Hom, Allopathy, Insurance etc
Posted: Tue Sep 06, 2005 5:30 am
In a message dated 9/5/05 7:23:05 PM Eastern Daylight Time,
minutus@yahoogroups.com writes:
As we have just seen with Codex Big Pharma is not about to share the pie with
anyone else. (Codex passed last month in America it was tagged onto another
bill and literally voted on just after midnight when there would be few
opposers) Our future and availability of remedies may be of great concern within the
next few years.
That machine that makes homeopathic remedies is interesting me more and more.
Can anyone give me websites to look into it.
Simon is right about us organizing and promoting Hom as a group. Recognition
by the NIH might not get us recognized by western medicine but it will with
the public.
I really don't see why we need to jump through the allopathic hoops.
Thousands of people are leaving their modality to come to ours. Last year 1.2 Billion
dollars was spent out of pocket for health care. The insurance companies have
noticed. People are coming to us by the droves because we listen to them and
come up with inexpensive ways for them to get well.
For the last few years insurance companies have written acupuncturists and
asked them to offer a discount program to their patients. Mind you the insurance
company is not saying to reimburse us they are asking us to reduce our fees
by 25 - 30% so that they can say they have alternative medicine as part of
their policy.
The law was passed that they had to reimburse us but it still sporadic and
only if written in their policy. One way around it is to bill for the
consultation and the modalities. However one must be careful and have proper
documentation and signed forms and be sure you don't charge cash pay patients differently
from insurance patients.
Because the word acupuncture was left out of a federal statute this year
Medicare did not pick ACU up as a payable modality and so many insurance companies
are going with the new policy that they will only reimburse services Medicaid
/ Medicare pays for.
But why do we want the insurance reimbursement? In America the big Pharma now
dictates to the insurance companies who dictate to the practitioners,
hospitals and clinics how much time to spend with the patient, what services will be
the proper protocol to get paid and what they won't pay for.
In 1996 when acupuncture needles became a "medical device" I said it would
take ten years for them to tell us what and how to practice. I was wrong it only
took 9 years.
This year with the advent of the new codes I was told they expect me to take
6 minutes for the complete intake and total 15 minutes for me to get the
needles in them and decide my whole protocol. After that I can bill for each 15
minutes but I have to prove why it was necessary and proper documentation. It
can't just be hanging out talking to the patient. Most acupuncturists typically
treat 45-60 minutes per visit.
My other hot button is that acupuncture and homeopathy are "individualized
care" which does not lend itself to true western double blind studies unless
they can find many people with the same life experiences and ways to deal with it.
Hundreds of thousands went through hurricane Katrina, We are reeling with the
shock, But after the Arnica, Aconite, hypericum, Ledum and Ignatia as a
limited broad Band-Aid each person is entitled to their individual remedy. Even in
epidemics there are usually 3-4 main remedies to fit the requirements.
By buying into "we need the recognition from the allopathic community" will
mean we have to buy into their system of care.
I have many MD, Chiropractic and Acupuncture friends who have dropped out of
medicine altogether rather than to be told how long to stay with a patient. My
gynecologist friend was told to get the yearly exam down from 25-30 minutes
to 12 minutes, He rushed and got it down to 18 minutes and the HMO dropped him
cos he wasn't seeing enough patients a day. He now sells computers. He was
afraid he would miss a cancer and the HMO wouldn't get sued he would.
After my accident my foot, low back, neck, wrist and shoulder were injured.
The Orthopedic clinic I was assigned to said there was no one doctor there to
treat my whole person. I needed 5 individual doctors to address each body part
and I couldn't do it on the same day or the insurance company would not pay
for it.
I couldn't believe that orthopedic surgeons could not treat the whole body.
Reality check of treating parts of the body and not the whole. I had been out
of the allopathic system for a number of years and also forgot that the
interview with the person who took your blood pressure and weight was the intake. The
MD spent on average 4-10 minutes with me after several hours of wait time.
I really don't see the need to beg for reimbursement when they will determine
what is customary and reasonable for "My Area" and then only pay 80% of that.
Many MD's in my area if they say they do alternative therapy are going to a
cash practice and because of MD behind their name people are paying $300-$500
out of pocket for the first visit with supplements. Yet gripe about some of
our $70 visit rates for an hour if we don't have MD credentials.
Just my two cents worth.
Sunny
[Non-text portions of this message have been removed]
minutus@yahoogroups.com writes:
As we have just seen with Codex Big Pharma is not about to share the pie with
anyone else. (Codex passed last month in America it was tagged onto another
bill and literally voted on just after midnight when there would be few
opposers) Our future and availability of remedies may be of great concern within the
next few years.
That machine that makes homeopathic remedies is interesting me more and more.
Can anyone give me websites to look into it.
Simon is right about us organizing and promoting Hom as a group. Recognition
by the NIH might not get us recognized by western medicine but it will with
the public.
I really don't see why we need to jump through the allopathic hoops.
Thousands of people are leaving their modality to come to ours. Last year 1.2 Billion
dollars was spent out of pocket for health care. The insurance companies have
noticed. People are coming to us by the droves because we listen to them and
come up with inexpensive ways for them to get well.
For the last few years insurance companies have written acupuncturists and
asked them to offer a discount program to their patients. Mind you the insurance
company is not saying to reimburse us they are asking us to reduce our fees
by 25 - 30% so that they can say they have alternative medicine as part of
their policy.
The law was passed that they had to reimburse us but it still sporadic and
only if written in their policy. One way around it is to bill for the
consultation and the modalities. However one must be careful and have proper
documentation and signed forms and be sure you don't charge cash pay patients differently
from insurance patients.
Because the word acupuncture was left out of a federal statute this year
Medicare did not pick ACU up as a payable modality and so many insurance companies
are going with the new policy that they will only reimburse services Medicaid
/ Medicare pays for.
But why do we want the insurance reimbursement? In America the big Pharma now
dictates to the insurance companies who dictate to the practitioners,
hospitals and clinics how much time to spend with the patient, what services will be
the proper protocol to get paid and what they won't pay for.
In 1996 when acupuncture needles became a "medical device" I said it would
take ten years for them to tell us what and how to practice. I was wrong it only
took 9 years.
This year with the advent of the new codes I was told they expect me to take
6 minutes for the complete intake and total 15 minutes for me to get the
needles in them and decide my whole protocol. After that I can bill for each 15
minutes but I have to prove why it was necessary and proper documentation. It
can't just be hanging out talking to the patient. Most acupuncturists typically
treat 45-60 minutes per visit.
My other hot button is that acupuncture and homeopathy are "individualized
care" which does not lend itself to true western double blind studies unless
they can find many people with the same life experiences and ways to deal with it.
Hundreds of thousands went through hurricane Katrina, We are reeling with the
shock, But after the Arnica, Aconite, hypericum, Ledum and Ignatia as a
limited broad Band-Aid each person is entitled to their individual remedy. Even in
epidemics there are usually 3-4 main remedies to fit the requirements.
By buying into "we need the recognition from the allopathic community" will
mean we have to buy into their system of care.
I have many MD, Chiropractic and Acupuncture friends who have dropped out of
medicine altogether rather than to be told how long to stay with a patient. My
gynecologist friend was told to get the yearly exam down from 25-30 minutes
to 12 minutes, He rushed and got it down to 18 minutes and the HMO dropped him
cos he wasn't seeing enough patients a day. He now sells computers. He was
afraid he would miss a cancer and the HMO wouldn't get sued he would.
After my accident my foot, low back, neck, wrist and shoulder were injured.
The Orthopedic clinic I was assigned to said there was no one doctor there to
treat my whole person. I needed 5 individual doctors to address each body part
and I couldn't do it on the same day or the insurance company would not pay
for it.
I couldn't believe that orthopedic surgeons could not treat the whole body.
Reality check of treating parts of the body and not the whole. I had been out
of the allopathic system for a number of years and also forgot that the
interview with the person who took your blood pressure and weight was the intake. The
MD spent on average 4-10 minutes with me after several hours of wait time.
I really don't see the need to beg for reimbursement when they will determine
what is customary and reasonable for "My Area" and then only pay 80% of that.
Many MD's in my area if they say they do alternative therapy are going to a
cash practice and because of MD behind their name people are paying $300-$500
out of pocket for the first visit with supplements. Yet gripe about some of
our $70 visit rates for an hour if we don't have MD credentials.
Just my two cents worth.
Sunny
[Non-text portions of this message have been removed]