Guest guest Posted July 7, 2004 Report Share Posted July 7, 2004 Minga makes a good point. Just because someone is the enemy of your enemy does not mean that he is your friend. Liberty NW has always tried to screw chiropractors and their patients just as much as SAIF (SAIF has tried all sorts of dirty tricks since 1197 to try to not pay for DC tx, although it appears that Minga found a claims adjustor at SAIF who still believes in helping injured people - he or she won't last). Until this incredibly unfair law is changed DCs and their patients will continue to be the whipping boys and girls of the worker's comp system. Freeman SAIF vs Liberty NW Listserv,After all the discussion on the serv lately advising to avoid SAIF, one of my secretaries mentioned something I'd forgotten. This is not necessarily an endorsement for SAIF, just mention of some things that happened at my office. 1. Liberty NW was the first WC carrier to deny all payment on a claim of mine where there was not double signatures on the 'treatment plan'. You know how we're required to get a referral from an MD with certain parameters included in the referral? I've always done that. The Rx includes treatment, frequency and duration signed by the MD referring. I have billing send a copy with the bills. SAIF always pays on that info. However, there's small print saying that the DC must also sign the referral and send a copy back to the MD or the insurer can deny ALL payment. This must be done within 7 days of the referral or it can be denied! SAIF has never, I repeat NEVER followed that letter of the law in my office. I wasn't aware of the law until that happened. 2. Liberty uses/used silent PPOs. I battled with them for over 2 years after they 'bought' a contract I had signed with 'chirocare', (not chironet - they don't participate in silent sales). I was never informed that the contract was sold to auto carriers, work comp carriers etc. In fact, I'd opted out of the contract 1 year prior to it being bought. However, my 'contract' was included in the sale somehow...without my knowledge. I lost lots of $ over 2 years trying to get them to stop nickle and dime reductions. Every LIberty auto claim that came in over 2 years was reduced dramatically. They said I had to notify them in writing that I wanted the contract nullified. Then I had to continue to honor it for 6 months after that date! I could've won in court, but obviously LIberty had more $ than me and it would've depleted my resources to take them to court. 3. SAIF recently (2 months ago) extended a claim without MD referral, simply on a letter I wrote asking for 2-3 more appts to finish up active exercise with a patient. The patient's claim rep called and spoke with mysecretary and simply OKed the office visits prior to scheduling!There's my 2 cents worth.Minga Guerrrero 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 July 7, 2004 Report Share Posted July 7, 2004 makes a good point about Minga's point. In an effort to remain professional and colleagial, we should avoid coarse terms such as " ...screw chiropractors " and use the Canadian colloquialism " hose chiropractors " . It just had to be said. E. Abrahamson, D.C. From: " Dr. Freeman " <drmfreeman@...> Reply- " Dr. Freeman " <drmfreeman@...> Date: Wed, 7 Jul 2004 10:29:11 -0700 (PDT) Subject: Re: SAIF vs Liberty NW Minga makes a good point. Just because someone is the enemy of your enemy does not mean that he is your friend. Liberty NW has always tried to screw chiropractors and their patients just as much as SAIF (SAIF has tried all sorts of dirty tricks since 1197 to try to not pay for DC tx, although it appears that Minga found a claims adjustor at SAIF who still believes in helping injured people - he or she won't last). Until this incredibly unfair law is changed DCs and their patients will continue to be the whipping boys and girls of the worker's comp system. Freeman SAIF vs Liberty NW Listserv, After all the discussion on the serv lately advising to avoid SAIF, one of my secretaries mentioned something I'd forgotten. This is not necessarily an endorsement for SAIF, just mention of some things that happened at my office. 1. Liberty NW was the first WC carrier to deny all payment on a claim of mine where there was not double signatures on the 'treatment plan'. You know how we're required to get a referral from an MD with certain parameters included in the referral? I've always done that. The Rx includes treatment, frequency and duration signed by the MD referring. I have billing send a copy with the bills. SAIF always pays on that info. However, there's small print saying that the DC must also sign the referral and send a copy back to the MD or the insurer can deny ALL payment. This must be done within 7 days of the referral or it can be denied! SAIF has never, I repeat NEVER followed that letter of the law in my office. I wasn't aware of the law until that happened. 2. Liberty uses/used silent PPOs. I battled with them for over 2 years after they 'bought' a contract I had signed with 'chirocare', (not chironet - they don't participate in silent sales). I was never informed that the contract was sold to auto carriers, work comp carriers etc. In fact, I'd opted out of the contract 1 year prior to it being bought. However, my 'contract' was included in the sale somehow...without my knowledge. I lost lots of $ over 2 years trying to get them to stop nickle and dime reductions. Every LIberty auto claim that came in over 2 years was reduced dramatically. They said I had to notify them in writing that I wanted the contract nullified. Then I had to continue to honor it for 6 months after that date! I could've won in court, but obviously LIberty had more $ than me and it would've depleted my resources to take them to court. 3. SAIF recently (2 months ago) extended a claim without MD referral, simply on a letter I wrote asking for 2-3 more appts to finish up active exercise with a patient. The patient's claim rep called and spoke with mysecretary and simply OKed the office visits prior to scheduling! There's my 2 cents worth. Minga Guerrrero 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 July 7, 2004 Report Share Posted July 7, 2004 Thanks for keeping an eye on me, . I know you had to hose your courage to the sticking point just to write this, and I truly appreciate your hosey sense of humor. D Freeman Mailing address: 1165 Union St NE, #300 Salem, OR 97301 503 586-0127 fax 503 763-3581 cell 503 871-0715 drmfreeman@... SAIF vs Liberty NW Listserv,After all the discussion on the serv lately advising to avoid SAIF, one of my secretaries mentioned something I'd forgotten. This is not necessarily an endorsement for SAIF, just mention of some things that happened at my office. 1. Liberty NW was the first WC carrier to deny all payment on a claim of mine where there was not double signatures on the 'treatment plan'. You know how we're required to get a referral from an MD with certain parameters included in the referral? I've always done that. The Rx includes treatment, frequency and duration signed by the MD referring. I have billing send a copy with the bills. SAIF always pays on that info. However, there's small print saying that the DC must also sign the referral and send a copy back to the MD or the insurer can deny ALL payment. This must be done within 7 days of the referral or it can be denied! SAIF has never, I repeat NEVER followed that letter of the law in my office. I wasn't aware of the law until that happened. 2. Liberty uses/used silent PPOs. I battled with them for over 2 years after they 'bought' a contract I had signed with 'chirocare', (not chironet - they don't participate in silent sales). I was never informed that the contract was sold to auto carriers, work comp carriers etc. In fact, I'd opted out of the contract 1 year prior to it being bought. However, my 'contract' was included in the sale somehow...without my knowledge. I lost lots of $ over 2 years trying to get them to stop nickle and dime reductions. Every LIberty auto claim that came in over 2 years was reduced dramatically. They said I had to notify them in writing that I wanted the contract nullified. Then I had to continue to honor it for 6 months after that date! I could've won in court, but obviously LIberty had more $ than me and it would've depleted my resources to take them to court. 3. SAIF recently (2 months ago) extended a claim without MD referral, simply on a letter I wrote asking for 2-3 more appts to finish up active exercise with a patient. The patient's claim rep called and spoke with mysecretary and simply OKed the office visits prior to scheduling!There's my 2 cents worth.Minga Guerrrero 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 July 7, 2004 Report Share Posted July 7, 2004 Has anyone had any luck getting WC carriers to pay if the tx. plan is imperfect? SAIF (motto: We saved so much on patient care that we gave it all to Neil!) denied a second round of care for a patient because the wacky referring osteopath thought that writing out " manipulation/ultrasound/trigger point massage 3x/wk X 4 weeks " on a prescription pad, was good enough for a simple/ severe low back sprain which had been accepted, was responding well to care, without time loss, in spite of the patient having M.S., and having gained 50 lb. from steroid treatment, and standing all day on cement as a floral designer! After all the care was rendered, SAIF said, " You didn't say, 'Simon says!' so we don't have to pay and you can't collect it from the patient! " OK. How 'bout if we...? NOPE! You can't get the M.D./D.O. to write it retroactively no matter how rational it is. Get Neil on the phone, we've got even more money for him! E. Abrahamson, D.C. From: AboWoman@... Date: Wed, 7 Jul 2004 13:20:54 EDT Subject: SAIF vs Liberty NW Listserv, After all the discussion on the serv lately advising to avoid SAIF, one of my secretaries mentioned something I'd forgotten. This is not necessarily an endorsement for SAIF, just mention of some things that happened at my office. 1. Liberty NW was the first WC carrier to deny all payment on a claim of mine where there was not double signatures on the 'treatment plan'. You know how we're required to get a referral from an MD with certain parameters included in the referral? I've always done that. The Rx includes treatment, frequency and duration signed by the MD referring. I have billing send a copy with the bills. SAIF always pays on that info. However, there's small print saying that the DC must also sign the referral and send a copy back to the MD or the insurer can deny ALL payment. This must be done within 7 days of the referral or it can be denied! SAIF has never, I repeat NEVER followed that letter of the law in my office. I wasn't aware of the law until that happened. 2. Liberty uses/used silent PPOs. I battled with them for over 2 years after they 'bought' a contract I had signed with 'chirocare', (not chironet - they don't participate in silent sales). I was never informed that the contract was sold to auto carriers, work comp carriers etc. In fact, I'd opted out of the contract 1 year prior to it being bought. However, my 'contract' was included in the sale somehow...without my knowledge. I lost lots of $ over 2 years trying to get them to stop nickle and dime reductions. Every LIberty auto claim that came in over 2 years was reduced dramatically. They said I had to notify them in writing that I wanted the contract nullified. Then I had to continue to honor it for 6 months after that date! I could've won in court, but obviously LIberty had more $ than me and it would've depleted my resources to take them to court. 3. SAIF recently (2 months ago) extended a claim without MD referral, simply on a letter I wrote asking for 2-3 more appts to finish up active exercise with a patient. The patient's claim rep called and spoke with mysecretary and simply OKed the office visits prior to scheduling! There's my 2 cents worth. Minga Guerrrero 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 July 7, 2004 Report Share Posted July 7, 2004 Listmates Our experience with treatment plans from the other side the fence is POOR……. We now type out the plan in detail and the referring doctor only has to sign 2 copies – one for him and one for us which we in turn copy for the carrier and us. Save a lot of hassel DrBob W. Pfeiffer,D.C.;D,A.B.C.O. P. O. Box 606 Pendleton, Or. 97801 541. 276.2550 From: Abrahamson [mailto:drscott@...] Sent: Wednesday, July 07, 2004 8:14 PM Subject: Re: SAIF vs Liberty NW Has anyone had any luck getting WC carriers to pay if the tx. plan is imperfect? SAIF (motto: We saved so much on patient care that we gave it all to Neil!) denied a second round of care for a patient because the wacky referring osteopath thought that writing out " manipulation/ultrasound/trigger point massage 3x/wk X 4 weeks " on a prescription pad, was good enough for a simple/ severe low back sprain which had been accepted, was responding well to care, without time loss, in spite of the patient having M.S., and having gained 50 lb. from steroid treatment, and standing all day on cement as a floral designer! After all the care was rendered, SAIF said, " You didn't say, 'Simon says!' so we don't have to pay and you can't collect it from the patient! " OK. How 'bout if we...? NOPE! You can't get the M.D./D.O. to write it retroactively no matter how rational it is. Get Neil on the phone, we've got even more money for him! E. Abrahamson, D.C. From: AboWoman@... Date: Wed, 7 Jul 2004 13:20:54 EDT Subject: SAIF vs Liberty NW Listserv, After all the discussion on the serv lately advising to avoid SAIF, one of my secretaries mentioned something I'd forgotten. This is not necessarily an endorsement for SAIF, just mention of some things that happened at my office. 1. Liberty NW was the first WC carrier to deny all payment on a claim of mine where there was not double signatures on the 'treatment plan'. You know how we're required to get a referral from an MD with certain parameters included in the referral? I've always done that. The Rx includes treatment, frequency and duration signed by the MD referring. I have billing send a copy with the bills. SAIF always pays on that info. However, there's small print saying that the DC must also sign the referral and send a copy back to the MD or the insurer can deny ALL payment. This must be done within 7 days of the referral or it can be denied! SAIF has never, I repeat NEVER followed that letter of the law in my office. I wasn't aware of the law until that happened. 2. Liberty uses/used silent PPOs. I battled with them for over 2 years after they 'bought' a contract I had signed with 'chirocare', (not chironet - they don't participate in silent sales). I was never informed that the contract was sold to auto carriers, work comp carriers etc. In fact, I'd opted out of the contract 1 year prior to it being bought. However, my 'contract' was included in the sale somehow...without my knowledge. I lost lots of $ over 2 years trying to get them to stop nickle and dime reductions. Every LIberty auto claim that came in over 2 years was reduced dramatically. They said I had to notify them in writing that I wanted the contract nullified. Then I had to continue to honor it for 6 months after that date! I could've won in court, but obviously LIberty had more $ than me and it would've depleted my resources to take them to court. 3. SAIF recently (2 months ago) extended a claim without MD referral, simply on a letter I wrote asking for 2-3 more appts to finish up active exercise with a patient. The patient's claim rep called and spoke with mysecretary and simply OKed the office visits prior to scheduling! There's my 2 cents worth. Minga Guerrrero 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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