tag:typepad.com,2003:weblog-1250480 %ISSUE_DATE%T09:25:32-07:00 Tips and information. TypePad tag:mpamedia.com,2008:post-56518 2013-05-13T12:00:32-07:00 2013-05-13T12:00:07-07:00

American Chiropractic Association (ACA) Vice President, Anthony Hamm, DC, FACO, has been re-elected co-chair of the American Medical Association's (AMA) RVS Update Committee (RUC) Health Care Professionals Advisory Committee Review Board (HCPAC). The RUC HCPAC develops recommendations on relative values for new and revised CPT codes reported principally by non-MD/DO professionals. Dr. Hamm's second two-year term begins in October.

American Chiropractic Association (ACA) Vice President, Anthony Hamm, DC, FACO, has been re-elected co-chair of the American Medical Association's (AMA) RVS Update Committee (RUC) Health Care Professionals Advisory Committee Review Board (HCPAC). The RUC HCPAC develops recommendations on relative values for new and revised CPT codes reported principally by non-MD/DO professionals. Dr. Hamm's second two-year term begins in October. tag:mpamedia.com,2008:post-56517 2013-06-01T12:00:32-07:00 2013-06-01T12:00:07-07:00

Recently Dynamic Chiropractic published a front-page article about various state essential health benefits and referred to Oregon and four other states not currently providing chiropractic as a covered benefit.

By Vern Saboe, DC, DACAN, DABFP, FACO; Lobbyist, Oregon Chiropractic Association Recently Dynamic Chiropractic published a front-page article about various state essential health benefits and referred to Oregon and four other states not currently providing chiropractic as a covered benefit. tag:mpamedia.com,2008:post-56510 2013-05-06T12:00:32-07:00 2013-05-06T12:00:07-07:00

On April 18, 2013, in an historic victory for the chiropractic profession, the Michigan Court of Appeals ruled that MAC lawsuits against Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network (BCN) could move forward as class-action lawsuits, meaning that damages could be awarded.

On April 18, 2013, in an historic victory for the chiropractic profession, the Michigan Court of Appeals ruled that MAC lawsuits against Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network (BCN) could move forward as class-action lawsuits, meaning that damages could be awarded. tag:mpamedia.com,2008:post-56507 2013-06-01T12:00:32-07:00 2013-06-01T12:00:07-07:00

As our world becomes more and more reliant on technology, equipment becomes more dependable and we become increasingly more comfortable with e-mail, the fax machine, the Internet and the smartphone, it is becoming easier and easier to work away from the office. This practice is referred to as telecommuting or, in the words of the Bureau of Labor Statistics' Occupational Outlook Quarterly, "the portable job."

By Paul Hooper, DC, MPH As our world becomes more and more reliant on technology, equipment becomes more dependable and we become increasingly more comfortable with e-mail, the fax machine, the Internet and the smartphone, it is becoming easier and easier to work away from the office. This practice is referred to as telecommuting or, in the words of the Bureau of Labor Statistics' Occupational Outlook Quarterly, "the portable job." tag:mpamedia.com,2008:post-56481 2013-05-15T12:00:32-07:00 2013-05-15T12:00:07-07:00

I have been planning for some time to write an article about how traditional SOAP notes do not fit chiropractic practice, and the unfairness of holding DCs to a model clearly created for and primarily applicable to medical physicians.

By James Edwards, DC I have been planning for some time to write an article about how traditional SOAP notes do not fit chiropractic practice, and the unfairness of holding DCs to a model clearly created for and primarily applicable to medical physicians. tag:mpamedia.com,2008:post-56476 2013-05-15T12:00:32-07:00 2013-05-15T12:00:07-07:00

Even with federal sequestration cuts taking effect in March, including a 2 percent reduction in Medicare reimbursement to health care providers, hope may be on the horizon in the form of a much-anticipated, perpetually suggested overhaul of Medicare's Sustainable Growth Rate formula, which serves as the basis for determining physician reimbursement.

By Editorial Staff Even with federal sequestration cuts taking effect in March, including a 2 percent reduction in Medicare reimbursement to health care providers, hope may be on the horizon in the form of a much-anticipated, perpetually suggested overhaul of Medicare's Sustainable Growth Rate formula, which serves as the basis for determining physician reimbursement. tag:mpamedia.com,2008:post-56450 2013-04-15T12:00:32-07:00 2013-04-15T12:00:07-07:00

Chiropractic practices often encounter patients who are significantly limited in one or more major life activities. It is the treating chiropractor's responsibility to document any impairment or limitations as it relates to one or more body systems. Doing so is a duty to the patient that impacts not only their health, but also future claims and accommodations being sought. A chiropractor's documentation also may represent the patient's "protection" under the ADA (American Disability Act) of a physical impairment that limits certain activities.

By Nancy Martin-Molina, DC, QME, MBA, CCSP Chiropractic practices often encounter patients who are significantly limited in one or more major life activities. It is the treating chiropractor's responsibility to document any impairment or limitations as it relates to one or more body systems. Doing so is a duty to the patient that impacts not only their health, but also future claims and accommodations being sought. A chiropractor's documentation also may represent the patient's "protection" under the ADA (American Disability Act) of a physical impairment that limits certain activities. tag:mpamedia.com,2008:post-56446 2013-04-15T12:00:32-07:00 2013-04-15T12:00:07-07:00

Although most chiropractors may not have heard of the term organized delivery system (ODS), most doctors readily recognize the names Triad Healthcare, American Health Specialty Network (ASHN), OptumHealth and other entities licensed as an ODS. Recent legal headlines have brought to light that the carrier-ODS relationship may be teetering, under pressure from regulators, doctors, patients and legislators for questionable practices that have been negatively impacting chiropractic care. Here's a sampling of some of the major ODS players impacting chiropractic patients and providers, including a synopsis of some of their dubious tactics challenged in court by the chiropractic profession over the past several years.

By Editorial Staff Although most chiropractors may not have heard of the term organized delivery system (ODS), most doctors readily recognize the names Triad Healthcare, American Health Specialty Network (ASHN), OptumHealth and other entities licensed as an ODS. Recent legal headlines have brought to light that the carrier-ODS relationship may be teetering, under pressure from regulators, doctors, patients and legislators for questionable practices that have been negatively impacting chiropractic care. Here's a sampling of some of the major ODS players impacting chiropractic patients and providers, including a synopsis of some of their dubious tactics challenged in court by the chiropractic profession over the past several years. tag:mpamedia.com,2008:post-56415 2013-04-01T12:00:32-07:00 2013-04-01T12:00:07-07:00

Although one of the fundamental principles guiding the Patient Protection and Affordable Care Act (PPACA) is to provide affordable insurance for all, the legislation undoubtedly targets the estimated 40-50 million Americans who currently do not have health insurance; and even more specifically, the millions who cannot afford to purchase insurance for themselves and/or their families. And while patients in all economic brackets often choose to pay for chiropractic care out of pocket, whether by choice or lack of coverage for chiropractic services, it is a relatively safe assumption that patients who cannot afford health insurance also cannot afford chiropractic care.

By Peter W. Crownfield, Executive Editor Although one of the fundamental principles guiding the Patient Protection and Affordable Care Act (PPACA) is to provide affordable insurance for all, the legislation undoubtedly targets the estimated 40-50 million Americans who currently do not have health insurance; and even more specifically, the millions who cannot afford to purchase insurance for themselves and/or their families. And while patients in all economic brackets often choose to pay for chiropractic care out of pocket, whether by choice or lack of coverage for chiropractic services, it is a relatively safe assumption that patients who cannot afford health insurance also cannot afford chiropractic care. tag:mpamedia.com,2008:post-56405 2013-03-15T12:00:32-07:00 2013-03-15T12:00:07-07:00

Consistent, current and complete health care documentation is an essential component of quality patient care. Practitioners are required to maintain uniform, organized records containing patient demographics, history and treatment information. To facilitate communication and promote efficient and effective treatment, Medicare has implemented the Physician Quality Reporting System (PQRS). This program will be mandatory beginning in 2015. For the 2013 PQRS reporting period, two measures are required for chiropractors: Pain Assessment and Functional Outcome Assessment.

By Ronald Feise, DC and J. Michael Menke, MA, DC, PhD Consistent, current and complete health care documentation is an essential component of quality patient care. Practitioners are required to maintain uniform, organized records containing patient demographics, history and treatment information. To facilitate communication and promote efficient and effective treatment, Medicare has implemented the Physician Quality Reporting System (PQRS). This program will be mandatory beginning in 2015. For the 2013 PQRS reporting period, two measures are required for chiropractors: Pain Assessment and Functional Outcome Assessment. tag:mpamedia.com,2008:post-56404 2013-03-15T12:00:32-07:00 2013-03-15T12:00:07-07:00

Many years ago, I contributed a regular column to Dynamic Chiropractic focused on occupational issues and the role the chiropractor plays. It's been a long time since I've contributed anything, so it's good to be back again. These days I write a blog on things related to worker's compensation, so in my ramblings this time, I'm going to focus my attention on the worker's compensation system and where chiropractors fit in.

By Paul Hooper, DC, MPH Many years ago, I contributed a regular column to Dynamic Chiropractic focused on occupational issues and the role the chiropractor plays. It's been a long time since I've contributed anything, so it's good to be back again. These days I write a blog on things related to worker's compensation, so in my ramblings this time, I'm going to focus my attention on the worker's compensation system and where chiropractors fit in. tag:mpamedia.com,2008:post-56374 2013-02-15T12:00:32-07:00 2013-02-15T12:00:07-07:00

It seems to take Congress a little longer every year, but doctors of chiropractic and other health care providers who treat Medicare patients can rest easy (for now), semi-secure in the knowledge that they have again avoided dramatic fee reductions just as they were about to take effect.

By Editorial Staff It seems to take Congress a little longer every year, but doctors of chiropractic and other health care providers who treat Medicare patients can rest easy (for now), semi-secure in the knowledge that they have again avoided dramatic fee reductions just as they were about to take effect. tag:mpamedia.com,2008:post-56373 2013-02-15T12:00:32-07:00 2013-02-15T12:00:07-07:00

ACA Takes on ASHN, CIGNA; Palmer Recruiting Participants for Two NIH-Funded Studies; Palmer Appoints New Board Member, Reappoints Four; Life West Faculty Published in Journal of Chiropractic Education; Founding Member of NBCE Passes Away.

By Editorial Staff ACA Takes on ASHN, CIGNA; Palmer Recruiting Participants for Two NIH-Funded Studies; Palmer Appoints New Board Member, Reappoints Four; Life West Faculty Published in Journal of Chiropractic Education; Founding Member of NBCE Passes Away. tag:mpamedia.com,2008:post-56364 2013-02-15T12:00:32-07:00 2013-02-15T12:00:07-07:00

Last year [May 20, 2012 issue], Dr. Tom Necela wrote an article about audits - how to "Protect Against and Profit From Them." It was all about looking at your records and stats, recognizing the issues and correcting the problems. Toward the end of the article, he advocated a self-audit to make sure your documentation is up to par.

By Douglas R. Briggs, DC, Dipl. Ac. (IAMA), DAAPM Last year [May 20, 2012 issue], Dr. Tom Necela wrote an article about audits - how to "Protect Against and Profit From Them." It was all about looking at your records and stats, recognizing the issues and correcting the problems. Toward the end of the article, he advocated a self-audit to make sure your documentation is up to par. tag:mpamedia.com,2008:post-56362 2013-03-01T12:00:32-07:00 2013-03-01T12:00:07-07:00

S.O.A.P: We all learned it in school and we all do our best to follow it in our daily charting of patient encounters. My good friend Dr. Mario Fucinari expresses it as a formula: S+O=A yields P. Your subjective findings plus your objective observations equal your assessment, which leads to your plan. Simple. Easy to understand.

By Ronald Short, DC, MCS-P S.O.A.P: We all learned it in school and we all do our best to follow it in our daily charting of patient encounters. My good friend Dr. Mario Fucinari expresses it as a formula: S+O=A yields P. Your subjective findings plus your objective observations equal your assessment, which leads to your plan. Simple. Easy to understand. tag:mpamedia.com,2008:post-56327 2013-01-16T12:00:32-07:00 2013-01-16T12:00:07-07:00

The American Chiropractic Association (ACA) has filed a class-action lawsuit against American Specialty Health Inc. and American Specialty Health Networks Inc. (collectively, "ASHN"), and CIGNA Corporation and Connecticut General Life Insurance Company (collectively, "CIGNA"). The litigation alleges a litany of problems with the defendants, including arbitrary reductions of care, lack of communication to providers and patients resulting in coverage and payment errors, and interference with doctors' duty to exercise professional clinical judgment in managing patients' treatment plans.

The American Chiropractic Association (ACA) has filed a class-action lawsuit against American Specialty Health Inc. and American Specialty Health Networks Inc. (collectively, "ASHN"), and CIGNA Corporation and Connecticut General Life Insurance Company (collectively, "CIGNA"). The litigation alleges a litany of problems with the defendants, including arbitrary reductions of care, lack of communication to providers and patients resulting in coverage and payment errors, and interference with doctors' duty to exercise professional clinical judgment in managing patients' treatment plans. tag:mpamedia.com,2008:post-56312 2013-01-15T12:00:32-07:00 2013-01-15T12:00:07-07:00

I recently noticed my fees being reduced by several payers. I inquired about the reductions, and the payers stated that it is a "multi-procedure" reduction. What does this mean and is it legal for them to reduce my fees in this manner?

By Samuel A. Collins I recently noticed my fees being reduced by several payers. I inquired about the reductions, and the payers stated that it is a "multi-procedure" reduction. What does this mean and is it legal for them to reduce my fees in this manner? tag:mpamedia.com,2008:post-56286 2013-01-15T12:00:32-07:00 2013-01-15T12:00:07-07:00

While health care conversations increasingly mention chiropractic care as a viable option for back and neck pain - and research increasingly supports its utility from a clinical standpoint - a recent nationwide study of complementary and alternative medicine (CAM)-related health care expenditures by 12,000-plus adults (ages 17 and older) with spinal conditions lends support to the suggestion that CAM in general, and chiropractic specifically, is also a cost-effective alternative to traditional medical care.

By Peter W. Crownfield, Executive Editor While health care conversations increasingly mention chiropractic care as a viable option for back and neck pain - and research increasingly supports its utility from a clinical standpoint - a recent nationwide study of complementary and alternative medicine (CAM)-related health care expenditures by 12,000-plus adults (ages 17 and older) with spinal conditions lends support to the suggestion that CAM in general, and chiropractic specifically, is also a cost-effective alternative to traditional medical care. tag:mpamedia.com,2008:post-56285 2013-01-15T12:00:32-07:00 2013-01-15T12:00:07-07:00

While chiropractic appears to be increasingly well-positioned courtesy of the Patient Protection and Affordable Care Act, with recent suggestion that many states are including chiropractic as an essential benefit, the health care reform law may have some unintended drawbacks for the profession. Case in point: American Specialty Health will no longer provide employer-direct insurance in California, which affects approximately 63,000 subscribers who currently have access to chiropractic and other alternative health benefits. Learn more from Lloyd Friesen, DC, ASH vice president of public affairs, and Douglas Metz, DC, chief health services officer and executive vice president, in this exclusive interview.

While chiropractic appears to be increasingly well-positioned courtesy of the Patient Protection and Affordable Care Act, with recent suggestion that many states are including chiropractic as an essential benefit, the health care reform law may have some unintended drawbacks for the profession. Case in point: American Specialty Health will no longer provide employer-direct insurance in California, which affects approximately 63,000 subscribers who currently have access to chiropractic and other alternative health benefits. Learn more from Lloyd Friesen, DC, ASH vice president of public affairs, and Douglas Metz, DC, chief health services officer and executive vice president, in this exclusive interview. tag:mpamedia.com,2008:post-56273 2012-12-16T12:00:32-07:00 2012-12-16T12:00:07-07:00

There is considerable frustration with insurance coverage today. It seems any number of plans routinely deny coverage, sometimes for no clear reason. Often, the denial has nothing to do with the provider, the therapies, the techniques or the care plan. It also has nothing to do with how the patient feels, whether the patient likes care or even if they want care. Many times the denial indicates that the care provided is not showing measured benefit for the patient.

By Douglas R. Briggs, DC, Dipl. Ac. (IAMA), DAAPM There is considerable frustration with insurance coverage today. It seems any number of plans routinely deny coverage, sometimes for no clear reason. Often, the denial has nothing to do with the provider, the therapies, the techniques or the care plan. It also has nothing to do with how the patient feels, whether the patient likes care or even if they want care. Many times the denial indicates that the care provided is not showing measured benefit for the patient. tag:mpamedia.com,2008:post-56257 2013-01-01T12:00:32-07:00 2013-01-01T12:00:07-07:00

If you are not reporting PQRS measures successfully in 2013, your fees will be reduced in the future! CMS gave providers five years (2008-2012) to learn how to properly participate in Medicare's Physician Quality Reporting System (PQRS). It even paid a bonus if you participated and did it right. The good news? The bonus will continue through 2014. The bad news? Starting in 2015 there will be a penalty (a reduction in your fees) if you are not participating or not doing it right. The worse news? That penalty will be based on your performance in 2013.

By Susan McClelland If you are not reporting PQRS measures successfully in 2013, your fees will be reduced in the future! CMS gave providers five years (2008-2012) to learn how to properly participate in Medicare's Physician Quality Reporting System (PQRS). It even paid a bonus if you participated and did it right. The good news? The bonus will continue through 2014. The bad news? Starting in 2015 there will be a penalty (a reduction in your fees) if you are not participating or not doing it right. The worse news? That penalty will be based on your performance in 2013. tag:mpamedia.com,2008:post-56246 2012-12-02T12:00:32-07:00 2012-12-02T12:00:07-07:00

The Office of Inspector General for Health and Human Services released its Fiscal Year 2013 Work Plan on Oct. 2, 2012. Chiropractic is listed in this year's plan just as we were listed in last year's. The work plan states: "Chiropractors - Part B Payments for Noncovered Services. We will review Medicare Part B payments for chiropractic services to determine whether such payments were in accordance with Medicare requirements.

By Ronald Short, DC, MCS-P The Office of Inspector General for Health and Human Services released its Fiscal Year 2013 Work Plan on Oct. 2, 2012. Chiropractic is listed in this year's plan just as we were listed in last year's. The work plan states: "Chiropractors - Part B Payments for Noncovered Services. We will review Medicare Part B payments for chiropractic services to determine whether such payments were in accordance with Medicare requirements. tag:mpamedia.com,2008:post-56214 2012-11-18T12:00:32-07:00 2012-11-18T12:00:07-07:00

I am thinking of using a Groupon-style service and want to know, how would I bill for this type of service when the patient has insurance?

By Samuel A. Collins I am thinking of using a Groupon-style service and want to know, how would I bill for this type of service when the patient has insurance? tag:mpamedia.com,2008:post-56122 2012-10-07T12:00:32-07:00 2012-10-07T12:00:07-07:00

Chiropractic's role in state worker's compensation systems appears to be increasingly tenuous, as evidenced by proposed legislation in several states including California, where Senate Bill 863 is currently under deliberation. In The Golden State, the California Chiropractic Association is vigorously opposing SB 863, which the CCA contends "would eliminate the right for injured workers to select a doctor of chiropractic specialist as a Qualified Medical Examiner, and would prohibit a [DC] who has reached the 24-visit treatment cap from continuing to manage the patient's care – even if the doctor is within the employer's Medical Provider Network."

By Editorial Staff Chiropractic's role in state worker's compensation systems appears to be increasingly tenuous, as evidenced by proposed legislation in several states including California, where Senate Bill 863 is currently under deliberation. In The Golden State, the California Chiropractic Association is vigorously opposing SB 863, which the CCA contends "would eliminate the right for injured workers to select a doctor of chiropractic specialist as a Qualified Medical Examiner, and would prohibit a [DC] who has reached the 24-visit treatment cap from continuing to manage the patient's care – even if the doctor is within the employer's Medical Provider Network." tag:mpamedia.com,2008:post-56111 2012-09-09T12:00:32-07:00 2012-09-09T12:00:07-07:00

I have written many times about the importance of thorough documentation (in fact, this may be becoming the general theme of my column). As much as it does not serve to beat the proverbial dead horse, I have reason to visit that topic again. I was recently called to give my opinions on standards of care in a deposition for a malpractice case. While on vacation, the patient had seen another practitioner - this doctor called her regular treating doctor and got a slew of treatment notes. He then rendered care he felt was very similar to what was reflected in the provided records.

By Douglas R. Briggs, DC, Dipl. Ac. (IAMA), DAAPM I have written many times about the importance of thorough documentation (in fact, this may be becoming the general theme of my column). As much as it does not serve to beat the proverbial dead horse, I have reason to visit that topic again. I was recently called to give my opinions on standards of care in a deposition for a malpractice case. While on vacation, the patient had seen another practitioner - this doctor called her regular treating doctor and got a slew of treatment notes. He then rendered care he felt was very similar to what was reflected in the provided records. tag:mpamedia.com,2008:post-56090 2012-08-26T12:00:32-07:00 2012-08-26T12:00:07-07:00

The health care community's on-going "scramble" to prepare for adoption of the International Classification of Diseases, 10th Edition (ICD-10) got a welcome reprieve recently when the Department of Health and Human Services announced a proposed delay in the compliance deadline until Oct. 1, 2014. Now the American Medical Association has taken the conversation a step further, proposing at its 2012 House of Delegates meeting that ICD-11 be considered as a possible option to replace ICD-9, effectively bypassing ICD-10 implementation altogether.

By Editorial Staff The health care community's on-going "scramble" to prepare for adoption of the International Classification of Diseases, 10th Edition (ICD-10) got a welcome reprieve recently when the Department of Health and Human Services announced a proposed delay in the compliance deadline until Oct. 1, 2014. Now the American Medical Association has taken the conversation a step further, proposing at its 2012 House of Delegates meeting that ICD-11 be considered as a possible option to replace ICD-9, effectively bypassing ICD-10 implementation altogether. tag:mpamedia.com,2008:post-56078 2012-08-26T12:00:32-07:00 2012-08-26T12:00:07-07:00

The Official Disability Guidelines (ODG) "provide evidence-based disability duration guidelines and benchmarking data for every reportable condition." With the recent appointment of Dr. Ronald Farabaugh, past chair of the Council on Chiropractic Guidelines and Practice Parameters and past president of the Ohio State Chiropractic Association, to the ODG Advisory Board, Dr. Jay Greenstein, CCGPP vice chair, sat down with Dr. Farabaugh to learn more about the ODG and why they – and guidelines in general – are so important to the chiropractic profession.

The Official Disability Guidelines (ODG) "provide evidence-based disability duration guidelines and benchmarking data for every reportable condition." With the recent appointment of Dr. Ronald Farabaugh, past chair of the Council on Chiropractic Guidelines and Practice Parameters and past president of the Ohio State Chiropractic Association, to the ODG Advisory Board, Dr. Jay Greenstein, CCGPP vice chair, sat down with Dr. Farabaugh to learn more about the ODG and why they – and guidelines in general – are so important to the chiropractic profession. tag:mpamedia.com,2008:post-56077 2012-09-09T12:00:32-07:00 2012-09-09T12:00:07-07:00

Beginning in 2011, doctors of chiropractic were among the hundreds of thousands of American health care practitioners to received checks of up to $18,000 from the federal government for implementing electronic health records (EHR) in their clinics. These early adopters are eligible for up to $44,000 each. Approximately $2.8 billion has been paid so far to Medicare providers and hospitals that have met the standards for "meaningful use," with $16.5 million of that being paid to DCs.

By Steven Kraus, DC, DIBCN, CCSP, FASA, FICC and Robert Moberg Beginning in 2011, doctors of chiropractic were among the hundreds of thousands of American health care practitioners to received checks of up to $18,000 from the federal government for implementing electronic health records (EHR) in their clinics. These early adopters are eligible for up to $44,000 each. Approximately $2.8 billion has been paid so far to Medicare providers and hospitals that have met the standards for "meaningful use," with $16.5 million of that being paid to DCs.