CHP/Xrays

[Guest guest]

Anyone a member of CHP who has had to order Xrays on a patient?? I'm wondering if others are experiencing the same difficulties. CHP is the MCO for Kaiser patients who have a chiropractic bennie. If we order an Xray on a Kaiser patient, the patient HAS to go to a Kaiser fascility, Has to be seen by a Kaiser Doctor and.....(this one I haven't experienced much until lately) That doctor can choose to order or not order the films requested. Talk about frustrating.

Is there anyone else struggling with this and are there any ways of improving the process??? Again, it's the patient who suffers.

ph Medlin D.C.

[Guest guest]

ph,  The best response to such humiliating policies is to do what I and many before me have done,  drop out of this insane system altogether and save yourself and your patients all this trouble.  I have too much pride to live within this condescending system regarding chiropractic.

WillOn Thu, Mar 24, 2011 at 8:08 AM, ph Medlin <spinetree@...> wrote:

 

Anyone a member of CHP who has had to order Xrays on a patient??  I'm wondering if others are experiencing the same difficulties. CHP is the MCO for Kaiser patients who have a chiropractic bennie.  If we order an Xray on a Kaiser patient, the patient HAS to go to a Kaiser fascility, Has to be seen by a Kaiser Doctor and.....(this one I haven't experienced much until lately) That doctor can choose to order or not order the films requested. Talk about frustrating.

 

Is there anyone else struggling with this and are there any ways of improving the process???  Again, it's the patient who suffers.

 

 

ph Medlin D.C.

-- Schneider DC PDX

[Guest guest]

Joe,

I'm a provider in CHP. The policies in place are dictated by contracts that allowed CHP to provide chiropractic services to lots and lots of patients. This part of the policy may not be optimal in our eyes, however, I choose to stay in this system for a number of reasons. We are given an opportunity to introduce DC care to large numbers of folks who could not otherwise afford it. CHP is run by providers who always strive to do better with each contract. CHP regularly asks for provider suggestions and input.

If CHP were to be inflexible with certain contract demands, we would most likely have lost the contract to ASHN or some other company not as accessible as CHP. In the end, all of life and relationships are based on give and take. For me, it's worth it to stay and work as best as I can to make changes from within.

When I've had similar situations, patients needing x-ray/lab/treatment extensions, I ask the patient for contact info to their PCP. I send a professional letter directly to the PCP (sometimes via the regional referral center); and state my reasons for suggesting any testing I might think necessary. I ask for upright films if possible and explain necessity. I've suggested lab tests when I think they're needed.

I advise writing the letter and read it back as though you were the doctor receiving it. How would you want feel if another doctor asked you for assistance in a case? Does your letter convey respect towards them and give them the info necessary to co-treat? What's the best way to word it to promote inter-disciplinary referrals, cooperation etc. If time does not allow for letters and contacting the regional referral center, I send a professional letter with the patient to their next PCP appt. By doing this, I've actually gotten more referrals from the PCPs I interact with, more latitude in extension requests and more credibility with the docs I interact with. I never tell the other professional what to do. I suggest a way to differentially diagnose that may help with patient care.

I do realize that some office models may not want to work in this way. Each of us must choose what's best for our office. Some are not able or willing to work in this system. To each their own.

Minga Guerrero DC

CHP/Xrays

Anyone a member of CHP who has had to order Xrays on a patient?? I'm wondering if others are experiencing the same difficulties. CHP is the MCO for Kaiser patients who have a chiropractic bennie. If we order an Xray on a Kaiser patient, the patient HAS to go to a Kaiser fascility, Has to be seen by a Kaiser Doctor and.....(this one I haven't experienced much until lately) That doctor can choose to order or not order the films requested. Talk about frustrating.

Is there anyone else struggling with this and are there any ways of improving the process??? Again, it's the patient who suffers.

ph Medlin D.C.

[Guest guest]

Joe

Kaiser patients with a chiropractic benefit do not have to go

to a Kaiser facility nor do they need to be seen by a Kaiser doctor.

You can refer them directly to epic and several other diagnostic

facilities.

Bruce Chaser, D.C.

Hawthorne Wellness Center

ph Medlin wrote:

Anyone a member of CHP who has had to order

Xrays on a patient?? I'm wondering if others are experiencing the same

difficulties. CHP is the MCO for Kaiser patients who have a

chiropractic bennie. If we order an Xray on a Kaiser patient, the

patient HAS to go to a Kaiser fascility, Has to be seen by a

Kaiser Doctor and.....(this one I haven't experienced much until

lately) That doctor can choose to order or not order the films

requested. Talk about frustrating.

Is there anyone else struggling with this

and are there any ways of improving the process??? Again, it's the

patient who suffers.

ph Medlin D.C.

[Guest guest]

Bruce,

Could you clarify between self referred CHP/Kaiser patients and NON self

referred Kaiser patients who can see us only with a formal referral from

Kaiser.

Can I send a patient to EPIC if they are NOT self referred ?

That would be a patient we get from a Kaiser physician through their referral

department.

Thanks

Cliff Marhoefer , DC

> >

> > Anyone a member of CHP who has had to order Xrays on a patient?? I'm

> > wondering if others are experiencing the same difficulties. CHP is the

> > MCO for Kaiser patients who have a chiropractic bennie. If we order

> > an Xray on a Kaiser patient, the patient HAS to go to a Kaiser

> > fascility, Has to be seen by a Kaiser Doctor and.....(this one I

> > haven't experienced much until lately) That doctor can choose to order

> > or not order the films requested. Talk about frustrating.

> > Is there anyone else struggling with this and are there any ways of

> > improving the process??? Again, it's the patient who suffers.

> > ph Medlin D.C.

> >

>

[Guest guest]

Cliff

Self referred Kaiser patients are patients who, because of their choice

or that of their employer, have chiropractic coverage and can see a CHP

provider without a referral. They can be referred to EPIC and other

facilities by the CHP provider. Kaiser patients who do not have a

chiropractic benefit either through their or their employers choice

will not have their chiropractic care covered just like Blue Cross,

etc. patients who do not have chiropractic coverage will not have

chiropractic services covered by their insurance company.

Kaiser does have a unique program where their providers can refer their

patients without chiropractic coverage to a CHP provider. In this

situation neither the patient nor their employer pays for chiropractic

coverage but if a Kaiser provider feels that it is necessary they can

refer their patients to a CHP provider and Kaiser will foot the

bill. Kaiser asks that those referred patients who need imaging go

through their PCP at Kaiser for them. Usually a brief note to the

referring physian describing necessity is all it takes for the PCP to

refer the patient for imaging at a Kaiser facility.

Hope this helps.

Bruce Chaser, D.C.

Hawthorne Wellness Center

kondorkliph wrote:

Bruce,

Could you clarify between self referred CHP/Kaiser patients and NON

self referred Kaiser patients who can see us only with a formal

referral from Kaiser.

Can I send a patient to EPIC if they are NOT self referred ?

That would be a patient we get from a Kaiser physician through their

referral department.

Thanks

Cliff Marhoefer , DC

> >

> > Anyone a member of CHP who has had to order Xrays on a

patient?? I'm

> > wondering if others are experiencing the same difficulties.

CHP is the

> > MCO for Kaiser patients who have a chiropractic bennie. If we

order

> > an Xray on a Kaiser patient, the patient HAS to go to a

Kaiser

> > fascility, Has to be seen by a Kaiser Doctor and.....(this

one I

> > haven't experienced much until lately) That doctor can choose

to order

> > or not order the films requested. Talk about frustrating.

> > Is there anyone else struggling with this and are there any

ways of

> > improving the process??? Again, it's the patient who suffers.

> > ph Medlin D.C.

> >

>