Getting Insurance Coverage for NDs
Here at the home office, we get many questions from doctors wondering if patients can get reimbursed by their insurance companies for naturopathic medical services. The CNDA is working directly with insurers and the California Department of Insurance (DOI) on this, but doctors can also get involved by giving your patients the tools to advocate for naturopathic insurance coverage.
The CNDA's efforts to get naturopathic doctors included in insurance plans is two-pronged: our doctors and lobbyists are meeting with insurance carriers directly to discuss coverage options and parity in reimbursement rates, while they are also meeting with the DOI to ensure that NDs are not being discriminated against by insurers. The DOI determines whether discrimination is occurring by investigating complaints made by consumers. If a patient of yours has been denied out-of-network insurance coverage for a medically necessary service or procedure you performed, they can submit a complaint to the CA Department of Insurance using this form on their website.
The DOI may require adequate records with appropriate ICD coding to determine why the claim was denied. If your records are incomplete, the DOI will not be able to verify the claim or whether discrimination has occurred. Another reason to maintain good records!
If you or one of your patients submits a complaint, you can let the CNDA know by emailing Lauren (firstname.lastname@example.org). This helps us keep track of how often this is happening, know which insurance carriers are likely to deny coverage, and share that information with the DOI at future meetings.
Patients can also contact their insurance carrier directly to request coverage of naturopathic medical services. Insurance companies are more likely to respond to consumer demand than practitioner demand!
Finally, if a patient's health care plan is through their employer, another avenue he or she can take is to speak with their human resources department. HR departments work with insurance brokers or directly with insurance companies, and can have a great deal of bargaining power. Letting HR departments know that their employees would like ND services covered can have a great impact!
Contact the CNDA if you would like more information on how you can help get naturopathic medicine covered by California insurance plans.