. Why should you care about something as abstract as Insurance Company Claims Codes?
Because your access to the natural, holistic and integrative therapies that you want for yourself and your family depend on how the companies code — or do not code — for those services. No code — no service coverage. And worse, no way to accumulate the data needed to prove that those very natural, holistic and integrative therapies are safer and more effective than the invasive techniques of state-licensed “standard of care” medicine. I’ve recently spoken or otherwise communicated with a very smart lady who is an expert in the arcane world of insurance coding.
. Here are my Notes from recent conversations with her: .
Right before former President Obama was elected, Big Pharma was spending $600K a day on lobbying Congress. To see the 2018 lobbying spend by company, see: https://www.opensecrets.org/lobby/indusclient.php?id=h04 — it’s over $212 million annually, with over 1,400 lobbyists employed. . Why is this money impacting every one of us? Because it’s easy to get “health care” as long as you see pill pushers or go to a hospital but you have to pay out of pocket if you want actual therapies that are not invasive and don’t rely on drugs and surgery. You could have this care without seeing a physician if there were codes to file insurance claims. . Big Pharma supports prescribers – not healers. The medical device industry is supported by hospitals and ongoing health problems – not by solving health problems. Big insurance prices insurance premiums at a minimum of 25% over expected claims – so it is not focused on saving money. This system intentionally keeps consumers in the dark according to Forbes: https://www.forbes.com/sites/danmunro/2013/02/11/healthcares-pricing-cabal/#5a3f3bd26700 . The government has mandated the entire industry use codes designed by and for physicians (known as CPT) which are developed by the AMA. But if you read the link the Forbes article, you will also see that the AMA developed the pricing for its coding system. . CPT codes have even more influence on government policy than just being named a mandatory standard. CPT is also known as HCPCS I. HCPCS II codes are developed by the Centers for Medicare and Medicaid Services. By contract with the AMA, HHS agreed to retire any HCPCS II codes that may duplicate CPT. The AMA got this monopoly by giving Medicare and Medicaid a free license for use of its codes. Every insurer, hospital and health provider in the country must pay licensing fees or royalties to the AMA for use of its codes. This generates anywhere from $70 – $150 million a year in revenue for the AMA – as stated in the Forbes article referenced above, the AMA effectively hides its CPT revenue by lumping it in with other products and services.) . Without effective coding no provider of integrative services can prove, in the eyes of FDA and other public health authorities, the safety and effectiveness of the therapy, thereby failing to provide the “risk/benefit analysis” which justifies, to Big Insurance, allowing the claim. . What can we do about it? For one, make sure that Section 2706, the Provider Nondiscrimination Clause, of the Affordable Care Act is not pulled, but instead, given sharper teeth.
Imagine if insurers had to pay for drugless and non-invasive therapies from any licensed health professional. You would not have to go to a physician to get diagnosed and sent home with a pharmaceutical. Your nurse practitioner could see you without having to follow the rules of being a physician extender. You could visit a massage therapist to reduce your stress or treat a tight muscle without having to take muscle relaxers or Prosac. You could see a holistic doctor and get vitamin or mineral IV therapy to enhance your immune system rather than be prescribed yet another round of damaging antibiotics – which were the initial cause of your immune system’s failure. . The integrative health care insurance case pending in New Jersey, if properly funded, could re-invigorate Section 2706, confirming that it covers integrative therapies. More about that here: http://vitaminlawyerhealthfreedom.blogspot.com/2018/12/provider-nondiscrimination-case.html .
All the evidence suggests if Insurance Companies did as their Premium-Payers wanted, and covered holistic and integrative therapies, their bottom line, and our health, would benefit significantly. . Support natural health therapies at the Institute’s Fundly crowd funding site here:CLICK HERE.
. Ralph Fucetola JD
Trustee, Natural Solutions Foundation
President, Institute for Health Research
. PS – don’t forget to assert your right to Informed Consent! Just say “No!” to mandated vaccines with the Advance Vaccine Directive https://tinyurl.com/AVDcard
Share with this link: http://drrimatruthreports.com/why-insurance-coding-matters-for-your-health-freedom/