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Tuesday, April 10, 2012

"Think Like a Chiropractor"

April 9, 2012
Chiropractic Medicare
"Think Like a Chiropractor"

Dear Doctors and staff,

Many times, when speaking of Medicare, HIPAA, or becoming "compliant" in Medicare, it comes off as a "negative" and a "downer". 

Most people have no idea the Medicare Chiropractic section was written by Chiropractors Dr. Bill Day of Washington, Dr. Bob Hulsebus of Illinois, etc. 

“If we do Chiropractic Medicare as Chiropractors instead of acting like another health discipline, as your Medicare Carriers want you to be, you will have little to no problem with Medicare.”

The Chiropractic Medicare guidelines do not say we are reimbursed for "treating" our patient’s symptoms. It says we are only paid in Medicare for “correcting a vertebral subluxation”.

The vertebral subluxation is the only "covered service" in Medicare for Chiropractors.  The vertebral subluxation is "always" a covered service in Medicare; however, it may not be a payable service if we cannot document the Chiropractic necessity of care. It is always the covered service which is the reason we must bill all Chiropractic adjustments to correct a vertebral subluxation.  For the patient to mark Option #2 on the ABN, calling it maintenance care when the Chiropractor corrects a vertebral subluxation, is very questionable and dangerous.  The adjustment to correct a vertebral subluxation is the only covered service in Medicare and must be billed within one year.

For the Chiropractor to call the Chiropractic adjustment to correct a vertebral subluxation "maintenance care," patient signs Option 2 on the ABN, creates several problems.

  1. The patient pays a monthly premium in Medicare for the healthcare that will not reimburse the patient if the Chiropractor does not bill or bill correctly.  The patient is cheated.
  2. When a Chiropractor provides a covered service (98940, 98941 or 98942) in Medicare, they are required to bill Medicare within one year.  You may call it Maintenance Care, however, if you corrected a vertebral subluxation that is a "covered service" and should be billed and documented for Medicare reimbursement.
  3. Just because a patient has NO obvious symptoms does not make this "maintenance care."  The patient may be on seven (7) prescription drugs and feel no symptoms.
  4. When a patient has a "vertebral subluxation", they must have a related "Neuronal Component" or it is not a Subluxation.
    1. Example...Subluxation of T6 with the neuronal trajectory of T6 spinal nerve to the stomach altering the function of the stomach. They are probably on three prescription drugs for a stomach problem   from their MD.

Think and be a Chiropractor in Medicare.  That is how the Medicare Program was developed in 1973.

Do you know the importance of learning the correct way to do Medicare by federal standards and becoming Medicare Compliant?

Have questions? Give Dr. Street a call today at (618) 395-3800.

Spring 2012 Seminar Schedule:

*Thursday, April 19, 1:00 pm - 5:00 pm at the Chariot Hotel - Louisville, KY

*Thursday, May 24, 8:30 am - 12:30 pm at King Oscar Hotel, Pacific, WA

*Thursday, May 24, 6:00 pm - 10:00 pm at Staybridge Suites, Mukilteo, WA

To Register Call:  (618) 395-3800

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