Guest guest Posted October 5, 2005 Report Share Posted October 5, 2005 I'd like to ask for feedback....kind of a "what would you do?". A patient just came in who hasn't been in for a couple of months. SHe told me she responded to one of the "DISC PAIN" adds in the newspaper, and tried a couple of months of the back conditioning type of machine that many of you know about. There are a few practitioners in the area who have them and do the newspaper marketing thing. Quite a few PT's have them also. Anyway, it didn't do much for her in terms of reducing her back pain (like the "86% success rate" suggested), and, actually, made her feel a lot worse. O.K....so here is the question. The practioner is doing a N.O.O. P.E. (no out of pocket expense plan). Is it legal?? She stated he billed her insurance for the adjustment,and also the machine rehab part, and she went 3 times a week for 8 weeks and didn't have to pay a nickel walking in and out of there. She also said all his patients on this therapy are like that regarding the insurance (don't know how she would know). Although we have the right to write off whatever we want, it is customary to have people pay their co-pays, etc, and I had learned in school and at seminars that the NOOPE of the 70's and 80's is actually illegal. Is that what you ladies and gentleman learned?? The Oregon Rules 811 015 0000 say something about complying with "applicable federal and state laws regarding billing practices". Is this a federal thing?? Doesn't seem to say anything specific about NOOPE in the OR rules. I don't really want to get the guy in trouble by instigating a board investigation review. I would however, like him to stop it if it is illegal. What would you do??? A. Let sleeping dogs lie? B. Ask the board to check it out? C. Give a personal call to someone I don't know and ask them if they are aware that it really isn't O.K. to NOOPE? (or is it really O.K ?) Don White, RN, DC Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2005 Report Share Posted October 5, 2005 There is nothing wrong with asking the board. Our executive director, Dave McTeague, is on this list serve. Ask him yourself if it is ok. That doesn't initiate a complaint or investigation. Let us know what you find out. I think it is illegal- violating the contract between the insurane company and the patient. Ann Goldeen, Astoria Billing Practice Question I'd like to ask for feedback....kind of a "what would you do?". A patient just came in who hasn't been in for a couple of months. SHe told me she responded to one of the "DISC PAIN" adds in the newspaper, and tried a couple of months of the back conditioning type of machine that many of you know about. There are a few practitioners in the area who have them and do the newspaper marketing thing. Quite a few PT's have them also. Anyway, it didn't do much for her in terms of reducing her back pain (like the "86% success rate" suggested), and, actually, made her feel a lot worse. O.K....so here is the question. The practioner is doing a N.O.O. P.E. (no out of pocket expense plan). Is it legal?? She stated he billed her insurance for the adjustment,and also the machine rehab part, and she went 3 times a week for 8 weeks and didn't have to pay a nickel walking in and out of there. She also said all his patients on this therapy are like that regarding the insurance (don't know how she would know). Although we have the right to write off whatever we want, it is customary to have people pay their co-pays, etc, and I had learned in school and at seminars that the NOOPE of the 70's and 80's is actually illegal. Is that what you ladies and gentleman learned?? The Oregon Rules 811 015 0000 say something about complying with "applicable federal and state laws regarding billing practices". Is this a federal thing?? Doesn't seem to say anything specific about NOOPE in the OR rules. I don't really want to get the guy in trouble by instigating a board investigation review. I would however, like him to stop it if it is illegal. What would you do??? A. Let sleeping dogs lie? B. Ask the board to check it out? C. Give a personal call to someone I don't know and ask them if they are aware that it really isn't O.K. to NOOPE? (or is it really O.K ?) Don White, RN, DC Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 6, 2005 Report Share Posted October 6, 2005 I'll let you guys know what I find out. NO one seems to know, and I find it odd that no one seem to know about something that I learned in school and have been taught at billing seminars as "illegal". I also remember people in Louisiana having to take NOOPE out of their yellow page ads. I do not want to do this....but the patient reporting it to me tweaked my interest in what is allowable. THe physician involved bills for an adjustment and rehab/pt codes, and writes off the rest. It only presented a problem for the returning patient when I went to collect my co-pay, and she said Dr. X doesn't collect copays. I think it is called "hammering the biilling" and not collecting from the patient. Don White, RN, DC Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 6, 2005 Report Share Posted October 6, 2005 Quick answer would be to just call the board and ask them about NOOPE without naming the individual. You may proceed however you wish after that. The way understand it though is that it is illegal to advertise: "we will pay your co -pay" etc., but ask the board and get back to us. Would be interesting to know. Coincidentally, my wife pointed out one of those ads this morning to me in the Oregonian. I think that one said something like a $84 one time fee or something I don't know. Dr. ph Medlin D.C.Spine Tree Chiropractic1627 NE Alberta St. #6Portland, OR 97211Ph: 503-788-6800c: 503-889-6204 Billing Practice Question I'd like to ask for feedback....kind of a "what would you do?". A patient just came in who hasn't been in for a couple of months. SHe told me she responded to one of the "DISC PAIN" adds in the newspaper, and tried a couple of months of the back conditioning type of machine that many of you know about. There are a few practitioners in the area who have them and do the newspaper marketing thing. Quite a few PT's have them also. Anyway, it didn't do much for her in terms of reducing her back pain (like the "86% success rate" suggested), and, actually, made her feel a lot worse. O.K....so here is the question. The practioner is doing a N.O.O. P.E. (no out of pocket expense plan). Is it legal?? She stated he billed her insurance for the adjustment,and also the machine rehab part, and she went 3 times a week for 8 weeks and didn't have to pay a nickel walking in and out of there. She also said all his patients on this therapy are like that regarding the insurance (don't know how she would know). Although we have the right to write off whatever we want, it is customary to have people pay their co-pays, etc, and I had learned in school and at seminars that the NOOPE of the 70's and 80's is actually illegal. Is that what you ladies and gentleman learned?? The Oregon Rules 811 015 0000 say something about complying with "applicable federal and state laws regarding billing practices". Is this a federal thing?? Doesn't seem to say anything specific about NOOPE in the OR rules. I don't really want to get the guy in trouble by instigating a board investigation review. I would however, like him to stop it if it is illegal. What would you do??? A. Let sleeping dogs lie? B. Ask the board to check it out? C. Give a personal call to someone I don't know and ask them if they are aware that it really isn't O.K. to NOOPE? (or is it really O.K ?) Don White, RN, DC Quote Link to comment Share on other sites More sharing options...
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