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Workers Comp Problem

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Group,

I only get 1-2 WC cases per year, so my experience is very limited on

how things work. Here's the problem:

I recently found out that SAIF is denying payment on a WC case because

the referring MCO doctor did not get pre-approval from SAIF. I am not

an MCO chiropractor. However, I do have a signed treatment plan

authorization from the MCO doctor, but SAIF says that it was never

" pre-approved " . We contacted the referring doctor's office and they

said there is nothing they can do after the fact. So, are we and our

patient just screwed, or is there something we can do?

Also, the patient has private insurance. If SAIF is denying our

treatment, can we bill her private insurance instead?

Any suggestions would be much appreciated!

Thanks,

Jamey Dyson, D.C.

Advanced Chiropractic

1295 Wallace Rd NW

Salem, OR 97304

503-361-3949

drjdyson1@...

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