FAQs Integrative Medicine Network
What is “Integrative Medicine” ? Integrative Medicine is an emerging medical specialty that incorporates the art and science of caring for the whole person –body, mind, and spirit –designed to treat and prevent disease. What is the IMN? Integrative Medicine Networks (IMN) is a national PPO of Integrative and Complementary and Alternative Medicine (CAM) Providers working to better serve patients by using a new set of health insurance reimbursement codes covering an additional 4000+ integrative medicine procedures, techniques, and modalities. What kinds of practitioners are joining the IMN? IMN is open to all medical and complementary medicine practitioners, including MDs, DOs, Chiropractors, Acupuncturists, Massage Therapists, Naturopathic Doctors, Nurses, and other allied health practitioners seeking to improve the health of their patients and clients and lower the cost of healthcare. What are key IMN Preferred Provider Membership Features and Benefits? Feature
Customized Encounter Forms by State and Modality, using ABC Codes Patient/Client Billing Statements
Benefit
Better and faster reimbursement from insurance companies paid directly to CAM practitioners when you identify codes for services provided Clients pay less out of pocket by submitting Billing Statements [with new ABC codes] directly to their insurance companies Available on CD-ROM, this insurance reimbursement “Bible” provides new ABC codes by state and modality Get additional patients/clients via IMN PPO Member network referrals Protects you by keeping your professional practice within your legal scope of practice
National CAM Coding Manual Direct Referrals Discount on Scope of Practice Guidebook
What is the cost of Membership? The Preferred Provider Membership cost $189 for the first year and includes many membership benefits [see chart]. Renewal memberships are priced at $89 per year.
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FAQs Integrative Medicine Network
Will insurance companies treat me differently if I am a credentialed IMN Preferred Provider? Yes. Being credentialed by IMN shows that you are serious about contributing to “Best Practices” and that you know how to accurately bill insurance companies with correct coding within your scope of practice Must I discount my professional fees to participate in your PPO network? No. CAM practitioners agree to a standard fee as part of the agreement to participate in the network The fees are based on Relative Value Units for each State and most of the time are at or near your current fees. RVUs establish the financial worth of specific interventions in relation to other interventions and support health economics studies, health insurance benefit plan design, managed care and provider contracting, utilization and clinical practice management, claims processing, outcomes research and a variety of actuarial analyses. What is a Patient/Client Encounter Form? An Encounter Form is a standardized insurance form that details the techniques, modalities, and procedures that you perform in your practice. .The form can be sent to insurance companies [by your office or given directly to the patient] for reimbursement. As a Preferred Provider you will receive Encounter Forms customized by state and modality. How many new ABC Codes are now in the process of being approved and implemented? Over 4,500 codes specific to 15 modalities are now being approved by exception by U.S. Department of Health and Human Services. Older medical code sets have significant gaps, because they do not adequately describe or reflect the care delivered by more than 3 million licensed healthcare practitioners and millions of other caregivers. What will happen to existing CPT Codes? Can I still use them? CPT codes will continue to be used and accepted by most payors for a number of years. ABC codes will be used in conjunction with CPT codes, are much more specific, and if documented correctly, will provide better reimbursement for you and your patients. Do CAM Practitioners need referrals from MDs in order to bill insurance companies with the new ABC Codes? No. Who is behind the ABC codes and how do they work? ABC codes were developed by Alternative Link of Albuquerque, NM specifically to help control costs and support consumer-driven healthcare. The new, supplemental coding system fills gaps that currently exist in older medical and dental coding systems and the national health information infrastructure.
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FAQs Integrative Medicine Network
ABC codes fit into the same forms, data fields, software applications, information systems and business processes as older HIPAA code sets, such as CPT, HCPCS II and CDT. These codes help healthcare consumers, practitioners and organizations gain more reliable information on the best practices of conventional, complementary and alternative medicine, so they can make better health policy and personal healthcare decisions. What organizations are supporting ABC codes? A number of organizations have publicly disclosed their use or planned deployment of ABC codes, including: Acupuncture and Oriental Medicine National Coalition Alternative Healthcare Options American Healthcare Alliance Bridges in Medicine Carolinas HealthCare System Integrative Medicine Networks Lovelace Sandia Health System Medical Professional Systems MediMerge Health Mitchell Medical National Assn. of Clinical Nurse Specialists N-CAM Wellness Benefits Company Preferred health Systems What about insurance fraud? Aren’t insurance companies suspect of these codes and practitioners? IMN Preferred Providers are trained to bill accurately and fairly subscribing to “Best Practices” treatment plans. Insurance companies recognize the value of Best Practices and the ability to lower overall healthcare costs. By documenting associated relative value units [RVUs] for provider contracts and fees, we assist qualified CAM practitioners in gaining appropriate reimbursement under health insurance programs. What access to CAM research can you offer me? IMN’s comprehensive CAM and integrative medicine library saves you time with
convenient 24/7 online access to thousands of articles and topics, allowing you to research specific patient health conditions and symptoms.
How do I join IMN? Three ways to join IMN: 1. Email: info@integrativemedicinenetworks.com and we’ll email you the CAM Provider Application 2. Call our Membership Director at 978-526-1110 3. Go to Welcome_General_IMN.pdf Download the application and fax to 978-231-0520 3