Oregon Health Plan

[Guest guest]

Sharron,

My experience with the Oregon Health Plans since its inception is that

although it claims to reimburse for chiropractic care it really does not.

The majority of the neuromusculoligamentous conditions we treat are

beyond the cutoff point in their list of diagnoses. The only exception I

have found is treatment of migraine headaches. Reimbursement is

miniscule (more of a joke) so even if possible, it is more of a service

to patients than a way to pay the bills.

J. Holzapfel, D.C.

Albany, OR.

kjholzdc@...

[Guest guest]

Sharon,

My experience with OHP is similar. I've talked with adminstrators, written

letters re changing the priority ranking of NMS conditions, all to no

avail. Reimbursement for me is also a service to patients who otherwise

would not receive chiropractic care.

Lily Roselyn, DC

At 11:49 AM 1/14/2002 -0800, J Holzapfel DC wrote:

>Sharron,

>My experience with the Oregon Health Plans since its inception is that

>although it claims to reimburse for chiropractic care it really does not.

> The majority of the neuromusculoligamentous conditions we treat are

>beyond the cutoff point in their list of diagnoses. The only exception I

>have found is treatment of migraine headaches. Reimbursement is

>miniscule (more of a joke) so even if possible, it is more of a service

>to patients than a way to pay the bills.

>

> J. Holzapfel, D.C.

>Albany, OR.

>kjholzdc@...

>

>

>

>

>

[Guest guest]

's right. You can bill, wait, follow up with the usual paper chase and

in the end never receive the pittance of a payment they claim to reimburse

for.

A patient of ours who is a family practice physician said it best, " We pay

to treat those people. " That about sums it up, we pay higher taxes, we pay

with our time to treat, and we pay trying to chase down the pittance of the

payment. Not to mention the liability. There was a case in town where an

OHP patient sued the doctor for malpractice (it was NOT malpractice and the

case was settled out of court).

I don't know what the answer is, there is obviously a segment of the

population with major medical problems and limited resources. Our society

can't turn our backs on these people. But the Oregon Health Plan is a joke.

Expanding that wasteful program only perpetuates the injustice.

I would rather see a program where we can treat the indigent for a tax

right-off. Even if they would only let me right off their normal allowed

pittance of a payment, I could be assured of something. Plus we elliminate

some of the bureaucracy and administration of OMAP. But, that makes far too

much sense, in other words, it'll never happen. In fact, last I heard

" Keep the Kicker " Kitzhaber is continuing his never-ending quest to expand

OMAP.

Don , DC - Corvallis

Re: Oregon Health Plan

> Sharron,

> My experience with the Oregon Health Plans since its inception is that

> although it claims to reimburse for chiropractic care it really does not.

> The majority of the neuromusculoligamentous conditions we treat are

> beyond the cutoff point in their list of diagnoses. The only exception I

> have found is treatment of migraine headaches. Reimbursement is

> miniscule (more of a joke) so even if possible, it is more of a service

> to patients than a way to pay the bills.

>

> J. Holzapfel, D.C.

> Albany, OR.

> kjholzdc@...

>

>

>

>

>

[Guest guest]

My business experience with the OHP can best be described in two words:NO

WAY! If a person with OHP calls, I offer the same cash price to them that

I give to unemployed, students, and employees of non profits. All these

people must sign a form stating this is not my regular fee, and we are

doing it because of special conditions. The price I charge to see these

folks is another 10% below the sr. citizen price, and it approximates my

cost of opening the doors(annual overhead divided byannual number of

patients equals cost of opening your doors- this does not include a

salary for me, it is just raw overhead.) IN the past, I used to get

physician referrals from the Multnomah County Health Clinics for OHP

patients, but when I started getting paid less than half the time, I

called it quits. ON the other hand, I have a relative Who is mentally

disabled, and gets good care from the County Health System in Clackamas

County. I guess Chiros are on the bottom of the State food chain. Ron

JohansenD.C. Portland

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[Guest guest]

Sharon: I only get paid if the patient is on the managed care plan (not an

open card), and I have a pre-approved referral from the primary provider.

There are a bunch of codes for what we treat, sort of, that are above the

current line. They aren't the usual 847 and 739 codes. I'm not at the

office now to look them up. I dont' take the open card at all. the OHP

claims to pay for diagnostic work-ups, but don't. If you want them, I can

probably dig them up.

Ann Goldeen, D.C.

1010 Duane Street

Astoria OR 97103

503-325-3311

Oregon Health Plan

> Dear Doctors,

>

> I was invited to a focus group discussion last week with an eye towards

> resolving the current state deficit of $830 million dollars. I was called

> due to being a registered voter and meeting some criteria of age and party

> affiliation. I was paid $50 dollars for 2 1/2 hours. My group was 10

women.

> After us was a group of 10 men.

>

> A facilitator led questioning that was predetermined. The session was

audio

> and video recorded and 'people' of some sort sat behind a two way mirror.

I

> only agreed to do this because they told me it had to do with' politics'.

>

> The gist of the session from my perspective was, there is an $830 million

> dollar budget shortfall and since people are hurt from 9/11 and since we

are

> to take care of people how do we raise more money ?

>

> During the Q & A the Oregon Health Plan was brought up (by me) and I

> questioned the continual expansion of it despite the difficultly cost wise

> in doing so. Thus my post to you...

>

> Do any DCs in Oregon receive payment from the OHP ?

> If so, what diagnoses are covered ?

> And if not, why not ?

>

> vty,

>

> Sharron Fuchs DC

>

>

>

>

>

>

[Guest guest]

Does anyone else look at OHP and say it is just another variation on the

same theme that has been played for decades? I do not believe they care

if their care is more cost effective or is even the best care for the

patients. I think they just care that they are the only game in town. The

more market segments they close, the closer they are to attaining their

goal.

Comments?

DeSiena

[Guest guest]

I always tell the patients that inquire about OHP is tha,t I accept them but they do not accept me!Dr. A Caughlin DC CAC155 NW 1st Ave Day, Or. 97845 office 541-575-1063 fax 541-575-5554CC: To: neroco2@...From: drjdyson1@...Date: Thu, 23 Feb 2012 13:31:59 -0800Subject: Re: Oregon Health Plan

I registered about 11 years ago and got my Medicaid (OHP) number. However, I quickly learned that they do not cover chiropractic services... I was told that it falls below the line of services that are considered "essential". Jamey Dyson, DCOn Feb 23, 2012, at 12:17 PM, neroco2@... wrote:

Greetings:Anyone out there participating on OHP?If so, what did you do to get on it?I have a few patients asking about it.Thanks.Neil R. Cohen, D.C.Dundee Chiropractic