Chiropractic Medicare Good Bye…. May 2019

Chiropractic Medicare Good Bye…. May 2019

After 35 plus years of providing Chiropractic Medicare information, answers to thousands of chiropractic Medicare questions plus lots of printed materials, DVD’s and CDs to help my fellow chiropractors and their Staff with Medicare…. It’s time to retire.

In doing so, I sincerely “thank” those that have attended “The Basics” Chiropractic Medicare Seminars all over America. It has been fun and exciting, plus, we have been in every major and many small towns in America.

“Thank you” to the Chiropractic Colleges, and Chiropractic State Associations who so kindly gave to me speaking engagements for their membership.

I will be ending my broadcast Chiropractic Medicare E-mail in 30 days, however you may have an interest in some Chiropractic Medicare and Chiropractic History materials before they disappear, especially since none of this information will be available for our profession in the future.

We still have considerable items in stock…. when they are gone, they are gone. These items will do me no good upon retirement so I am making them available to my fellow chiropractors so they don’t go to waste and at a great discounted fee (up to 75% off).

Items Remaining…. for 30 days:

1.) “The Basics” Chiropractic Medicare Program booklet and DVD

2.) “The Basics” Chiropractic Office Fundamentals Book 12th. Edition

3.) Chiropractic Medicare Audits and Appeals DVD and booklet

4.) Chiropractic HIPAA Forms and CD ready to use

5.) Medicare Chiropractic Compliance Book and CD ready to implement

SPECIAL:

Bundle #4.)  Chiropractic Medicare DVD and Booklet, The Basics Office Fundamentals Book, HIPAA book and CD, Par or Non-Par CD. 

Bundle #5.) The Basics Chiropractic Medicare booklet and DVD, and The Basic Chiropractic Medicare Compliance Book and CD ready to implement.

Other Specials… Chiropractic History:

D.D. Palmer’s Early Years, The Discovery of Chiropractic Presentation book and CD (includes a copy of “Sweet Home” New Boston, Illinois Historic Tour)

Zarbuck’s Chiropractic History. Collected Chiropractic History collected and written by Merwyn V. Zarbuck, D.C. including the historic Chiropractic Parallax. A real collectors piece for any chiropractor interest in chiropractic history. 

Super Special: Only place this Chiropractic History collectors item is available!

            First, D.D. Palmer put together small paper booklets called “The Chiropractor” and later B. J. Palmer continued publishing “The Chiropractor” that was used to produce the first Chiropractic Green Books (even though it was red). Those Palmer booklets are now available as Volume I and Volume II., “The Chiropractor” 1904 to 1906. (These will never be available again after 30 days)

“The Chiropractor” D.D. Palmer Volume 1 and “The Chiropractor” B. J. Palmer Volume II 1904 to 1906 

To order:

Call  1-800-692-4476   You may use: Visa, MasterCard and Discover or paypal.

All items will be available for 30 days or until stock is depleted.

Thank you everybody!!

Seminar in February 2019

New Seminar date!

Date: Thursday, February 21, 2019 Cancelled
Time: 1:00 PM - 5:00 PM
Location: O'Fallon, Illinois
Location address:
 Hilton Garden Inn O'Fallon

For questions please call: (618) 395-3162

More ABN discussion

Newsletter from February 18, 2013
“ABN Advanced Notice of Non-coverage”

NOTE: This is the only document in your office that can not be stored electronically. It must stay in the original paper form. Either stored per patient or by date for fast recovery if requested by your Medicare carrier.

THE ABN
It has become my conclusion the ABN in it’s origination has but one primary purpose....to cut reimbursement by the Medicare Carrier. It contains rules that supersede the Federal law of mandatory claim submission. It has led many a Chiropractor down the yellow brick road of “Treating Patient Symptoms” instead of locating and correcting vertebral subluxations like Federal Law indicates.
When a Chiropractor calls the chiropractic adjustment that corrected a vertebral subluxation “Maintenance Care”, and had the patient check Option 2 on the ABN to not bill Medicare because it is called “Maintenance Care” since the patient felt no symptoms...and then collected from the patient, the regular office fee (not the Medicare fee) at the time of visit....Who Got Had?
The consumer (patient) just got cheated out of Medicare reimbursement. They pay over $100 dollar premium for Medicare each month. You say the patient had no symptoms. Consider this, as many as 1,800,000 seniors over the age of 65 may be dependent on Medicare-provided prescription drugs. The average number of prescriptions per year for each senior is 38.5 with the average number of different prescriptions daily being 5 or more.
Most of our patients are on 5, 6, 8, 10 drugs each day....they can not feel their symptoms. And yet, if the patient has no symptoms we just call it “Maintenance Care” and then not bill Medicare. I don’t think so! Our job as Chiropractors is quite clear in Medicare. We do not get paid to “treat” symptoms. We are only paid in Medicare to locate and correct vertebral subluxations.
If the patient have a subluxation and no pain symptoms....How about that subluxation of T6 spinal nerve and the trajectory of that nerve to the stomach, altering the normal function of the stomach. They are already on three prescription drugs for a stomach problem. S.O.A.P. notes shall indicate your findings, and your documentation will support the care given. I recommend, when you correct a vertebral subluxation, call it what it is....The primary job you do, and it is covered by Medicare. Help your patients get reimbursed in Medicare for the Chiropractic covered service of correcting a subluxation.

"Think Like a Chiropractor"

Newsletter

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

Three Important Areas

Newsletter
February 8, 2012
Chiropractic Medicare
Three Important Areas We ALL MUST become Proficient In!

Dear Doctors and Staff,

This is the year for Chiropractors in Medicare.  Last year the Inspector General indicated that out of 100 claims filed to Medicare by Chiropractors, 67 had errors.  They believe they have overpaid Chiropractors by millions. With that in mind, nearly every Chiropractor filing Medicare claims will be audited in 2012.

There are three key areas in which we must be prepared:

First, we must know the correct way to provide great Chiropractic care to our seniors and document by federal standards. You must know the correct way to do Chiropractic Medicare!!! If you don't know the correct way to do Medicare an audit will be devastating.

The second area of our concern is HIPAA (i.e. knowing how to protect personal Health Information in your office, developing your in-house HIPAA policies, procedures and training.)

The third area of concern is becoming Medicare Compliant. By the end of 2012 each and every Chiropractic office must be aware and prepared for the seven (7) areas of compliance set by the Federal Government.

We offer many helpful items to help with these areas to help you get prepared. If you have questions, comments, concerns about Chiropractic Medicare, please give me a call at 618-395-3800.

Warmest regards,
Dr. Street

Chiropractic Medicare X-rays (Newsletter from 8/29)

Chiropractic Medicare X-Rays ~ Newsletter from August 29

Medicare is an excellent Chiropractic program.  No other insurance company, PPO, HMO, etc., requires Chiropractic Philosophy, Science and Art as in the Medicare guidelines. Chiropractic Medicare was written by chiropractors (Dr. Day, Dr. Hulsebus, etc.)

There are two(2) parts to Chiropractic Medicare to make a mandatory claim:
    1.  The Chiropractor must prove a vertebral subluxation.
    2.  The Chiropractor must "document" the chiropractic necessity of care by "federal standards."

I strongly recommend doing x-rays on each Medicare patient.  (P.A.R.T. is weak and can be challenged, where as, using your x-rays, you are the authority in regards to locating subluxations.) 

You must have a minimum of two views of each region you adjust (AP & Lateral).  The films must be of good quality and evidence of collination.  The x-ray films must be on location or in a location the doctor has access too, as the Medicare carrier may request those films as they did at the beginning of Chiropractic Medicare.

I suggest doing the following x-rays on each Medicare patient each year.  (If the doctor proves vertebral subluxation by way of x-rays, then the Chiropractor must have a new x-ray that is not over 12 months old, or the Medicare claim will be denied.)
    1 14x36 AP full spine
    1 8x10 Lat. Cervical (including occipital)
    1 7x17 Lat. Thoracic
    1 7x17 Lat. Lumbar (including Sacrum and coccyx)

Chiropractic x-rays are important in that it helps locate vertebral subluxations, pathologies, etc., and they are mandatory for we Chiropractors that use them to prove a subluxation.

P.A.R.T. Exam, X-ray, and the Demonstration of Subluxation

One of the requirements for the initial visit is the diagnosis of a subluxation that corresponds to the symptoms the patient demonstrates.  In other words, these symptoms must bare a direct relationship to the level of subluxation. The diagnosis of subluxation can be made either by a dated x-ray or by a physical exam noting 2 of the 4 following criteria to support a manually demonstrated subluxation:

1. Pain/tenderness evaluated in terms of location, quality and intensity.


2. Asymmetry/misalignment identified on a sectional or segmental level.


3. Range of motion abnormality (changes in active, passive and accessory joint movements resulting in an increase or a decrease of sectional or segmental mobility.)


4. Tissue, tone changes in the characteristics of contiguous or associated soft tissue, including skin, fascia, muscle and ligament.

**One of the two criteria documented must be either asymmetry or range of motion

         abnormality.

I strongly suggest doing spinal x-rays a minimum of once each year, instead of P.A.R.T.  Using your x-rays to determine subluxation is never challenged, where as anyone can challenge the findings of a subluxation with P.A.R.T.

 

If you have no x-ray of the area you adjusted, less than one (1) year old, you must do a P.A.R.T. form each Chiropractic visit.  Even if some of your examinations consist of the same procedures as in P.A.R.T., you must have a P.A.R.T. form each visit.  When you have current x-rays of your Medicare patient, no P.A.R.T. form is necessary.  P.A.R.T. should be placed in Item #19 on the claim form to tell the Medicare carrier you are using P.A.R.T. with this patient.