Moda Dropping Beacon Members
Monday, September 24, 2018
Posted by: Beth Martin | Executive Director
We’ve gotten a number of reports that Moda will no longer be covering Naturopathic Physicians that are not credentialed as Patient Centered Primary Care Homes (PCPCH) or NDs who are credentialed as primary care providers (PCPs) through Moda effective January 1, 2019.
If you are currently providing primary care services to Beacon members, Moda is requesting that you direct your patients to visit www.mymoda.com, or call Moda customer service at 877-605-3229. Services provided to Beacon members on or after January 1, 2019 will be considered out-of-network and Moda’s individual products will not include insurance coverage for services provided by out-of –network providers.
We understand that this will be a blow to many ND practices, and that the Beacon Network will no longer offer reimbursements to most NDs. OANP is aware of the issue, have sent a complaint to the Oregon Health Authority, and are pursuing this issue with the Department of Consumer and Business Services (DCBS).
If you have patients that would like to keep you as their PCP, please have them fill out a complaint to the DCBS:
OANP is working with OHA to put together a PCPCH recognition "boot camp" for those clinics that are interested in achieving tier 1 PCPCH credentialing. If you or your clinic are interested in this, please email email@example.com.