RE: more Federal OTJ hijinks

[Guest guest]

Jack

They cannot change your CPT codes at all. What you provide with your HCFA and attached chart note is a legal document. It is illegal for them to change a legal document to suit their own "whim" or to save a few bucks. If you Dx a three area problem, chart it as such and treat it as such, and bill it as such, then if they cannot change it. If they do, they are committing fraud.

Tell them so, and as Tom Petty and the Heart-breakers say, "don't back down". You are right. They are wrong. Stick to your guns and if that fails, call Ron Wyden's and Gordon 's US Senate offices and let them in on the details of the problem. Trust me, you will have this fixed in a day if both or either of them get involved. They are both good, long-time Chiro patients and supporters.

Love ya

-------------- Original message -------------- Listmates....well the old USPS has done it again....I treated a postal employee about 18 months ago for a cervical and a shoulder injury OTJ....and she was actually referred to me by a local ManDat walks on water....and his Dx was close to my own, I did good exam, chart notes, etc. follow-up status reports to the kindly MD....strange as it may seem, the Fed OTJ insurance folks feigned reluctance to pay the bill.....and interesting and laboe intense flurry of denials, rebuttals and doe-si-do ensued....wherein they eventually begrudgingly finally paid for the cervical cx....but denied the shoulder claim....until I demonstrated a prior injury under similar circumstance where she DID get treated as accepted OTJ injury....so another long doe-si-do and they paid for most of the bill (lady was treated for total of less than 20 times)...so we've been billing for the final portion....and now they are announcing they will only pay for "98940" without 'preauthorization.....there's only $190 left but I don't think it's in the national interest to allow deadbeat insurance swine to make this kind of error in judgement....it sets a bad exampe for the rest of the lair ....any tips?My billing lady reports she has done battle for the last 4 months and they won't budge on this little switcheroo.....J. Pedersen DCOregonDCs 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]

Jack, I know it would put a dent in your practice volume, but you could

just say no to these types of patients in the future. I have eliminated

all types with onerous paperwork(Medicaid, medicare,SAIF)and am now

mentally prepared for the types of patients that will respond to and PAY

FOR my treatment. In the meantime I would make one last collection

attempt and then forget it and move on. Ron JohansenDCn Portland

On Wed, 09 Feb 2005 20:54:57 -0800 JPedersenDC <chirodoc1@...>

writes:

>

> Listmates....

>

> well the old USPS has done it again....

>

> I treated a postal employee about 18 months ago for a cervical and a

>

> shoulder injury OTJ....

>

> and she was actually referred to me by a local ManDat walks on

> water....and his Dx was close to my own, I did good exam, chart

> notes,

> etc. follow-up status reports to the kindly MD....

>

> strange as it may seem, the Fed OTJ insurance folks feigned

> reluctance

> to pay the bill.....and interesting and laboe intense flurry of

> denials,

> rebuttals and doe-si-do ensued....

>

> wherein they eventually begrudgingly finally paid for the cervical

> cx....but denied the shoulder claim....until I demonstrated a prior

>

> injury under similar circumstance where she DID get treated as

> accepted

> OTJ injury....so another long doe-si-do and they paid for most of

> the

> bill (lady was treated for total of less than 20 times)...so we've

> been

> billing for the final portion....

>

> and now they are announcing they will only pay for " 98940 " without

> 'preauthorization.....

>

> there's only $190 left but I don't think it's in the national

> interest

> to allow deadbeat insurance swine to make this kind of error in

> judgement....it sets a bad exampe for the rest of the lair ....

>

> any tips?

>

> My billing lady reports she has done battle for the last 4 months

> and

> they won't budge on this little switcheroo.....

>

> J. Pedersen DC

>

>

>

>

>

[Guest guest]

I long since stopped treating OWCP claims. I told them they either paid

me or went elsewhere, I would not deal with federal work comp.

K. Carpentier, DC, DABCO

Burns, OR

more Federal OTJ hijinks

Listmates....

well the old USPS has done it again....

I treated a postal employee about 18 months ago for a cervical and a

shoulder injury OTJ....

and she was actually referred to me by a local ManDat walks on

water....and his Dx was close to my own, I did good exam, chart notes,

etc. follow-up status reports to the kindly MD....

strange as it may seem, the Fed OTJ insurance folks feigned reluctance

to pay the bill.....and interesting and laboe intense flurry of denials,

rebuttals and doe-si-do ensued....

wherein they eventually begrudgingly finally paid for the cervical

cx....but denied the shoulder claim....until I demonstrated a prior

injury under similar circumstance where she DID get treated as accepted

OTJ injury....so another long doe-si-do and they paid for most of the

bill (lady was treated for total of less than 20 times)...so we've been

billing for the final portion....

and now they are announcing they will only pay for " 98940 " without

'preauthorization.....

there's only $190 left but I don't think it's in the national interest

to allow deadbeat insurance swine to make this kind of error in

judgement....it sets a bad exampe for the rest of the lair ....

any tips?

My billing lady reports she has done battle for the last 4 months and

they won't budge on this little switcheroo.....

J. Pedersen 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.