Interview with the Founder Geoff DePaula M.Ac., Lic.Ac., Dipl.C.H.
Practitioner Membership Sign Up & FAQ’s
Q: Is there a fee for joining or getting referrals?
No, joining is FREE and there is no referral fee! We want to support integrative practitioners in any way we can. This was developed by an acupuncturist who understands the private practice of a holistic practitioner. We will be generating revenue from our dynamic CEU courses that we will offer to many different kinds of practitioners.
Q: Do I have to discount my services?
No, you will be covered for your services at YOUR published rate! However, rates will be evaluated by fellow practitioners prior to sending referrals to you. We do this to make sure they are within acceptable ranges for your profession, and the geographic area in which you practice. HOWEVER, when we send you a referral, you can know that your services will be a “covered benefit” for that employee/patient.
*Note- if you already participate in a national network such as Cigna, Aetna, etc. – you will be reimbursed based on your rates that you have already agreed to with that network. In other words, you will be reimbursed based on your rates that you have agreed to with that network OR YOUR FULL FEE, if you only participate with our network.
Q: Will my services be covered?
We will be promoting a wide variety of integrative modalities be covered for optimal health promotion. However, ultimately, it is up to each corporation to decide what they want to cover, and what they do not want to cover. That being said, if WE refer a patient to you, via our electronic referral system, it will be a covered benefit -until the employee’s coverage is used up for that time period (per year, per quarter, etc.). In addition, if an employee of a corporation does not have coverage for your services, and we referred them to you, you will know from day one that they will be a cash paying patient.
Q: Why are patients prescreened?
Prescreening is used to determine the appropriate modality and best practitioner placement for each unique patients needs. Also, we will “prequailfy” the employee to see if they have benefits (& for what integrative services), so when we send you a referral, you will know that your services will be a “covered benefit” for that employee/patient or if their company is not covering your services, and the patient will be paying cash. It is our intention to have as WIDE a variety of integrative services covered as possible.
Q: Will I be able to communicate with the patient’s other practitioners through the software?
Yes! As soon as the other practitioners provide treatment and are active participants in the patient’s care, there will be the ability for practitioners to contact each other through the software.
Q: Do I have to submit a HCFA bill?
The billing will be done electronically, and may or may not be a HCFA (depending on the practitioner’s situation). However, our goal is for the form to be VERY user friendly and simple to use.
Q: If I choose not to join, will I continue to receive emails?
Only if you choose to. You can opt out at anytime, and of course we do not sell or share email addresses.
Q: Who determines level of reimbursement?
We are encouraging the healthcare system to move towards a paradigm of price transparency. Therefore, you as the practitioner will set your own rates, just as you would in your practice.
Q: Can I bill for multiple modalities?
It will depend on the type of care that is being delivered on a case-by-case basis. What we are going to be encouraging is that patients get the care they need- no more and no less. This system is about making sure people get well and stay well and we can lower costs by not overbilling the system (and also not restricting care). You will be evaluated based on your cost-effectiveness of the care that you deliver. You will also be evaluated by the patient on the quality of the care that you delivered. If you are found to be a practitioner that delivers great results for a good price (thus providing a good value) then you will receive many referrals. If there is a trend that you are overbilling the system and not delivering good patient health outcomes (compared to other practitioners), then you will subsequently receive less and less referrals. The bottom line is, “do a good job” and we will see the results via employee claims savings (of Western medicine $), reduced absenteeism and presenteeism.
Q: Are you doing any sort of screening of practitioner qualifications?
Yes, we will be screening all of the practitioners in our network for license, malpractice insurance (if applicable), certifications, schooling, qualifications, training, etc. We will also be asking how long you have been in practice. For some modalities we will only be accepting certian qualifications.
Q: Related-on the patient side-what are the patients told about the skill level, qualifications of practitioners involved.
Potential patients will be educated about the qualifications, the number of years the practitioner has been in practice, and the school that the practitioner attended, what the practitioner charges for their services, to name a few.
Q: What sort of systems will I need (as a practitioner) in order to interface with the Electronic Medical Records (EMR) system?
YOU WILL NOT NEED TO PURCHASE ANY ADDITIONAL SOFTWARE. You will need access to a high-speed Internet connection and access to a computer (or tablet). Ideally you would be able to scan in documents and upload them to the system, however that is not a requirement. The trend in healthcare is to have everyone on HIPAA secure, electronic medical records. If you are not there yet this will encourage you to head in that direction. This system will be designed for holistic practitioners, and it will be very user-friendly. If you choose not to participate any longer in our program, you can download that Patients records for your clinic records at no charge before you exit.
Q: What will reimbursement be like?
Our goal is to have practitioners reimbursed automatically through direct deposit from the third-party administrators (who pay the bills on behalf of the corporations) into a bank account of the practitioner’s choosing. However, initially it may be sent as a check via the mail. Most likely you will receive the check within 7 to 10 business days (or less) depending on where in the country you live in relation to the third-party administrator. If you are a practitioner that has experience dealing with large insurance companies that delay payment, we believe you will find this process refreshingly easy!
* Note – Insurance Contracted Providers
If you are contracted with an insurance company (ex: Cigna, Aetna, etc.) whose network is utilized by the corporation for the employee health benefits plan from which the employee referral comes, you will need to refer to your insurance company provider contract to decide how to bill. Chances are you will bill as you ordinarily would through that insurance company. If not, you will receive reimbursement as the other integrative practitioners would through the corporate plan directly through the third-party administrator who pays the practitioners on behalf of the corporation. This may be determined based on the situation of the pre-existing contractual arrangements you may have and/or laws of the State you practice in.
Q: Can I read the Provider Agreement before I sign up?
Absolutely, if you scroll down this page on the right you will see the Agreement. You can download it as a PDF document.
* License and Malpractice
If you practice a modality that is a licensed profession, we will require a copy of your current active license, and active malpractice insurance coversheet be uploaded into our system. This will be mandatory for chiropractors, acupuncturists, massage therapy, ND, MD, NP, PA, and any other modality that has licensure. This will be required for final approval and inclusion into the integrative medicine provider network.
We will be sending you instructions in the next several weeks about how to do that by uploading it into the software system.