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Wednesday, March 30, 2011

Who is responsible for Chiropractic Medicare Coverage?

Fellow chiropractors…. Please lend me your ears, eyes, and Chiropractic Medicare Commitment!

To my knowledge, Medicare is the only health care reimbursement program that recognizes and has a specific accurate chiropractic understanding. The chiropractors in the early seventies that wrote the chiropractic Medicare Guidelines did it correctly. They worked hard for us to have the privilege to be providers in Medicare and to assure that seniors also had the privilege of Medicare reimbursement for freedom of choice. Yes, chiropractic Medicare is a privilege and 98.6% of all Chiropractors do receive Medicare reimbursement for correcting vertebral subluxations. I agree, the reimbursement is not the dollar value of the adjustment, but many chiropractic practices across America receive large sums of dollars from Medicare.
You may be upset Medicare does not pay for other services by chiropractors, but the non-coverage of x-rays and exams are our fault…. not Medicare. One of our national Chiropractic associations decided we did not need x-rays. And then came the Demonstration Project. A test program by the government to see if we Chiropractors could save Social Security money. This project took place in Scott County, IA. 33 counties in Northern Illinois, Maine, New Mexico and 33 counties in West Virginia. All services by a Chiropractor were reimbursed by Medicare. X-rays, exams, therapy, referrals for MRI’s, CT scans, etc. The result is devastating. Every State EXCEPT ILLINOIS showed zero cost factor…. costing the Medicare program nothing. The Chiropractors in Illinois racked up the bills so much….The Demonstration Project was a MAJOR failure.  Even worse…. The Inspector General said they want money back and implemented audits on the entire Chiropractic Medicare providers.
The last Inspector General’s Report indicated that out of 100 claims filed by Chiropractors, 68% have errors and were inappropriately paid. Again… they want the money back. Presently New York State and two other states have pre-payment reviews on ALL claims billed to their Medicare carrier. The Inspector General’s report went to your Senator and Congressman. The IG thinks we chiropractors are not to bright.
The latest IG report indicated they believe we should only see our patients on Medicare 12 visits each year…. And if you adjust your Medicare patient up to 24 visits, they believe you have committed fraud.
Because a large majority of Chiropractors have breached their contract with Medicare! We all signed a Federal Contract to KNOW AND FOLLOW the Medicare rules. Yet, the majority of Chiropractors do not know the rules and do not even know the correct way to DOCUMENT THE CHIROPRACTIC NECESSITY OF CARE BY Federal Standards.  If we don’t straighten up and do Medicare correctly we will lose the privilege of seeing Medicare patients because we will lose Chiropractic Coverage in Medicare!
Take a moment and evaluate your practice. There are 700 plus new Medicare recipients each day in America and that number is increasing. Chiropractors are not intentionally doing Medicare wrong. The simple fact, if you do not DOCUMENT THE CHIROPRACTIC NECESSITY OF CARE BY Federal Standards, that adjustment becomes now considered "maintenance care", a non-covered in Medicare. (AND S.O.A.P. Notes is not documentation!!)
 Either you or your chief Staff must learn to do Medicare correctly. We have shared our information with thousands over the past 33 years. The Chiropractors that have our information and used it correctly have lost NO audits. The reason being, our presentation shows the correct way chiropractors should be doing Medicare. 
If you have questions please give me a call. If you believe you are doing it correctly, give me a call before you receive a request for your records. 618-395-3800.
Best regards and protect chiropractic Medicare for the senior consumer freedom of choice and for chiropractic.

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