A Roadmap for Improving Insurance Coverage of Naturopathic Medicine in California
I hope this message finds you healthy and happy! I would like to share with you an update on our efforts at the California Naturopathic Doctors Association to improve insurance coverage for naturopathic doctors.
In early 2014, the CNDA created a new committee focused on improving insurance reimbursement for patients of NDs and increasing credentialing options for NDs interested in becoming in-network providers. Over the past several months, we have had many productive conversations with the California Departments ofInsurance and Managed Healthcare (DOI and DMHC)-the state agencies responsible for regulating insurancecoverage in California. Our conversations focused on naturopathic doctor training and the cost savings of naturopathic medicine for primary care services. We also discussed the need for enforcement of Section 2706 of the federal Affordable Care Act, which states that insurance companies cannot discriminate against a provider type, and that providers who are licensed to provide primary care services must be covered by insurance plans.
As a distinct provider type trained and licensed to perform primary care services, California naturopathic doctors clearly deserve a place in ACA health care plans. To date, however, NDs have not been included in these plans. To ensure enforcement of the ACA's non-discrimination clause, the CNDA is currently supporting state legislation, AB 2015: Provider Non-Discrimination, and collaborating with the American Association of Naturopathic Physicians. However, we still need your help to demonstrate to our state agencies the need for anti-discrimination enforcement and legislation!
Doctors can support the CNDA's efforts and help improve insurance coverage for NDs in the following three ways:
1. Take a 5-minute survey about your experience with insurance credentialing in California.
This survey is a quick way to help us quantify and understand how many NDs are currently covered as in-network providers with an insurer, and how many NDs have been denied credentialing. We are collaborating with Bastyr University in San Diego to compile this data, which we will then provide to the Departments of Insurance and Managed Healthcare. Your survey responses can be anonymous if you prefer.
2. Encourage patients to submit superbills to their insurers for primary care services provided by you.
If you are unfamiliar with creating or using superbills, the CNDA has resources and templates available to get you up to speed on the process.
If your patients are denied reimbursement, let the CNDA know so that we can include these denials in our report to the DOI and DMHC. For more information on collecting patient claim denials, download the following documents and contact the CNDA (email@example.com):
Patients can also submit appeals to their insurance company for denied claims, and if appeals are denied, submit a complaint to the California Department ofInsurance. The CNDA has detailed, step-by-step instructions available to doctors and patients seeking to file a complaint for reimbursement denials.
If you are interested in becoming an in-network provider, apply for credentialing directly with insurance companies today! You can find step-by-step instructions and document templates to ease the process on our website. If you are denied a contract, please let us know (firstname.lastname@example.org) so that we can keep track of which companies are complying with the Affordable Care Act, and which are not.
Patients can support this work by keeping the pressure on insurance companies to reimburse you for naturopathic services - this means submitting superbills, filing appeals, and calling your insurance company's customer service department to demand coverage! More information on how to advocate for insurance coverage can be found at our For Patients page.
Thank you for helping shape our profession's future in California. I strongly encourage you to visit our newly created Insurance webpages, designed to provide doctors, patients, employers and insurers with resources and information for improving insurance coverage of naturopathic medicine in our state. Please get in touch if you have questions, thoughts, or concerns.
Dr. Dhurga Reddy
Dr. Reddy is the Insurance Chair and a member of the CNDA Board of Directors. For more information about her practice, visit www.dhurgareddynd.com.