education

A Special Message to Patients of Naturopathic Doctors

  • Does your insurance plan not cover NDs?
  • Does it have an annual cap of $1,000, $1,500 or some other amount on services of all “alternative care providers?”
  • Do labs ordered by your ND apply to your annual cap?
  • Did you have to purchase more expensive insurance in order to get better coverage of your ND?

 

If you answered yes to any of these questions, your insurance plan may be operating illegally, and we need your help to bring them into compliance with the law!

 

The Affordable Care Act (ACA) contains a provision called “Section 2706 – Provider Non-Discrimination.” Insurance plans issued on or after January 1, 2014 are now prohibited from discriminating against providers like naturopathic physicians (and acupuncurists, chiropractors, etc) in either coverage in your plan benefits, or participation as an “in-network” provider.

 

If you are seeing your ND for a service or condition that your insurer would ordinarily cover if you were to see an MD or other provider, than your insurer must by law also now cover your ND – at a minimum as an out-of-network provider. This applies to ALL PLANS except for medicare.

 

What You Can Do TODAY to Help Bring Insurers Into Compliance!

 

Oregon’s Insurance Commissioner has requested that we file formal complaints any time a patient or doctor identifies a plan or insurer that seems to be discriminating against naturopathic doctors.

 

  1. File complaints at www.cbs.state.or.us/ins/consumer/tomake.html or call 1-888-877-4894 and select the Life & Health option
    1. Detail how your plan covers (or doesn’t) your naturopathic doctor with different limitations, restrictions, or caps than other doctors
    2. State that Section 2706 of the ACA prohibits this kind of provider discrimination
    3. Ask the Commissioner to ENFORCE THE LAW

 

Examples of discrimination might be (select any of the following or write in your own):

  • Not covering ND services at all, even as an out-of-network provider.
  • Applying a $1,000 or other annual cap for services that are identical to those of other providers not subject to this cap.
  • Applying labs and diagnostic imaging against a different “alternative care” cap instead of applying it to the plan’s normal deductible.
  • Refusing to pay for a pharmaceutical, lab, or diagnostic imaging where it would be covered when done by another provider.
  • Not covering mandated routine preventive screenings like mammograms, etc.
  • ND is in-network with insurer but some plans offered by insurer deny coverage of services by ND (i.e., you can see an ND in the Silver plan, but not the Bronze plan).
  • Reimbursement rates for same quality and performance of services done by an ND are substantially different for ND than for other providers.

 

  1. Go to http://www.CoverMyND.org to send a message to the Governor to ENFORCE THE LAW
Community Involvement

Community Involvement

Much of the talk in our office is about physical wellness, but since we treat the whole person, this post is going to focus on another area of wellness –community involvement.

A sense of connection with one’s community has many positive effects on one’s mental and emotional health:

  • You become a part of something bigger than yourself
  • You have a feeling of belonging
  • You have a feeling of purpose
  • You become involved in helping create health in your environment
  • You establish new friendships
  • You encounter new ideas
  • And many many more

VFM recently reached out to the community by attending a screening of the movie Numen that was hosted by Mountain Mel’s at the Sandy Public Library.  The focus of the film as well as the movie was on community involvement and herbal medicine.  It is a lovely film and comes highly recommended for those who would like to learn more about the subject of herbal medicine and its worldwide importance.  Mountain Mel’s is focused on bringing herbal and holistic medicine into the eastern county community specifically in the Welches area; be sure to contact them with any interest or ideas you may have.

The doctors of VFM also engage in many ongoing community activities, from teaching at all levels to directing plays and to being involved in our local schools and organizations we are always on the lookout for ways we can contribute to the community.  Let us know how you are involved in the community, and let us know how VFM can show our support.

The Therapeutic Order

Many people believe that naturopathic medicine is about what treatments it uses.  While the contents of the naturopathic toolbox are very important, those tools do not define the profession.  You can read more about the tenets of naturopathic medicine here.  As a reminder, they include the following six key concepts:

  • First – do no harm
  • The healing power of nature – the body’s innate ability to heal itself
  • Identify and treat the cause of disease
  • Treat the whole person
  • Prevention first
  • The doctor as teacher

There is another key foundational philosophy in naturopathic medicine which will be the topic of this month’s blog post – the therapeutic order.

the-therapeutic-order

The therapeutic order is used to determine which treatments are needed for each patient in their given condition.  The order is usually depicted as a pyramid as shown with treatments ranging from creating a solid foundation of nutrition and lifestyle habits all the way to heroic measures such as surgery and chemotherapy.

When considering the therapeutic order one can see that naturopathic doctors have many, many different ways of addressing their patients as well as their conditions.  In fact, within each level of the pyramid, there are multiple different options of treatment and focus allowing us to tailor treatment to the individual.  It can also be seen that without a strong foundation (nutrition and lifestyle efforts) in place, there will be a continued need for more complex and invasive treatments.

Finally, it should be mentioned that multiple levels of the pyramid can be addressed simultaneously.  For instance, in the case of hypertension, once the cause of the disregulation of blood pressure has been identified, a patient may be on an antihypertensive medication (level 6), be on an herbal combination aimed to strengthen the cardiovascular system (level 3), and be starting a new exercise regimen (level 1).  Another patient may be more apt to focus on diet and avoidance of pharmaceuticals and focus on the removal of foods that they react to (level 1) while taking an herbal antihypertensive formula (level 5).  Both approaches have their merits and areas to be cautious about.  The treatment plan that will work the best is the one that works for the patient while addressing the underlying causes of disease.

Naturopathic medicine is more than its tools it is a whole system of medicine with a very solid philosophical foundation to guide the use of its varied tools and practitioners.

What topics are you interested in learning about?  Send us your questions:  info@vibrantfamilymedicine.com or www.facebook.com/VibrantFamily