Guest guest Posted February 23, 2004 Report Share Posted February 23, 2004 Docs, I have referred a pt who sustained severe injuries in recent MVA to neurologist whose office has requested that the pt pay 50% of that office visit at the time of service. Is this common practice?? I haven't seen this situation on a PIP claim. Many thanks, Lily Roselyn, DC Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 23, 2004 Report Share Posted February 23, 2004 Hi Lily, Their office maybe hasn't read the Bulletin the Insurance Commissioner posted on 2/13/04. If the patient's PIP policy has already renewed, then per item 7 of the interpretation of HB 3668/CH.813, the neurologist may have just broken the law? (Did you all read my email last week on this important change to PIP billing? ) Prior to this law change, I have known it to not be uncommon to require payment, as our law did allow any provider to do this and allowed the patient to subrogate with their Health Insurance plan for payment. The best protection you can offer your patient is to make sure they are following their plan rules and getting the appropriate referral to a plan neurologist, which may need to come from their PCP and have them sign a subrogation letter, assuming they have health insurance. Then, if the PIP falls apart they have a back-up and they don't have to pay so much upfront. However, this may not be possible if the Insurance Commissioner gets to keep his interpretation in with the new law, and if so, good luck getting any of our patients onto other care. Hope it works out, MVA reimbursement > Docs, > I have referred a pt who sustained severe injuries in recent MVA to > neurologist whose office has requested that the pt pay 50% of that office > visit at the time of service. Is this common practice?? I haven't seen > this situation on a PIP claim. > Many thanks, > Lily Roselyn, DC > > > OregonDCs rules: > 1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated. > 2. Always sign your e-mails with your first and last name. > 3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 23, 2004 Report Share Posted February 23, 2004 MD's seem to be having more and more trouble getting paid in work comp and PI cases. There is a group medical office here that refuses both types. I think their billing people are incompetent. These are the easiest cases to get paid on of all. I have heard of neurologists' in Portland requesting some money upfront. I think it is weird, but securing their income. Ann Goldeen MVA reimbursement > Docs, > I have referred a pt who sustained severe injuries in recent MVA to > neurologist whose office has requested that the pt pay 50% of that office > visit at the time of service. Is this common practice?? I haven't seen > this situation on a PIP claim. > Many thanks, > Lily Roselyn, DC > > > OregonDCs rules: > 1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated. > 2. Always sign your e-mails with your first and last name. > 3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 23, 2004 Report Share Posted February 23, 2004 Hi Ann, I know that Providence Medical Groups will only accept existing patients for PIP and WC's. The problem is they can't wait on the cash flow. We are more accustomed to waiting and fighting. The Sister's can't afford to do that or afford to pay the staff for the extra work. These are high risk patients. In 10 years of practicing we have had many cases denied for the most bizarre reasons and we have to go to battle, all works out in the end, but it can take 4-6 months to get resolved sometimes and with HB 3668 expect more providers to not take as many PIP patients. Our PIP is at least 30-40% of our business and HB 3668 may force us to change that. All provider types may have to start limiting their liabilities or they could find themselves out of business if HB 3668 doesn't get repealed soon. Why? The carriers have been given a good reason not to pay us, since we can no longer turn the bill over to the patient or their attorney and providers can't legally hire an attorney to get a billed paid. But this is what Farmers is trying to do. DC's and PT's receive the largest percentage of PIP claims, about 60% between the two, so they knew where to hit it hard to limit patients access to care. Where do your referrals come from? The ER or MD's? No from patients who got educated on how much Chiropractic Care helped them to recover, but if less can get it, then less know about it's benefits to tell others. Sorry to be so negative, but those in power are tightening the noose on PIP everyday and I think most MD offices don't have the stomach for it, they haven't had to wear the Scarlet Letter for so many years, like DC's. We are accustomed to the abuse, it is just too foreign to them and their billing staffers. Thanks, Stockton Cedar Mill Chiropractic Clinic .. MVA reimbursement > > > > Docs, > > I have referred a pt who sustained severe injuries in recent MVA to > > neurologist whose office has requested that the pt pay 50% of that office > > visit at the time of service. Is this common practice?? I haven't seen > > this situation on a PIP claim. > > Many thanks, > > Lily Roselyn, DC > > > > > > OregonDCs rules: > > 1. Keep correspondence professional; the purpose of the listserve is to > foster communication and collegiality. No personal attacks on listserve > members will be tolerated. > > 2. Always sign your e-mails with your first and last name. > > 3. The listserve is not secure; your e-mail could end up anywhere. > However, it is against the rules of the listserve to copy, print, forward, > or otherwise distribute correspondence written by another member without his > or her consent, unless all personal identifiers have been removed. > > Quote Link to comment Share on other sites More sharing options...
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