Archive for the ‘Insurance’ Category|
Friday, November 7th, 2014
Well it’s that time of year again. We are in the final countdown to years end (I can’t believe we are in November already!) with all kinds of healthcare changes. Perhaps you’ve met your deductible, your out of pocket max or you have a flex spending or health savings account that doesn’t roll over. Now is the time to take care of your health (and use those dollars you have put aside for yourself).
We are heading into the dark months and the holidays, now is the time to get ahead of the game. Come in and get your health evaluated, get a plan to keep the holiday weight off, get established on an exercise plan, get your blood work evaluated, you get the picture, come in!
As I’m sure you’ve read, we have welcomed Sarieah Macdonald, CNM into our practice. I am really excited to be offering truly integrative care. I’ve always talked about patient centered care, were east meets west, we’ve got it all under one roof here at Nature Cures!
With the holidays approaching the office will be closed on Thanksgiving and the day after, additionally we will be closed Wednesday December 25th through Tuesday January 2nd. We have a lot in store for you in this next year, why not get started now. Come in and use it or lose it, deductibles renew next year, get that work done now.
Come in for a complimentary consult and discuss what your health concerns or goals are and let’s see if what we do may be helpful for you and your health concern!
Tuesday, April 15th, 2014
Will Insurance Cover My Visit?
Several practitioners at Nature Cures Clinic are covered under many insurance policies including: Blue Cross/Blue Shield; Moda/ODS; Cigna; Pacific Source, First Choice, Aetna.
As an integrated clinic, we have providers whose services are considered ‘standard’ as well as those considered ‘alternative’. As such, we have learned that different plans provide different degrees of coverage and co-pays.
Therefore, we encourage you to check your benefits to determine if the provider you would like to see is ‘In-Network’ or ‘Out-of-Network’ with your insurance provider (check out this article about Understanding Insurance benefits); what your visit(s) co-pay will be; and if any pre-authorization will be needed.
Benefits for coverage may not always be detailed correctly online or in an insurance handbook. Therefore, we ask that patients use our form to call their insurance company so that they receive the most accurate information possible.
To assist you in finding out exactly which of our services your insurance plan may cover and what your financial responsibility would be, please use the following forms when you contact your insurance company:
Using insurance to see: Sarieah Macdonald, NMNP,CNM use this form
Using insurance to see: Greg Eckel, ND, LAc use this form
Tuesday, February 18th, 2014
I tell you what, no health care training prepares one for the crazy-making that is insurance companies!
That said, I’m pleased to announce that I am fully IN network with Blue Cross/ Blue Shield; Moda/ODS; Cigna; Pacific Source; Aetna and soon to be with United Health Care!
In the meantime, I have learned that there are certain insurance plans offered by these companies, where they will pay up to 70% for out of network benefits! Wowzers!
What does that mean for you?
Well, if you have one of these insurances, it means that you can see me just as you would see any other primary care provider.
For those with OUT of network benefits, it means that you quite likely may have a significant portion of your visit with me covered!
I realize it can be a tough financial decision to choose a provider that you have to pay a little bit more to see, but I also know the cost savings of seeing someone you don’t know, who doesn’t listen to you, or who you don’t feel comfortable with- is rarely worth it.
Nonetheless, we are doing everything we can to get in network with all the many different insurance companies, to try to remove any barrier impeding your access to the healthcare you deserve.
Monday, November 4th, 2013
Midwives have historically provided holistic care with emphasis on health promotion and preventative care. As a profession, we believe in providing education, support, and encouragement to women to prevent dis-ease states from developing.
Meaning that midwives, like naturopaths, believe in that age-old saying: “an ounce of prevention is worth a pound of cure”.
For me personally, this means I believe patients should be encouraged to have a collaborative relationship with providers. A place where they feel confortable getting answers to all kinds of questions, and where they can see a provider they know and feel comfortable with, before they are in a health crisis just as much as if they are in a health crisis.
I believe that preventative visits are important.
Now, in full disclosure, it could be said that I like to think I’m radical because I believe that a woman’s preventative health visit should include easy access to compassionate, affordable reproductive care- including birth control, emergency contraception, STI testing, health counseling, breastfeeding support and menopause care.
All of which is frequently difficult to access, largely due to those practicing ‘gate keeping’ theory of women’s healthcare in which undue barriers have been erroneously erected.
But, to be honest, these ideals which I claim as my own are actually shared by the biggest women’s health groups around: American College of Obstetrics & Gynecologists, American College of Nurse Midwives, American Medical Association, Centers for Disease Control & Prevention.
As it turns out, there is almost universal agreement that increasing access to reproductive and preventative health is important. Despite differing philosophies around the provision and type of care, easy access to affordable health care for women is a cornerstone of all organizations specializing in women’s health care.
And so enters into the conversation the new provisions afforded women under the Affordable Care Act (ACA).
Regardless of what one thinks about the ACA, in it there exists a roadmap to improved access and affordability with a focus on reproductive and preventative health with regard to the unique health care needs of women.
In that vein, I share with you some resources from the National Women’s Law Center that give a clear outline on what the ACA offers women, what the new insurance plans cover, and how to access the care you need.
I have mixed feelings about what will be the ultimate outcome of the ACA, yet I feel every woman should feel personal agency over her healthcare. I hope that whatever comes in the future of healthcare contains avenues for personal agency over reproductive health while recognizing the importance of preventative health care.
Tuesday, October 29th, 2013
Getting your health insurance to work for you can often feel like a full-time job in an unfamiliar and ever-changing landscape.
Trying to get a clear understanding of your benefits with all of the changes in insurance coverage, the Affordable Care Act, the restructuring of insurance homes and coordinated care organization’s, can be a real challenge.
When you add into that challenge the difficulties of getting logged into a working website or reaching a live person to talk to on the other end of a customer service line, the entire process can be overwhelming.
While I know a lot about providing health care, I am not an expert on the systems that help consumers access it. This is frustrating for me, as a provider who wants to see and help as many people as I can.
So in an effort to hopefully make it a bit easier for people to access care, I am sharing what I have learned in my own process of becoming an “In Network” provider with Aetna, Blue Cross/Blue Shield, MODA/ODS, United Healthcare, Pacific Source, and CIGNA (expected in-network date January, 2014).
My hope is that what I have learned about these insurance companies may help you get the care you want, need, and deserve.
So to begin with, when you have a provider you want to see it is important to know if the provider is an “In Network Provider” or an “Out-of-Network Provider”.
‘In-Network’ providers, also called ‘preferred providers’, are ones that have an agreement with your insurance company so that, generally, your out of pocket expenses for most visits are limited to your co-pay or by a yearly deductible. This varies by plan, as does the amount or percent that the insurance company will pay for a given exam, procedure or type of visit.
“In- Network” providers bill your insurance and generally all you pay at the conclusion of an office visit is the amount of your co-pay or the amount your insurance won’t cover for the visit. Some visits, like well-woman exams are covered 100% by most insurance companies.
‘Out-of-Network’ providers are those that do not have an agreement with a given insurance company. Yet for providers like myself, nurse practitioners and CNMs, many insurance plans will still provide ‘out of network’ coverage for services like well-woman exams.
This means, while the entire cost may not be limited to a co-pay, you may be able to see an “out of network” provider with your insurance company contributing some amount toward the cost.
Knowing if your insurance company provides any ‘out of network’ care to see a NP (nurse practitioner) or a CNM (certified nurse midwife) – I am both- can be a real game changer when it comes to picking a provider who you want to see.
To check how best to get your insurance company and benefits to work for you, email Nature Cures Clinic today for our new checking benefits form and while you’re at it schedule a free 30 minute meet-and-greet to get to know Sarieah Macdonald, NMNP, CNM.
Thursday, July 21st, 2011
By Dr. Greg Eckel, Naturopathic Physician at Nature Cures Clinic__________
The health insurance industry seems to be purposefully obtuse and complex. As a recent conversation reveals it is also costly. If you are responsible for your own health insurance you probably already know this. If your employer carries the insurance you’ve probably seen the portion you have to pay for has been on the increase.
One recent example that I had to write about was around a patient needing imaging of their abdomen. The insurance company confirmed they cover preventative screenings, however, if any positive finding (meaning anything that shouldn’t be there) would mean that the imaging would be deemed a surgical procedure, which they don’t cover any of the costs. The procedure could cost upwards of $5,000. My patient wouldn’t know if they had to cover the cost of the procedure until after they were woken up!! This is on top of a $600.00 a month cost just for the insurance to not cover a needed procedure! Yikes!
Instead of ranting and raving about this, it got me thinking about other ways of going about delivering our healthcare. I’m going to ask for some help and some brainstorming from you all out there in blog land though. Health insurance drives up the cost of running this little thing we call Nature Cures. We accept it for our patients as they have coverage and pay for it and should be able to use it. However, as more and more stories like the one mentioned above come in, I’d like to explore some options.
I was thinking about our patients who pay out of pocket for our services. Through creating a foundation, non-profit, some other vehicle (this is where I need your help to connect me to the people who know, perhaps you do?) where patients would get a tax deduction. The entity would employ doctors to deliver care. There would less transactions at the clinic. This would possibly cut down on the amount of health insurance transactions we would need to do around here. And patients would get the care they need from our office. Of course this doesn’t solve the above mentioned problem, but it does address the access to care for a lot of people to naturopathic and Chinese medicine care.
No need to worry if you are a patient of ours and have insurance coverage. We aren’t getting rid of the benefit. I’m just exploring some options with you all and starting a dialogue here.
If you have any ideas, I’d love to hear them! We really like creating around here and want to support you in creating as well. Perhaps we could come up with a novel model that would help change health care delivery for the better!
Monday, January 11th, 2010
Listen to: Health Care Reform Bill Podcast
Listen as Dr. Eckel and Dr. Nigh help you read in-between the lines of what the Health Care Reform Bill is really all about. The doctors will tell you how you can become an active participant in these decisions that are being made about your health, rather than just act as a passive consumer, accepting government policies that assume that they know best about how your health needs to be met.
Friday, April 10th, 2009
Listen to the Mismanaged Health Care Podcast
Dr. Eckel and Dr. Nigh share their thoughts on some of the more common health conditions they believe are mismanaged in medicine, such as diabetes, thyroid disease. They’ll tell you about a patient who is a good example of how the conventional world of medicine relies upon drugs to do the work in “fixing” her health condition. With the naturopathic approach, they will explain to you that the work should be done mostly by the patient. The approach that they outline will help you in eliminating your symptoms because you’re most likely to eliminate the cause of your disease!
Friday, January 30th, 2009
Prepare to be amused as you listen to Dr. Eckel and Dr. Nigh express their outrage over some recent medical headlines that may just leave you outraged, as well.
Listen to Medical Outrage Podcast