Just a note to let you know that Dr. Milasich and the other representatives at the Chiropractic Quality Assurance Commission at the Dept of Health (WA State)  have pushed through a new code approved for our profession: S9090 for “Vertebral Axial Decompression.”

 This code will be billable to insurance carriers for patients that are on our traction/decompression and PSRT tables.  It was just approved this last Thursday, 4/15/10, so it may take a while for the insurance carriers to get on the ball…Be patient (and re-bill as necessary).

 I believe this is a huge accomplishment for our profession:  Providing a useful service that is now recognized and PAID by third party carriers.  Woot! 

 Have a great week,

 Katy Brown

(Milasich Chiropractic – Tacoma, WA)

 Please be informed that while employing the Pettibon System in your clinic, you must document what you are doing with the patient and the patient’s response to care.  I have seen many disciplinary issues while serving on the Chiropractic Quality Assurance Commission lately involving providers billing for said services and not having the proper documentation to back up their billings.  If the patient’s insurance denies the services, the provider is liable. 

 There was one case that involved 125 recorded cervical traction and wobble chair maneuvers that were performed in the office over a six month period.  The patient recalled using the equipment exactly 20 times.  The charting was inaccurate, and the doctor wonders why they aren’t being reimbursed.  This is the kind of nonsense that is ridiculous, with any health care provider, especially with one who is correcting the spine. 

 Please do your part and take care of patients, always documenting such.  We cannot control your practice, but would like to save you possible duress, and would like to preserve the integrity of chiropractic as a whole.

Dr. Michael Milasich, D.C. – Tacoma WA

Board Member, WA Chiropractic Quality Assurance Commission

This CD is perfect for those doctors fighting the good fight against the insurance companies when they baselessly deny payment, or claim that you’ve not documented medical necessity.

The Pettibon Institute fully supports all of its hard-working doctors. We want our doctors to have all the best tools available to be the most successful doctors. Help us help you! Again, for your one-time annual donation, you will get this CD FREE! Your donations are helping us make future products a reality, such as documentation/appeals CDs, research-based MD/DO marketing products, and the first ever spinal weight testing book. However, we need your donations to support these fantastic projects.

We have a limited number of FREE gifts on hand. Please make your donation today to further Pettibon research and increase your chances of beating the insurance companies at their own games. 1-800-766-4885

Sincerely,

Mark W. Morningstar, DC

Director of Research, Pettibon Institute

“Just because a company arbitrarily decides that a procedure is experimental doesn’t mean that they can’t be forced to pay. But since most chiropractors don’t fight this (or maybe don’t know how) the insurance company saves millions in claims that a certain percentage of chiropractors won’t fight. 

For example, virtually every insurance company says that MUA (Manipulation Under Anesthesia) is experimental, but that doesn’t stop us from getting paid. We simply have documentation that the patient’s problem was resolved using our (treatment) plan and once we’ve exhausted the insurance company’s appeal system, we file external appeals through the state of Michigan Office of Insurance Regulations. The OIR is very pro-patient, and they’re decisions are binding. And once an insurance company knows that you’re going to continually take it to this level (which costs them money to fight), they’ll simply pay you without hassle.“
Each state has its own system for external appeal. The Pettibon docs out there should get together and figure out what that system is and consistently use it.

Mark W Morningstar, DC DAASP FRCCM FAAIM

www.michiganwellnessandpainrelief.com 

In looking into this specifically for Washington State I was able to find the Patient Bill of Rights , if you are interested.  If you are experiencing a similar issue and have found solutions like this for other states, please chime in.