So i called to make an appointment with a highly recommended LLND in NH. The cost of the initial visit is $600! I know we cant put a price on health, but it's simply unaffordable at this point, not to mention the labs, supps, follow up visits, etc that are sure to come afterwards.
They lady on the phone said that they do not work with any insurance providors. I assume that to mean they do not submit to insurance.
Can i submit the invoice for the visit to my insurance myself? If so, what is the likelihood that it gets paid? I'm going to call my insurance, but want to know what questions i should be asking to make sure i get the right answers.
Basically, i want to know if i can submit visits, supps, labs, etc from this LLND, or any for that matter, to my insurance and if they will get paid.
Thanks for any insight on this!
Posted by Lymetoo (Member # 743) on :
I submitted mine (from an LLMD) and was reimbursed 80%...depends upon your ins plan.
SEE "TF's" REPLY ON THE ABOVE LINK. PERFECT EXPLANATION!!!
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This dr who is charging $600 is likely going to spend 2 hrs with you.
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Moving to General Support
Posted by Keebler (Member # 12673) on :
- First, when you talk to your insurance company:
DO NOT MENTION the word "lyme"
This LL ND is just an "ND" for your conversation.
You can't afford to be labeled with lyme right now as it may compromise the rest of your insurance coverage for all doctors.
Sorry, but unless that specific ND is covered by your insurance, it will not reimburse - unless you have some kind of out of network coverage that
also covers NDs. Most insurances do not cover naturopathic doctors, whatsoever, for anything. VERY few do.
However, had your ND been on any such insurance plan, or known of any in your region that covers ND care, they would have likely told you.
So, the question to ask your insurance provider,
Do they cover:
Out of network? If so, how does that work if for
Naturopathic doctors? If so, which ones, for what services or diagnoses, and how to you submit reimbursment?
Do they cover acupuncture (L.Ac.)? If so, same questions as with ND. (I'm asking because your ND may also be a L.Ac.)
Sometimes, for some diagnoses (mainly pain or migraine), some insurance policies cover a certain number of acupuncture sessions.
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WHY NDs are not (usually) covered by any insurance?
The way the AMA, the medical model, pharmaceutical industry & insurance industries are designed. As a whole, they'd rather see NDs out of business altogether.
In only 15 states are NDs licensed to practice on their own. In a few others, they can practice with certain ties to a MD. In some states, they can't practice at all.
Sad but true. -
Posted by Keebler (Member # 12673) on :
- You might first talk to them before calling your insurance company. Get the "lay of the political landscape" in your state regarding insurance possibilities.
The good news is that looks like NDs are licensed in NH as Primary Care Providers. Whether insurance companies agree is another matter. ---------------
New Hampshire Association of Naturopathic Doctors -
[ 02-17-2012, 02:23 PM: Message edited by: Keebler ]
Posted by gmb (Member # 23562) on :
Insurance companies also mess with out-of network rates. I have a $4000 deductable on out of network treatment. So you would think my $500 LLMD visit would count towards my deductable.. right?
NOT... They log in the Office visit and credit only $125 for the visit, which is the same amount as they have contracted with their in network physicians
gmb
Posted by Catgirl (Member # 31149) on :
Ditto what gmb said. But my insurance did that with a NP too (cut the actual cost they considered to be applicable or reasonable).