Setting up your Naturopathic Office

How to Use the BCNA Fee Schedule

Why a Fee Schedule?

There are both practical and professional reasons. Practically, it’s important to recognize the cost of running an independent clinic, to create consistency across the province, to have a guideline to share with third parties, and to have a benchmark against what is being charged by similar practitioners. Also, it’s in the BCNA Constitution that the association develop and have the membership endorse a fee schedule.

But a second and equally important reason is about success and professionalism. Having a schedule endorsed by the membership helps to better position naturopathic medicine for success in the marketplace and our collective success as doctors. Establishing, and using a uniform schedule, shows that NDs are a unified profession. This is an essential step in terms of industry branding and helping the public identify with NDs as qualified primary care providers. Finally, it sets and creates expectations for patients in terms of what ND services cost and diminishes questions around fee variances.

How Was the Schedule Developed?

A special committee was struck at last year’s AGM. Dr. Kira Cai is the Chair. Her committee includes Drs. MJ Atkins, Sacha Elliott, Pam Hutchison and Bobby Parmar. Directors first collated existing schedules, online and through clinic contact, to create a range of averages and medians. In addition, the committee created a program to examine loaded costs (i.e., what it actually costs to perform a therapy or test). Finally, they looked at market costs; what is currently charged by NDs as well as other practitioners, for the same or similar services.

The committee spent several months collating, compiling and developing a loaded cost model. The preliminary work was completed in early 2014 showing a compensation schedule in keeping with common naturopathic clinic fees in BC. After additional feedback from the BCNA Board a final version was created for the membership.

Isn’t There Already a Fee Schedule?

The CAND has a schedule which covers some items, such as consults, with a very broad range of fee recommendations, so as to embrace all provinces in the country. BC has the most advanced scope of practice in Canada; the fees in BC are necessarily different than non-licensed jurisdictions. It was important that BCNA has a schedule which represents the current practice of naturopathic medicine in a detailed and thorough fashion. Additionally, the CAND does not have a loaded cost model for members to gauge expenses, profit and loss.

When Will the Fee Schedule Be Implemented?

The fee schedule was officially endorsed at the AGM in 2014 after a lengthy presentation outlining various points and how each fee item was determined.

Will Members Be Forced to Adhere to the Schedule?

No. Members are free to charge whatever fees they consider appropriate. The schedule is meant as a guideline. BCNA will encourage members to adhere to the schedule, to charge within 10 per cent of the recommended fees. BCNA will not force members to adhere to the schedule or monitor fees charged. Using the fee schedule is completely voluntary.

However, once the membership has endorsed a fee schedule, BCNA will use that with government, extended health insurers, and others, as a guideline for the profession. That means that insurers, using the “reasonable and customary” rule on fees, may not reimburse your patients if you are outside the 10 per cent range.

How Do I Gauge My Clinic’s Loaded Costs?

The BCNA is introducing a member program at the AGM, along with the fee schedule. It will allow individual doctors, or several doctors in a clinic, to enter in overhead costs; specific items such as patients treated, services offered, and common overhead costs such as utilities, lease costs, supplies, insurance, dues and CE, can be entered into a spreadsheet which calculates a unique report. Using the program will help a member determine actual costs per service (e.g., actual cost to administer an IV or perform acupuncture). The program will be demonstrated and explained at the AGM, then available for members to access through the BCNA member portal.

Is the Fee Schedule Static?

No. If endorsed at the AGM, BCNA intends to review and modify, if required, at least every 24 months.