treatments?!

It also doesn't mean we will have to practice like the MDs do.

Clearly our core philosophies,  modalities, and treatment
options are vastly different, I don't see how we would be
pushed into conforming.

There will, however, be glitches, I'm sure, as every new system
has. It's a process but definitely would be a step in the right
direction!

...Aaand that's my 2cents! ;-)

Sincerely,

Dr. Riyana R. Chinoy, BSc (Kinesiology), NMD

bradwestnd

Feb 28[-- Image: Frame9 --]



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Michael,

You start off noting that "Currently we connect patients with a
medical billing coder and she assists patients in successful
reimbursement for a fee".  I am very interested in this
approach for my patients in California and have never heard of
anyone doing this.  I know we can hire a medical biller or
coder and they take a small percent of what we get reimbursed
or paid but how does your system work.  Seems like a great
option maybe most of us missed or dont understand.

Brad "missing Prego and his quotes and posts" West, ND

Bay areas of Nor Cal

richardmaliknd

Mar 1[-- Image: yui_3_15_0_1_1401378300526_3334 --]



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I accept most insurance plans in my region.  At least in my
area, insurance tends to cover NDs if the patient's insurance
originates from a state that licenses NDs (i.e. CT or VT).  It
is more difficult, but not impossible, to get coverage for
patients whose insurance originates from states that do not
license NDs (i.e. MA or NY) and depends on the quality (cost)
of the patient's plan.

I started taking insurance about 4 or 5 years ago.  It takes
some time to figure out the insurance system's requirements and
to implement systems that make it as simple as possible.  I run
a micro-practice model with just me and my wife.  We work hard
and work like crazy.

We love, love, love taking insurance!  There are challenges, but
on the whole it is great.  I do not feel limited by insurance as
to what I can do for my patients. If I recommend a test or
procedure that is not covered by insurance, I simply have to
communicate clearly with my patient about it.  It is an honor
to be able to see patients that are on Medicaid (even though
the reimbursement is not so great).

I hope my perspective and experience is helpful.

Richard Malik, ND

Salisbury, CT

Manchester Center, VT

Mike Whitney

Message 13 of 15 , Mar 1[-- Image: Frame10 --]



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Love this post!

Mike

Sent from my iPad

Michael W. Whitney NMD DC FABNO

Fellow of the American Board of Naturopathic Oncology

Board of Directors Oncology Association of Naturopathic
Physicians

Shiva Barton, ND

Message 14 of 15 , Mar 2[-- Image: Frame11 --]



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Richard,

I agree with you. Of course, we can't bill insurance in MA
because WE
ARE NOT LICENSED - ARRRRGGHHH! but no matter the inconvenience I
would
like to be able to treat more people who can not now afford to
use our
services. That would be a blessing for my desire to help
everyone get
well, no matter what their income. It is easy for me to say "no
matter
the inconvenience" since its all abstract to me at this point.

Shiva Barton, ND
Winchester, MA

jasonbarkernd

Message 15 of 15 , Mar 2[-- Image:
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Thanks everyone for your replies regarding insurance. I've got
some good ideas and I'm going to write a script for the front
desk.

Thanks again,

Jason Barker, ND

Fort Collins, CO