Collecting Patient Denials
The CNDA is working to gather information on whether or not California insurance companies are reimbursing or covering patients for visits to naturopathic doctors. To this end, we are currently working with naturopathic clinics to compile documentation from patients on insurer responses to superbill submittals. The CNDA is gathering this evidence to share with the California Department of Managed Health Care (DMHC), the California Department of Insurance (DOI), and the federal Department of Health and Human Services (HHS).
If you would like to support the CNDA in this effort to document insurance claim denials, we have created:
- A guide for you and your office staff to follow when working with patients to submit superbills and appeals, and
- An excel spreadsheet for clinic staff to use when tracking patient claims and follow up.
- A guide for your patients to use to navigate the superbill submittal and appeal process.
- An email template and call to action for staff to edit and send out to your patients about this effort.
The insurance reimbursement process basically goes like this:
- Give your patient a superbill for them to submit to their insurer for reimbursement.
Follow up with your patient after 45 days to find out the claim status, and if available, collect any EOBs the insurer provided your patient.
- If an insurer requests more information from your office or the patient, you will need to supply the insurer with that additional request.
- If the reimbursement claim is approved, collect copies of this information from your patient. If the claim is denied, ask your patient to file an appeal with their insurer.
- Follow up with your patient after 45 business days to find out the appeal status. Collect copies of any documentation.
- Your office should strip the documents of identifying information and forward them to the CNDA.
- Email electronic copies (scan, pdf, pictures) to firstname.lastname@example.org, or
- Fax the documents to 815-550-2411, or
Mail them to:
CNDA C/O: Frances McAdam
5601 W. Slauson Avenue, #275
Culver City, CA 90230
If you have any questions or feedback, call the home office at 310-670-8100, or email us at email@example.com.