Letter from Farmers Ins

[Guest guest]

listserv,

I just received a bulk enclosure with an EOB from Farmers on a PIP claim. The note is printed on bright green paper and says;

In 2003, the Oregon Legislature passed an amendment to the Oregon Personal Injury Protection (PIP) Statute. This change governs the amounts medical providers may charge to patients who recieve PIP benefits.

As explained by the Oregon Insurance Division (bulletin INS 2003-7), a provider may not charge a fee that exceeds either (1) the amount the provider charges the general public, or (2) the amount allowed by the Workers Compensation Fee Schedule, whichever amount is less.

You will be seeing these guidelines applied as new losses are affected by this change.

Has anyone else gotten this? I wasn't aware that the amount was 'what the general public is charged' (that's pretty vague, since the general public includes both insured, double insured, indigent, non-insured etc.) and I wasn't aware that it's 'whichever is less'. I plan on investigating this. Does anyone else know about these last two questions?

Minga Guerrero DC

Portland OR

[Guest guest]

Minga:

This was HB 3668, or more specifically an amendment that was slipped into HB 3668 with four days left in the longest session in Oregon history....we missed it....I missed it. Our lobbyist Marshall Coba sent me the bill late in the session and I didn't see the small inserted amendment....but then again neither did anyone else.

The law does not specifically say whichever is less, that is an interpretation by the Insurance Division's in House Council as per the intent of the law.

The CAO's Legislative Committee is on it!

Vern Saboe, DC

Albany

Letter from Farmers Ins

listserv,I just received a bulk enclosure with an EOB from Farmers on a PIP claim. The note is printed on bright green paper and says;In 2003, the Oregon Legislature passed an amendment to the Oregon Personal Injury Protection (PIP) Statute. This change governs the amounts medical providers may charge to patients who recieve PIP benefits.As explained by the Oregon Insurance Division (bulletin INS 2003-7), a provider may not charge a fee that exceeds either (1) the amount the provider charges the general public, or (2) the amount allowed by the Workers Compensation Fee Schedule, whichever amount is less.You will be seeing these guidelines applied as new losses are affected by this change. Has anyone else gotten this? I wasn't aware that the amount was 'what the general public is charged' (that's pretty vague, since the general public includes both insured, double insured, indigent, non-insured etc.) and I wasn't aware that it's 'whichever is less'. I plan on investigating this. Does anyone else know about these last two questions? Minga Guerrero DCPortland OR 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.

[Guest guest]

Listserv,

Thanks so much for your response and all the work you're doing.

I'm glad to see that your take on Farmer's interpretation is the same as mine. There was never a mention of 'whichever fee is less' or a general public clause. However, just in case, my secretary is putting a 'general public' category into our fee schedule. This does not inlcude the folks with financial hardship who are discounted. It doesn't include medicare either.

Minga Guerrero DC