I recently read an article that indicated it would be great if yoga was covered by insurance. It stated that with the evidence based research coming out showing that yoga benefits people suffering with many different illnesses, it is likely that insurance companies will include yoga. It also stated that yoga therapy could save insurance companies a lot of money. I might be one of the few yoga teachers horrified by the prospect.
I have been a provider with insurance companies. As a chiropractor I accepted insurance and billed insurance companies on behalf of patients. When I started practicing chiropractic January 2000, Blue Cross Blue Shield paid $39.00 for an adjustment (code 98943). For that same code in 2009, BCBS paid $29.64. Just to be clear, that was the allowable amount. So if a patient had a $20 co-pay, the patient paid $20 and BCBS paid $9.64. It wasn’t just BCBS that lowered rates paid to doctors over the 10 years I practiced. It was across the board, all insurance companies did it.
So while the cost of living increased, my office space rent increased, the insurance company employees pay increased, the CEOs received huge bonuses; the insurance companies paid doctors less. At the same time they raised insurance rates significantly, each year. I know this because I paid for my own insurance. When you have a small business, you are responsible for providing your own healthcare benefits. My rates increase about $30 per month each year. Pretty soon, I won’t be able to pay for health insurance – rates will be just too high. As for my insurance, it’s not a fancy plan. I have a huge deductible and a $50 co-pay.
Here is another thing about insurance companies – they will do whatever they can to cut costs. As a chiropractor, I would have to fill out pages of notes and do hours worth of tests to show care was needed. That wasn’t a problem. Of course, I was doing care that was needed. I did a very thorough examination and took great, legible notes. I would submit them to the insurance company in a timely manner and then they would deny care for the patient. There were no logical or “medical” reasons to deny care. When you enter a contract with them, they state they can deny care. They don’t pay and because you agree to their terms, you cannot bill the patient. Another tactic they like to use is to originally tell you they will pay for care and once you submit your bills, they deny payment.
Truly the experience for many doctors’ offices is horrifying. There are billing departments that just fight claims all day. Their job is to fight for payment for services already rendered. You have to have a lot of cash to get you through because you will not get paid in a timely manner. Yoga teachers are similar to chiropractors in their desire to help people. My first year of practice, I wrote off the same amount of money as I collected. That means I only got paid for half of the service I provided. It’s really hard to survive that way.
Most yoga studios do not have the time, space or energy to waste fighting for payment. I cannot imagine the day that yoga studios have insurance departments. And if you think it won’t happen to yoga, you are wrong. It happens to all doctors, psychologists, counselors, physical therapists and occupational therapists. It happens to all service providers that enter into contacts with insurance companies.
Insurance companies also pay different providers different rates for the same or similar services. Here is a comparison. I went to an allergist to find out what I was allergic to. I was in the office about 2 hours for my first visit. The nurse took my vitals, about 5 minutes and asked some questions about 5 minutes. The doctor came in and asked me the same questions the nurse asked and a few more totaling about 10 minutes. They office billed my insurance company $511.00. The allowable amount was $222.68 – I paid $50 and the insurance company paid $172.68. Now a patient would come to my office for a first visit. He or she would be in the office for less than two hours, maybe an hour to an hour and half. In that time the patient would be with me. I would perform a thorough case history and do a physical examination and evaluation. Depending on the individual, I would either adjust her or send her out for more tests first. I would bill the same code as my allergist’s office. I was with the patient much longer and did a complete evaluation. I would bill about $105.00. The allowable amount depended on insurance companies. The same company that allowed $222.68 to my allergist paid me zero. Yes, nothing. They did not pay chiropractics for examinations. Some other companies would pay between $25-65. Do you think they will pay a yoga teacher more?
A few years ago I had someone ask me if I accepted insurance at the yoga studio because their insurance company paid for yoga. I told them I did not. However, I was curious as to what the insurance company paid. I inquired about the process and payment. The insurance company said they did cover yoga. How did it work? You, as a yoga teacher, become a provider. As a provider you agree to discount their clients 25%. They pay nothing. That is how they cover yoga…
The insurance situation has not gotten better. Look into how many doctors no longer take insurance. Many doctors will only provide “out of network” benefits. The cost of practice and living is too high for doctors to survive on the minimal fees from insurance companies. I think insurance is there for catastrophe coverage. We need to have it. However, yoga does not need to get swept up in its mess.