Insurance Issues
Insurance Complaint Forms
February 1, 2010
Help Stave Off Drastic Medicare Cuts!
Call to
Action: Get Involved and Help Stop 21% Medicare Fee Cut Proposed for
2010
As we have previously reported, Congress has
delayed the 21% fee cuts that had been proposed for 2010 until March
1. Congress must take action prior to March 1 to address this decrease
for the remainder of the year. Please contact your member of Congress
today to urge them to block the implementation of these drastic fee
cuts. The easiest way to do so is to visit the
ACA Legislative Action Center* and create an e-mail message using
a template the ACA has created for your convenience.
* If you received this email by fax, the ACA
Legislative Action Center can be found by going to
www.acatoday.org, clicking on “Advocacy,” and then “Legislative
Action Center” in the menu at left.
February 25, 2009
Results
of the 2009 MAC Workers’ Compensation Survey
MAC Will Not Ignore Pattern of
Discriminatory Activity of Employers and WC Carriers
By: Dr. Donald Reno, MAC President
In late January, the MAC Weekly Review contained a survey regarding
Michigan’s workers’ compensation system – we specifically wanted to
gather information regarding chiropractic participation with workers’
comp and ways to increase this participation. The survey was developed
by MAC Board of Directors member Dr. Dennis Whitford of Mt. Pleasant,
our representative to the Workers’ Compensation Health Care Services
Advisory Committee. This important body is charged with reviewing
rules and regulations pertaining to health care benefits and services
under workers’ comp.
The results show that access to chiropractic care in Michigan’s
workers’ compensation system is sorely lacking. The results show:
73 percent of respondent doctors do not see as many Workers’ Comp
patients as they would like
93 percent would take on more Workers’ Comp cases if patients had
direct access to chiropractic services
63 percent have had a patient told by their employer, after the
“10-Day Rule” has expired,” not to see a chiropractor
51 percent have had a patient told by the workers’ comp carrier,
after the “10-Day Rule” has expired, not to see a chiropractor
73 percent have had trouble collecting from workers’ comp carriers
49 percent have had a patient told they do not have a work injury
because they have a pre-existing condition
51 percent have had a workers’ comp carrier deny a service based on
an arbitrary managed care fee/utilization schedule
On February 10, Dr. Whitford presented this information to the
Workers’ Compensation Health Care Services Advisory Committee. His
first suggestion was to mandate a notification of the workers’ comp
rules to all injured workers. Second, he let the Committee know that
the MAC is not going to let this pattern of discriminatory activity of
carriers continue.
As a result of Dr. Whitford’s efforts and the findings of this survey,
the State is now working with him to survey third-party payers on
their policies toward chiropractic care. The MAC is committed to
ending discrimination against doctors of chiropractic and their
patients.
If you have any additional evidence of discrimination by employers or
workers’ comp carriers, please fill out the MAC Insurance Complaint
Form, which can be found online at www.chiromi.com/insurance.
Attention DCs Who Bill
BCBSM for 97012 and Other Physical Medicine Codes!
In the May 2008
edition of the BCBSM Record, on page 31, the following appeared:
When billing chiropractic claims, include all required documentation.
Chiropractors who bill using procedure code *97012 and other physical
therapy codes must include the following in their documentation in
the patient record to be reimbursed for this service:
-
The device
used to apply the therapy
-
The location
of the therapy (for example, cervical, thoracic, or lumbar region of the
spine
-
The time of
treatment (duration of the treatment)
-
The medical
reasoning (for example, to reduce a disc bulge or reduce scarring)
Please
note: The documentation must be included in the patient record. It is
not necessary to send it with the claims.
* CPT codes,
descriptions and two-digit numeric modifiers only are © 2007 American
Medical Association. All rights reserved.
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