As part of an ongoing campaign designed to address and correct the inappropriate practices of certain chiropractic managed care networks, the American Chiropractic Association is gathering information from doctors of chiropractic regarding past and current problems affecting patient care and reimbursement.
Specifically, the ACA is gathering information on these and other wrongful practices: automatic downcoding or limiting physician discretion in the planning of care; CPT code bundling; improper utilization review (including refusal to recognize coding modifiers); and performance management issues, such as limiting the number of visits, X-rays and modalities.
This aggressive anti-abuse campaign stems from a March 2002 ACA House of Delegates resolution that formally outlined the association's opposition to these improper practices by chiropractic networks, and authorized the collection of data to determine the types of abuses inflicted upon chiropractors by third-party administrators. As part of this process, the ACA recently retained prestigious plaintiff law firm Milberg Weiss to assist in data collection/analysis.
Several disturbing trends have emerged in reviewing data collected over the past three years from "managed care data collection" forms completed by doctors of chiropractic. Doctors of chiropractic appear most troubled by three managed care carriers: American Chiropractic Network (ACN), American Specialty Health Plans (ASHP), and Landmark Healthcare. According to doctors who completed data collection forms, these carriers routinely deny requested treatment and reduce or deny reimbursement.
"We have heard your complaints, and we are further analyzing our options to deal with these activities," emphasized ACA President Donald Krippendorf, DC. "We need your continued support and information to protect not only your practice and profession, but also the quality of care you provide your patients."
If you have experienced problems with chiropractic managed care carriers, particularly with respect to the restriction of treatment, downcoding, bundling, and/or improper use of modifiers, the ACA urges you to complete the data collection form available on the association's Web site:
www.acatoday.com/pdf/managed_care_collection.pdf. The completed form can be submitted via fax to 703-243-2593, Attention: PDR Department. All information will be kept confidential.
Additional information regarding the ACA's data collection campaign appears online at www.acatoday.com/insurance/managed_care/
resourcesheet.shtml.
When I graduated from chiropractic college in 1981 and started practice, I heard it all, and very little was positive. “You are a quack; you do not know what a subluxation is; you couldn’t get into a real health care program, so you chose the one that is slightly above a mail-order degree; you have no proof that chiropractic works; Are you really licensed?”, and so much more.
| Digital Exclusive
A central challenge in creating our identity is that chiropractic is a method of care, not a technique or procedure. This is an important concept for us to promote. Our patients are treated with lifestyle modification, exercise, nutritional supplements, diet and a whole-body approach to accelerate the natural healing process. We are not simply CMT providers.
The results of a global survey released late last year (2023) unveiled some startling findings among medical and nursing students. The “Clinician of the Future: 2023 Education Edition” surveyed 2,212 students, of which 446 were in the United States, from 91 countries.
