Guest guest Posted October 27, 2011 Report Share Posted October 27, 2011 chiropractors will naturally go uncontrollably " ape " Ok, I’ll try to avoid it, but I can’t promise anything... (I just got opposable thumbs last month!) -- E. Abrahamson, D.C. Chiropractic physician Lake Oswego Chiropractic Clinic 315 Second Street Lake Oswego, OR 97034 503-635-6246 Website: http://www.lakeoswegochiro.com From: <msmith@...> Date: Thu, 27 Oct 2011 18:00:02 -0700 Abrahamson <drscott@...>, < > Subject: RE: My first VA referral! Assuming since they've not authorized and will not pay for cervical xrays, that they've already done them and would be happy to forward them over for your review. Also, don't forget that in all liklihood this poor Vet wouldn't be able to get even a medical doctor to see him to help his neck pain 6 times in the next 6 years. So don't fret. I did get a kick out of the following, though: 1. Passive therapies must be minimized and " priority given to providing patient with instruction and practice in techniques and activities that will maximize his/her ability to progress in self management of symptoms and recovery. " 2. These restrictions must be met or this authorization will be terminated. It actually looks on paper like he was referred to you to be taught how to get a grip, and cope with his neck pain on his own without the help of you or anyone else in the future. All ridicule aside, you've got to appreciate the fear and prejudicial fear of the referring source which is probably coming from the pre-programmed belief that chiropractors will naturally go uncontrollably " ape " and treat a patient forever and blow through $15,000 bucks unless tight reigns are placed upon the referral. I have a hunch that the referring source was fearful in making the referral. So I hope you don't look at it as a snipe, but rather an opportunity. If it were me, I'd even go the extra mile and right a nice narrative letter back to the referring doctor about everything you found, did, and recommended for the honorable veteran. My experience with the folks at the VA, is that they truly are dedicated health care providers who continually and daily are required to and do make more with less. They have to. I have found them to be extremely compassionate and passionate. They would go " ape " and insane themselves if they were not. Just a thought. G. Gatti, Gatti, Maier, Sayer, Thayer, & Associates 1781 Liberty St. SE Salem, OR 97302 1-(800) 289-3443 msmith@... <blocked::blocked::blocked::mailto:msmith@...> From: [mailto: ] On Behalf Of Abrahamson Sent: Thursday, October 27, 2011 4:25 PM Subject: My first VA referral! A gentleman walked in and told us that he was referred by the VA to seek chiropractic care [a “chiropractic therapist”] for long term affects of a motor vehicle accident 2 years ago. His physician told him that medication and therapy was not working and he needed to find a local chiropractor. From the looks of the referral letter, (scanned and redacted below) the V-4-Fee manager is not happy about this. My question for you is do I: celebrate the scraps tossed out and hope that my performance will elevate chiropractic leading to more comprehensive referrals? (Bearing in mind that allowing these guys to dumb down chiropractic to this level will harm us in the long run.) send a letter back and tell them that 6 visits for a 2 years of scar tissue in a middle aged man is a joke? just treat the guy for 6 visits while attempting to educate him about reality and let it go? Note also that it requires me to use my 6 years of training and mountains of experience to design and establish independent home care (I think they PAY PT’s and OT’s to do this) for no pay as they will only pay for adjustment codes! VA referral, suitable for framing: Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx 10/24/11 In Reply Refer 648/V-4-FEE -Patient name redacted- To Whom -It Way Concern: Please take this letter to a local licensed CHRIOPRACTOR in your community as the provider has been authorized to provide outpatient medical treatment to the above-named veteran at Department of Veterans Affairs (VA) expense. VA has approved ONE Evaluation AND SIX treatments ONLY over1 a SIX MONTH time period for NECK PAIN* . Authorization is effective 10/24/11 and expires 04/24/12. NO CONTINUED CARE REQUESTS WILL BR GRANTED. NEED TO MINIMIZE PASSIVE TREATMENTS AND ESTABLISH INDEPENDENT HOME PROGRAM AS WELL. THE PVAMC WILL ONLY PAY FOR ONE EVALUATION AND (6) VISITS USING CPT CODES 98940 / 98941 and 98942. 0NLY FOR CHIROPRACITC CARE. No other diagnostic or therapeutic services are furnished by a chiropractor, that includes ultrasound treatment, traction, electrical, moist hot or cold packs, x-rays and any other diagnostic testing. THE F0LLOWING RESTRICTlONS APPLY TO THIS AUTHORIZATION: 1. Passive therapies must be minimized and priority given to providing patient with instruction and practice in techniques and activities that will maximize his/her ability to progress in self management of symptoms and recovery. ' " " " 2. These restrictions must be met or this authorization will be terminated. This authorization superseded all previous authorizations. Payment by VA will be according to VA Fee Schedule and will be considered payment in full for services provided during the above-authorized period. Supplemental or duplicate claims for these services must NOT be submitted to other parties;.The veteran should not make any payments, since the VA may not be able to reimburse the total amount expended by the veteran. Please send all medical notes with requests for payment to: Dept of Veteran Affairs, PO Box 1035, Portland, Or 97207. If you have any questions regarding this matter, please contact us at the above address or calf Carol at (360) 759-1674 or if outside the Portland/Vancouver area toll free 1-800-949-1004 Op 2 . Fax number: (360) 905-1731.. Medical questions should be directed to your medical provider. Sincerely yours, Carol for Molly Kok Manager* Business Office Enclosure: Please take this letter and the enclosed page to your local chiropractic therapist. Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx I love vets so I’ll do what I can. E. Abrahamson, D.C. Chiropractic physician Lake Oswego Chiropractic Clinic 315 Second Street Lake Oswego, OR 97034 503-635-6246 Website: http://www.lakeoswegochiro.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2011 Report Share Posted October 27, 2011 I have adjusted a few VA people and I have found that depending upon their level of disability (like 100% is the best) and either who their Doctor is or who their social worker is will determine how many visits they will give them. The standard I think has been 6 visits for either per year or per 12 months. But I have had some who have had a couple of rounds of 6 visits and yes I have written a brief report to the MD and social worker or benefits coordinator, which helps sometimes. I have also had someone whose MD and benefits coordinator would presribe about 16 visits over 2 - 3 months at a time and renewed it a few times. So good luck Elliott Mantell DC From: Schneider <portlandchiro1@...> Abrahamson <drscott@...>Cc: " " < >Sent: Thursday, October 27, 2011 5:05 PMSubject: Re: My first VA referral! My gut is to do all of the above-with emphasis on letter talking about madness of so few visits to really do a quality job. The vet deserves better than scaps from our table of abundant quality. Schneider DCPDX On Thu, Oct 27, 2011 at 4:24 PM, Abrahamson <drscott@...> wrote: A gentleman walked in and told us that he was referred by the VA to seek chiropractic care [a “chiropractic therapistâ€] for long term affects of a motor vehicle accident 2 years ago.His physician told him that medication and therapy was not working and he needed to find a local chiropractor. From the looks of the referral letter, (scanned and redacted below) the V-4-Fee manager is not happy about this.My question for you is do I: celebrate the scraps tossed out and hope that my performance will elevate chiropractic leading to more comprehensive referrals? (Bearing in mind that allowing these guys to dumb down chiropractic to this level will harm us in the long run.) send a letter back and tell them that 6 visits for a 2 years of scar tissue in a middle aged man is a joke? just treat the guy for 6 visits while attempting to educate him about reality and let it go? Note also that it requires me to use my 6 years of training and mountains of experience to design and establish independent home care (I think they PAY PT’s and OT’s to do this) for no pay as they will only pay for adjustment codes!VA referral, suitable for framing:Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx10/24/11 In Reply Refer 648/V-4-FEE -Patient name redacted-To Whom -It Way Concern:Please take this letter to a local licensed CHRIOPRACTOR in your community as the provider has been authorized to provide outpatient medical treatment to the above-named veteran at Department of Veterans Affairs (VA) expense. VA has approved ONE Evaluation AND SIX treatments ONLY over1 a SIX MONTH time period for NECK PAIN* .Authorization is effective 10/24/11 and expires 04/24/12. NO CONTINUED CARE REQUESTS WILL BR GRANTED. NEED TO MINIMIZE PASSIVE TREATMENTS AND ESTABLISH INDEPENDENT HOME PROGRAM AS WELL.THE PVAMC WILL ONLY PAY FOR ONE EVALUATION AND (6) VISITS USING CPT CODES 98940 /98941 and 98942.0NLY FOR CHIROPRACITC CARE. No other diagnostic or therapeutic services are furnished by a chiropractor, that includes ultrasound treatment, traction, electrical, moist hot or cold packs, x-rays and any other diagnostic testing. THE F0LLOWING RESTRICTlONS APPLY TO THIS AUTHORIZATION:1. Passive therapies must be minimized and priority given to providing patient with instruction and practice in techniques and activities that will maximize his/her ability to progress in self management of symptoms and recovery. '" ""2. These restrictions must be met or this authorization will be terminated.This authorization superseded all previous authorizations. Payment by VA will be according to VA Fee Schedule and will be considered payment in full for services provided during the above-authorized period. Supplemental or duplicate claims for these services must NOT be submitted to other parties;.The veteran should not make any payments, since the VA may not be able to reimburse the total amount expended by the veteran. Please send all medical notes with requests for payment to: Dept of Veteran Affairs, PO Box 1035, Portland, Or 97207.If you have any questions regarding this matter, please contact us at the above address or calf Carol at (360) 759-1674 or if outside the Portland/Vancouver area toll free 1-800-949-1004 Op 2 . Fax number: (360) 905-1731.. Medical questions should be directed to your medical provider.Sincerely yours,Carolfor Molly KokManager* Business OfficeEnclosure: Please take this letter and the enclosed page to your local chiropractic therapist.Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx XxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxI love vets so I’ll do what I can. E. Abrahamson, D.C.Chiropractic physicianLake Oswego Chiropractic Clinic315 Second StreetLake Oswego, OR 97034503-635-6246Website: http://www.lakeoswegochiro.com -- Schneider DC PDX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2011 Report Share Posted October 27, 2011 Now that I read your prescription it is more strict than the ones I have received. I think I had one that was similar, but most allowed therapies if that is part of your protocol. My opinion is to do the care, educate your patient and send a letter to the VA doctor and social worker as to why the patient needs more care. Remind them that congress passed a law entitling veteran's to Chiropractic care. Good luck Elliott From: Dr. Elliott Mantell <commongroundchiropractic@...> Schneider <portlandchiro1@...>; Abrahamson <drscott@...>Cc: " " < >Sent: Thursday, October 27, 2011 6:39 PMSubject: Re: My first VA referral! I have adjusted a few VA people and I have found that depending upon their level of disability (like 100% is the best) and either who their Doctor is or who their social worker is will determine how many visits they will give them. The standard I think has been 6 visits for either per year or per 12 months. But I have had some who have had a couple of rounds of 6 visits and yes I have written a brief report to the MD and social worker or benefits coordinator, which helps sometimes. I have also had someone whose MD and benefits coordinator would presribe about 16 visits over 2 - 3 months at a time and renewed it a few times. So good luck Elliott Mantell DC From: Schneider <portlandchiro1@...> Abrahamson <drscott@...>Cc: " " < >Sent: Thursday, October 27, 2011 5:05 PMSubject: Re: My first VA referral! My gut is to do all of the above-with emphasis on letter talking about madness of so few visits to really do a quality job. The vet deserves better than scaps from our table of abundant quality. Schneider DCPDX On Thu, Oct 27, 2011 at 4:24 PM, Abrahamson <drscott@...> wrote: A gentleman walked in and told us that he was referred by the VA to seek chiropractic care [a “chiropractic therapistâ€] for long term affects of a motor vehicle accident 2 years ago.His physician told him that medication and therapy was not working and he needed to find a local chiropractor. From the looks of the referral letter, (scanned and redacted below) the V-4-Fee manager is not happy about this.My question for you is do I: celebrate the scraps tossed out and hope that my performance will elevate chiropractic leading to more comprehensive referrals? (Bearing in mind that allowing these guys to dumb down chiropractic to this level will harm us in the long run.) send a letter back and tell them that 6 visits for a 2 years of scar tissue in a middle aged man is a joke? just treat the guy for 6 visits while attempting to educate him about reality and let it go? Note also that it requires me to use my 6 years of training and mountains of experience to design and establish independent home care (I think they PAY PT’s and OT’s to do this) for no pay as they will only pay for adjustment codes!VA referral, suitable for framing:Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx10/24/11 In Reply Refer 648/V-4-FEE -Patient name redacted-To Whom -It Way Concern:Please take this letter to a local licensed CHRIOPRACTOR in your community as the provider has been authorized to provide outpatient medical treatment to the above-named veteran at Department of Veterans Affairs (VA) expense. VA has approved ONE Evaluation AND SIX treatments ONLY over1 a SIX MONTH time period for NECK PAIN* .Authorization is effective 10/24/11 and expires 04/24/12. NO CONTINUED CARE REQUESTS WILL BR GRANTED. NEED TO MINIMIZE PASSIVE TREATMENTS AND ESTABLISH INDEPENDENT HOME PROGRAM AS WELL.THE PVAMC WILL ONLY PAY FOR ONE EVALUATION AND (6) VISITS USING CPT CODES 98940 /98941 and 98942.0NLY FOR CHIROPRACITC CARE. No other diagnostic or therapeutic services are furnished by a chiropractor, that includes ultrasound treatment, traction, electrical, moist hot or cold packs, x-rays and any other diagnostic testing. THE F0LLOWING RESTRICTlONS APPLY TO THIS AUTHORIZATION:1. Passive therapies must be minimized and priority given to providing patient with instruction and practice in techniques and activities that will maximize his/her ability to progress in self management of symptoms and recovery. '" ""2. These restrictions must be met or this authorization will be terminated.This authorization superseded all previous authorizations. Payment by VA will be according to VA Fee Schedule and will be considered payment in full for services provided during the above-authorized period. Supplemental or duplicate claims for these services must NOT be submitted to other parties;.The veteran should not make any payments, since the VA may not be able to reimburse the total amount expended by the veteran. Please send all medical notes with requests for payment to: Dept of Veteran Affairs, PO Box 1035, Portland, Or 97207.If you have any questions regarding this matter, please contact us at the above address or calf Carol at (360) 759-1674 or if outside the Portland/Vancouver area toll free 1-800-949-1004 Op 2 . Fax number: (360) 905-1731.. Medical questions should be directed to your medical provider.Sincerely yours,Carolfor Molly KokManager* Business OfficeEnclosure: Please take this letter and the enclosed page to your local chiropractic therapist.Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx XxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxI love vets so I’ll do what I can. E. Abrahamson, D.C.Chiropractic physicianLake Oswego Chiropractic Clinic315 Second StreetLake Oswego, OR 97034503-635-6246Website: http://www.lakeoswegochiro.com -- Schneider DC PDX Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2011 Report Share Posted October 28, 2011 I have had a few of these. I have sat the patient down and showed them the "Mission Statement" of my chiropractic practice....it includes the words "high-quality chiropractic care". I explain, that if I were to follow/accept the PRESCRIPTION (it is NOT a referral, see below link) , that I would not be fulfilling my mission, therefore I can not accept it. I am happy to make other cash-based arrangements for normal, high-quality chiropractic care. http://www.springbrookclinic.com/index.php?p=53568 J. , DC www.springbrookclinic.com www.DaytonOregon.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2011 Report Share Posted October 28, 2011 I can break the bonds of bureaucracy to benefit the brother. -- E. Abrahamson, D.C. Chiropractic physician Lake Oswego Chiropractic Clinic 315 Second Street Lake Oswego, OR 97034 503-635-6246 Website: http://www.lakeoswegochiro.com From: Vern Saboe <vsaboe@...> Reply-Vern Saboe <vsaboe@...> Date: Thu, 27 Oct 2011 21:58:45 -0700 Abrahamson <drscott@...>, <Oregondcs >, <msmith@...> Subject: Re: My first VA referral! is again (I call him the " brainiac " of the law firm) spot on. This is indeed an opportunity and you should use it to educate. How I have handled this same situation with the limited perscription and the referent to passive modalities is this. First I shake that veterans hand strongly and thank him for his service to our country then I give him a consultation in my private office getting all his info, I work him/her up like she has 100% insurance and give that veteran my professional best. Which means I put together my treatment plan with needed passive modalities whatever I need to get the job done understanding most have permanent injuries that I will improve, lessen their discomfort, teach them core strengthening exercises, strength and flexibilty home exercises etc., etc. I will see that Veterans as many visits as I believe he or she needs but only bill the VA for the visits they have authorized and then request more with a well written letter explaining my assessment, treatment and its rational response of the patient, explaining the active protocols I've given the patient and the reality that they are not going to be " fixed " more times than not but managed. How our treatments would benefit the veteran over the continued use of prescription medications including narcotics and even OTCs with all of their health side effects.....I then encourage the veteran to write or at least speak to their medical PCP at the VA about their positive experience etc.,etc.,.... In the end I probably give away 75% of my treatment to that veteran but by doing so and getting the positive outcomes you and I are paving the road for expansion of chiropractic services within the VA including a full time DC at the VA, expansion to the outpatient clinics, fee for service, and opening the teaching hospital at the VA to 4th year interns to perform rotations and volunteer work learning as they go and later residency programs for young DCs in primary care, orthopedics and neurology....can you imagine the inpact with a well train DC neurologist performing Dr. Carrick's on MTBI patients in the VA hospital! I will be meeting with the Chief of Staff at the VA medical center shorty and will give you all an update....in short give him your best! Vern My first VA referral! A gentleman walked in and told us that he was referred by the VA to seek chiropractic care [a “chiropractic therapist”] for long term affects of a motor vehicle accident 2 years ago. His physician told him that medication and therapy was not working and he needed to find a local chiropractor. From the looks of the referral letter, (scanned and redacted below) the V-4-Fee manager is not happy about this. My question for you is do I: celebrate the scraps tossed out and hope that my performance will elevate chiropractic leading to more comprehensive referrals? (Bearing in mind that allowing these guys to dumb down chiropractic to this level will harm us in the long run.) send a letter back and tell them that 6 visits for a 2 years of scar tissue in a middle aged man is a joke? just treat the guy for 6 visits while attempting to educate him about reality and let it go? Note also that it requires me to use my 6 years of training and mountains of experience to design and establish independent home care (I think they PAY PT’s and OT’s to do this) for no pay as they will only pay for adjustment codes! VA referral, suitable for framing: Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx 10/24/11 In Reply Refer 648/V-4-FEE -Patient name redacted- To Whom -It Way Concern: Please take this letter to a local licensed CHRIOPRACTOR in your community as the provider has been authorized to provide outpatient medical treatment to the above-named veteran at Department of Veterans Affairs (VA) expense. VA has approved ONE Evaluation AND SIX treatments ONLY over1 a SIX MONTH time period for NECK PAIN* . Authorization is effective 10/24/11 and expires 04/24/12. NO CONTINUED CARE REQUESTS WILL BR GRANTED. NEED TO MINIMIZE PASSIVE TREATMENTS AND ESTABLISH INDEPENDENT HOME PROGRAM AS WELL. THE PVAMC WILL ONLY PAY FOR ONE EVALUATION AND (6) VISITS USING CPT CODES 98940 / 98941 and 98942. 0NLY FOR CHIROPRACITC CARE. No other diagnostic or therapeutic services are furnished by a chiropractor, that includes ultrasound treatment, traction, electrical, moist hot or cold packs, x-rays and any other diagnostic testing. THE F0LLOWING RESTRICTlONS APPLY TO THIS AUTHORIZATION: 1. Passive therapies must be minimized and priority given to providing patient with instruction and practice in techniques and activities that will maximize his/her ability to progress in self management of symptoms and recovery. ' " " " 2. These restrictions must be met or this authorization will be terminated. This authorization superseded all previous authorizations. Payment by VA will be according to VA Fee Schedule and will be considered payment in full for services provided during the above-authorized period. Supplemental or duplicate claims for these services must NOT be submitted to other parties;.The veteran should not make any payments, since the VA may not be able to reimburse the total amount expended by the veteran. Please send all medical notes with requests for payment to: Dept of Veteran Affairs, PO Box 1035, Portland, Or 97207. If you have any questions regarding this matter, please contact us at the above address or calf Carol at (360) 759-1674 or if outside the Portland/Vancouver area toll free 1-800-949-1004 Op 2 . Fax number: (360) 905-1731.. Medical questions should be directed to your medical provider. Sincerely yours, Carol for Molly Kok Manager* Business Office Enclosure: Please take this letter and the enclosed page to your local chiropractic therapist. Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx I love vets so I’ll do what I can. E. Abrahamson, D.C. Chiropractic physician Lake Oswego Chiropractic Clinic 315 Second Street Lake Oswego, OR 97034 503-635-6246 Website: http://www.lakeoswegochiro.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2011 Report Share Posted October 28, 2011 Ah..you are a “special” colleague to be sure y….love ya bro! VErn From: Abrahamson [mailto:drscott@...] Sent: Friday, October 28, 2011 10:11 AMVern Saboe; Oregondcs ; Subject: Re: My first VA referral! I can break the bonds of bureaucracy to benefit the brother.-- E. Abrahamson, D.C.Chiropractic physicianLake Oswego Chiropractic Clinic315 Second StreetLake Oswego, OR 97034503-635-6246Website: http://www.lakeoswegochiro.comFrom: Vern Saboe <vsaboe@...>Reply-Vern Saboe <vsaboe@...>Date: Thu, 27 Oct 2011 21:58:45 -0700 Abrahamson <drscott@...>, <Oregondcs >, <msmith@...>Subject: Re: My first VA referral! is again (I call him the " brainiac " of the law firm) spot on. This is indeed an opportunity and you should use it to educate. How I have handled this same situation with the limited perscription and the referent to passive modalities is this. First I shake that veterans hand strongly and thank him for his service to our country then I give him a consultation in my private office getting all his info, I work him/her up like she has 100% insurance and give that veteran my professional best. Which means I put together my treatment plan with needed passive modalities whatever I need to get the job done understanding most have permanent injuries that I will improve, lessen their discomfort, teach them core strengthening exercises, strength and flexibilty home exercises etc., etc. I will see that Veterans as many visits as I believe he or she needs but only bill the VA for the visits they have authorized and then request more with a well written letter explaining my assessment, treatment and its rational response of the patient, explaining the active protocols I've given the patient and the reality that they are not going to be " fixed " more times than not but managed. How our treatments would benefit the veteran over the continued use of prescription medications including narcotics and even OTCs with all of their health side effects.....I then encourage the veteran to write or at least speak to their medical PCP at the VA about their positive experience etc.,etc.,....In the end I probably give away 75% of my treatment to that veteran but by doing so and getting the positive outcomes you and I are paving the road for expansion of chiropractic services within the VA including a full time DC at the VA, expansion to the outpatient clinics, fee for service, and opening the teaching hospital at the VA to 4th year interns to perform rotations and volunteer work learning as they go and later residency programs for young DCs in primary care, orthopedics and neurology....can you imagine the inpact with a well train DC neurologist performing Dr. Carrick's on MTBI patients in the VA hospital!I will be meeting with the Chief of Staff at the VA medical center shorty and will give you all an update....in short give him your best!Vern My first VA referral! A gentleman walked in and told us that he was referred by the VA to seek chiropractic care [a “chiropractic therapist”] for long term affects of a motor vehicle accident 2 years ago.His physician told him that medication and therapy was not working and he needed to find a local chiropractor. From the looks of the referral letter, (scanned and redacted below) the V-4-Fee manager is not happy about this.My question for you is do I: celebrate the scraps tossed out and hope that my performance will elevate chiropractic leading to more comprehensive referrals? (Bearing in mind that allowing these guys to dumb down chiropractic to this level will harm us in the long run.) send a letter back and tell them that 6 visits for a 2 years of scar tissue in a middle aged man is a joke? just treat the guy for 6 visits while attempting to educate him about reality and let it go? Note also that it requires me to use my 6 years of training and mountains of experience to design and establish independent home care (I think they PAY PT’s and OT’s to do this) for no pay as they will only pay for adjustment codes!VA referral, suitable for framing:Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx10/24/11 In Reply Refer 648/V-4-FEE -Patient name redacted-To Whom -It Way Concern:Please take this letter to a local licensed CHRIOPRACTOR in your community as the provider has been authorized to provide outpatient medical treatment to the above-named veteran at Department of Veterans Affairs (VA) expense. VA has approved ONE Evaluation AND SIX treatments ONLY over1 a SIX MONTH time period for NECK PAIN* .Authorization is effective 10/24/11 and expires 04/24/12. NO CONTINUED CARE REQUESTS WILL BR GRANTED. NEED TO MINIMIZE PASSIVE TREATMENTS AND ESTABLISH INDEPENDENT HOME PROGRAM AS WELL.THE PVAMC WILL ONLY PAY FOR ONE EVALUATION AND (6) VISITS USING CPT CODES 98940 /98941 and 98942.0NLY FOR CHIROPRACITC CARE. No other diagnostic or therapeutic services are furnished by a chiropractor, that includes ultrasound treatment, traction, electrical, moist hot or cold packs, x-rays and any other diagnostic testing. THE F0LLOWING RESTRICTlONS APPLY TO THIS AUTHORIZATION:1. Passive therapies must be minimized and priority given to providing patient with instruction and practice in techniques and activities that will maximize his/her ability to progress in self management of symptoms and recovery. ' " " " 2. These restrictions must be met or this authorization will be terminated.This authorization superseded all previous authorizations. Payment by VA will be according to VA Fee Schedule and will be considered payment in full for services provided during the above-authorized period. Supplemental or duplicate claims for these services must NOT be submitted to other parties;.The veteran should not make any payments, since the VA may not be able to reimburse the total amount expended by the veteran. Please send all medical notes with requests for payment to: Dept of Veteran Affairs, PO Box 1035, Portland, Or 97207.If you have any questions regarding this matter, please contact us at the above address or calf Carol at (360) 759-1674 or if outside the Portland/Vancouver area toll free 1-800-949-1004 Op 2 . Fax number: (360) 905-1731.. Medical questions should be directed to your medical provider.Sincerely yours,Carolfor Molly KokManager* Business OfficeEnclosure: Please take this letter and the enclosed page to your local chiropractic therapist.Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx XxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxI love vets so I’ll do what I can. E. Abrahamson, D.C.Chiropractic physicianLake Oswego Chiropractic Clinic315 Second StreetLake Oswego, OR 97034503-635-6246Website: http://www.lakeoswegochiro.com Quote Link to comment Share on other sites More sharing options...
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