Re: Referrals from Chiropractors

[Guest guest]

Mark:

What state are you in? Can you accept chiropractic referrals?

Jeff

Jeffery R. Weiss MS PT/AT,C

Director of Rehabilitation

Alle-Kiski Medical Center

Natrona Heights, PA

jweiss1@...

Fax

>>> mmfellwo@... 12/13/05 01:29PM >>>

Hello Group,

I was told that our critical access hospital was not getting paid by CMS for

radiology procedures referred by the local chiropractor. I do not know why the

claims were denied; whether it was a critical access regulation or some other

rule.

I have not had referrals from him in the past, but I just started PT on 2

patients referred by him within the past few weeks. Our bills have gone out but

not returned . . .

Is there any reason PT would be denied payment too?

Thanks,

Mark Fellwock, PT, MBA

------------------------------------------------------------

The St. email system added the following official information to this

message.

------------------------------------------------------------NOTICE OF

CONFIDENTIALITY [sTV-NOTIFY-041405]

----------------------------------------------------

The information in this email, including attachments, may be confidential and/or

privileged and may contain confidential health information. This email is

intended to be reviewed only by the individual or organization named as

addressee. If you have received this email in error please notify St.

Health immediately - by return message to the sender or to infosec@...

- and destroy all copies of this message and any attachments. Please note that

any views or opinions presented in this email are solely those of the author and

do not necessarily represent those of St. Health. Confidential health

information is protected by state and federal law, including, but not limited

to, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and

related regulations.

==============================================================================

[Guest guest]

Mark:

What state are you in? Can you accept chiropractic referrals?

Jeff

Jeffery R. Weiss MS PT/AT,C

Director of Rehabilitation

Alle-Kiski Medical Center

Natrona Heights, PA

jweiss1@...

Fax

>>> mmfellwo@... 12/13/05 01:29PM >>>

Hello Group,

I was told that our critical access hospital was not getting paid by CMS for

radiology procedures referred by the local chiropractor. I do not know why the

claims were denied; whether it was a critical access regulation or some other

rule.

I have not had referrals from him in the past, but I just started PT on 2

patients referred by him within the past few weeks. Our bills have gone out but

not returned . . .

Is there any reason PT would be denied payment too?

Thanks,

Mark Fellwock, PT, MBA

------------------------------------------------------------

The St. email system added the following official information to this

message.

------------------------------------------------------------NOTICE OF

CONFIDENTIALITY [sTV-NOTIFY-041405]

----------------------------------------------------

The information in this email, including attachments, may be confidential and/or

privileged and may contain confidential health information. This email is

intended to be reviewed only by the individual or organization named as

addressee. If you have received this email in error please notify St.

Health immediately - by return message to the sender or to infosec@...

- and destroy all copies of this message and any attachments. Please note that

any views or opinions presented in this email are solely those of the author and

do not necessarily represent those of St. Health. Confidential health

information is protected by state and federal law, including, but not limited

to, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and

related regulations.

==============================================================================

[Guest guest]

Medicare does not recognized chiropractors as someone who can refer to PT.

It must be an MD.

Amy Marshall, PT

BIAPT

Referrals from Chiropractors

> Hello Group,

> I was told that our critical access hospital was not getting paid by CMS

> for radiology procedures referred by the local chiropractor. I do not

> know why the claims were denied; whether it was a critical access

> regulation or some other rule.

> I have not had referrals from him in the past, but I just started PT on 2

> patients referred by him within the past few weeks. Our bills have gone

> out but not returned . . .

>

> Is there any reason PT would be denied payment too?

>

> Thanks,

> Mark Fellwock, PT, MBA

>

>

> ------------------------------------------------------------

> The St. email system added the following official information to

> this message.

> ------------------------------------------------------------NOTICE OF

> CONFIDENTIALITY [sTV-NOTIFY-041405]

> ----------------------------------------------------

> The information in this email, including attachments, may be confidential

> and/or privileged and may contain confidential health information. This

> email is intended to be reviewed only by the individual or organization

> named as addressee. If you have received this email in error please notify

> St. Health immediately - by return message to the sender or to

> infosec@... - and destroy all copies of this message and any

> attachments. Please note that any views or opinions presented in this

> email are solely those of the author and do not necessarily represent

> those of St. Health. Confidential health information is protected

> by state and federal law, including, but not limited to, the Health

> Insurance Portability and Accountability Act (HIPAA) of 1996 and related

> regulations.

> ==============================================================================

>

>

>

[Guest guest]

Check the latest Medicare ruling (I think it;s from June)...it's federal and

says specifically that Chiropractors and dentists can not refer to PT. Actually

it says that only physicians can refer, and chiropractors are not considered

physicians... ouch....check the APTA website, it has all the details.

Amy:)

Re: Referrals from Chiropractors

Mark:

What state are you in? Can you accept chiropractic referrals?

Jeff

Jeffery R. Weiss MS PT/AT,C

Director of Rehabilitation

Alle-Kiski Medical Center

Natrona Heights, PA

jweiss1@...

Fax

>>> mmfellwo@... 12/13/05 01:29PM >>>

Hello Group,

I was told that our critical access hospital was not getting paid by CMS for

radiology procedures referred by the local chiropractor. I do not know why the

claims were denied; whether it was a critical access regulation or some other

rule.

I have not had referrals from him in the past, but I just started PT on 2

patients referred by him within the past few weeks. Our bills have gone out but

not returned . . .

Is there any reason PT would be denied payment too?

Thanks,

Mark Fellwock, PT, MBA

------------------------------------------------------------

The St. email system added the following official information to this

message.

------------------------------------------------------------NOTICE OF

CONFIDENTIALITY [sTV-NOTIFY-041405]

----------------------------------------------------

The information in this email, including attachments, may be confidential and/or

privileged and may contain confidential health information. This email is

intended to be reviewed only by the individual or organization named as

addressee. If you have received this email in error please notify St.

Health immediately - by return message to the sender or to infosec@...

- and destroy all copies of this message and any attachments. Please note that

any views or opinions presented in this email are solely those of the author and

do not necessarily represent those of St. Health. Confidential health

information is protected by state and federal law, including, but not limited

to, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and

related regulations.

==============================================================================

[Guest guest]

Check the latest Medicare ruling (I think it;s from June)...it's federal and

says specifically that Chiropractors and dentists can not refer to PT. Actually

it says that only physicians can refer, and chiropractors are not considered

physicians... ouch....check the APTA website, it has all the details.

Amy:)

Re: Referrals from Chiropractors

Mark:

What state are you in? Can you accept chiropractic referrals?

Jeff

Jeffery R. Weiss MS PT/AT,C

Director of Rehabilitation

Alle-Kiski Medical Center

Natrona Heights, PA

jweiss1@...

Fax

>>> mmfellwo@... 12/13/05 01:29PM >>>

Hello Group,

I was told that our critical access hospital was not getting paid by CMS for

radiology procedures referred by the local chiropractor. I do not know why the

claims were denied; whether it was a critical access regulation or some other

rule.

I have not had referrals from him in the past, but I just started PT on 2

patients referred by him within the past few weeks. Our bills have gone out but

not returned . . .

Is there any reason PT would be denied payment too?

Thanks,

Mark Fellwock, PT, MBA

------------------------------------------------------------

The St. email system added the following official information to this

message.

------------------------------------------------------------NOTICE OF

CONFIDENTIALITY [sTV-NOTIFY-041405]

----------------------------------------------------

The information in this email, including attachments, may be confidential and/or

privileged and may contain confidential health information. This email is

intended to be reviewed only by the individual or organization named as

addressee. If you have received this email in error please notify St.

Health immediately - by return message to the sender or to infosec@...

- and destroy all copies of this message and any attachments. Please note that

any views or opinions presented in this email are solely those of the author and

do not necessarily represent those of St. Health. Confidential health

information is protected by state and federal law, including, but not limited

to, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and

related regulations.

==============================================================================

[Guest guest]

Check the latest Medicare ruling (I think it;s from June)...it's federal and

says specifically that Chiropractors and dentists can not refer to PT. Actually

it says that only physicians can refer, and chiropractors are not considered

physicians... ouch....check the APTA website, it has all the details.

Amy:)

Re: Referrals from Chiropractors

Mark:

What state are you in? Can you accept chiropractic referrals?

Jeff

Jeffery R. Weiss MS PT/AT,C

Director of Rehabilitation

Alle-Kiski Medical Center

Natrona Heights, PA

jweiss1@...

Fax

>>> mmfellwo@... 12/13/05 01:29PM >>>

Hello Group,

I was told that our critical access hospital was not getting paid by CMS for

radiology procedures referred by the local chiropractor. I do not know why the

claims were denied; whether it was a critical access regulation or some other

rule.

I have not had referrals from him in the past, but I just started PT on 2

patients referred by him within the past few weeks. Our bills have gone out but

not returned . . .

Is there any reason PT would be denied payment too?

Thanks,

Mark Fellwock, PT, MBA

------------------------------------------------------------

The St. email system added the following official information to this

message.

------------------------------------------------------------NOTICE OF

CONFIDENTIALITY [sTV-NOTIFY-041405]

----------------------------------------------------

The information in this email, including attachments, may be confidential and/or

privileged and may contain confidential health information. This email is

intended to be reviewed only by the individual or organization named as

addressee. If you have received this email in error please notify St.

Health immediately - by return message to the sender or to infosec@...

- and destroy all copies of this message and any attachments. Please note that

any views or opinions presented in this email are solely those of the author and

do not necessarily represent those of St. Health. Confidential health

information is protected by state and federal law, including, but not limited

to, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and

related regulations.

==============================================================================

[Guest guest]

This is one of those instances where you need to clearly understand the

differences between practice issues and reimbursement issues. While Medicare

has a national policy stating that a chiropractor is not authorized to initiate

or approve a PT plan of care for reimbursement purposes, Florida law (as an

example) does allow a Florida-licensed chiropractor to be considered a

" practitioner of record " in terms of referring patients and approving plans of

care.

In such cases, we would just inform the patient that it's perfectly acceptable

for us to treat them on the basis of that referral, but that Medicare won't pay

for it. We have the same problem with TMJ patients referred from dentists. We

usually recommend that they discuss the referral with their primary care

physician and ask him/her to authorize therapy so it would be covered.

Ken Tuley, PT

Director, Rehab Services

Health First, Inc.

Brevard County, FL

>>> amymcbreenpt@... 12/14/05 1:41 PM >>>

Check the latest Medicare ruling (I think it;s from June)...it's federal and

says specifically that Chiropractors and dentists can not refer to PT. Actually

it says that only physicians can refer, and chiropractors are not considered

physicians... ouch....check the APTA website, it has all the details.

Amy:)

Re: Referrals from Chiropractors

Mark:

What state are you in? Can you accept chiropractic referrals?

Jeff

Jeffery R. Weiss MS PT/AT,C

Director of Rehabilitation

Alle-Kiski Medical Center

Natrona Heights, PA

jweiss1@...

Fax

>>> mmfellwo@... 12/13/05 01:29PM >>>

Hello Group,

I was told that our critical access hospital was not getting paid by CMS for

radiology procedures referred by the local chiropractor. I do not know why the

claims were denied; whether it was a critical access regulation or some other

rule.

I have not had referrals from him in the past, but I just started PT on 2

patients referred by him within the past few weeks. Our bills have gone out but

not returned . . .

Is there any reason PT would be denied payment too?

Thanks,

Mark Fellwock, PT, MBA

------------------------------------------------------------

The St. email system added the following official information to this

message.

------------------------------------------------------------NOTICE OF

CONFIDENTIALITY [sTV-NOTIFY-041405]

----------------------------------------------------

The information in this email, including attachments, may be confidential and/or

privileged and may contain confidential health information. This email is

intended to be reviewed only by the individual or organization named as

addressee. If you have received this email in error please notify St.

Health immediately - by return message to the sender or to infosec@...

- and destroy all copies of this message and any attachments. Please note that

any views or opinions presented in this email are solely those of the author and

do not necessarily represent those of St. Health. Confidential health

information is protected by state and federal law, including, but not limited

to, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and

related regulations.

==============================================================================

[Guest guest]

This is one of those instances where you need to clearly understand the

differences between practice issues and reimbursement issues. While Medicare

has a national policy stating that a chiropractor is not authorized to initiate

or approve a PT plan of care for reimbursement purposes, Florida law (as an

example) does allow a Florida-licensed chiropractor to be considered a

" practitioner of record " in terms of referring patients and approving plans of

care.

In such cases, we would just inform the patient that it's perfectly acceptable

for us to treat them on the basis of that referral, but that Medicare won't pay

for it. We have the same problem with TMJ patients referred from dentists. We

usually recommend that they discuss the referral with their primary care

physician and ask him/her to authorize therapy so it would be covered.

Ken Tuley, PT

Director, Rehab Services

Health First, Inc.

Brevard County, FL

>>> amymcbreenpt@... 12/14/05 1:41 PM >>>

Check the latest Medicare ruling (I think it;s from June)...it's federal and

says specifically that Chiropractors and dentists can not refer to PT. Actually

it says that only physicians can refer, and chiropractors are not considered

physicians... ouch....check the APTA website, it has all the details.

Amy:)

Re: Referrals from Chiropractors

Mark:

What state are you in? Can you accept chiropractic referrals?

Jeff

Jeffery R. Weiss MS PT/AT,C

Director of Rehabilitation

Alle-Kiski Medical Center

Natrona Heights, PA

jweiss1@...

Fax

>>> mmfellwo@... 12/13/05 01:29PM >>>

Hello Group,

I was told that our critical access hospital was not getting paid by CMS for

radiology procedures referred by the local chiropractor. I do not know why the

claims were denied; whether it was a critical access regulation or some other

rule.

I have not had referrals from him in the past, but I just started PT on 2

patients referred by him within the past few weeks. Our bills have gone out but

not returned . . .

Is there any reason PT would be denied payment too?

Thanks,

Mark Fellwock, PT, MBA

------------------------------------------------------------

The St. email system added the following official information to this

message.

------------------------------------------------------------NOTICE OF

CONFIDENTIALITY [sTV-NOTIFY-041405]

----------------------------------------------------

The information in this email, including attachments, may be confidential and/or

privileged and may contain confidential health information. This email is

intended to be reviewed only by the individual or organization named as

addressee. If you have received this email in error please notify St.

Health immediately - by return message to the sender or to infosec@...

- and destroy all copies of this message and any attachments. Please note that

any views or opinions presented in this email are solely those of the author and

do not necessarily represent those of St. Health. Confidential health

information is protected by state and federal law, including, but not limited

to, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and

related regulations.

==============================================================================

[Guest guest]

This is one of those instances where you need to clearly understand the

differences between practice issues and reimbursement issues. While Medicare

has a national policy stating that a chiropractor is not authorized to initiate

or approve a PT plan of care for reimbursement purposes, Florida law (as an

example) does allow a Florida-licensed chiropractor to be considered a

" practitioner of record " in terms of referring patients and approving plans of

care.

In such cases, we would just inform the patient that it's perfectly acceptable

for us to treat them on the basis of that referral, but that Medicare won't pay

for it. We have the same problem with TMJ patients referred from dentists. We

usually recommend that they discuss the referral with their primary care

physician and ask him/her to authorize therapy so it would be covered.

Ken Tuley, PT

Director, Rehab Services

Health First, Inc.

Brevard County, FL

>>> amymcbreenpt@... 12/14/05 1:41 PM >>>

Check the latest Medicare ruling (I think it;s from June)...it's federal and

says specifically that Chiropractors and dentists can not refer to PT. Actually

it says that only physicians can refer, and chiropractors are not considered

physicians... ouch....check the APTA website, it has all the details.

Amy:)

Re: Referrals from Chiropractors

Mark:

What state are you in? Can you accept chiropractic referrals?

Jeff

Jeffery R. Weiss MS PT/AT,C

Director of Rehabilitation

Alle-Kiski Medical Center

Natrona Heights, PA

jweiss1@...

Fax

>>> mmfellwo@... 12/13/05 01:29PM >>>

Hello Group,

I was told that our critical access hospital was not getting paid by CMS for

radiology procedures referred by the local chiropractor. I do not know why the

claims were denied; whether it was a critical access regulation or some other

rule.

I have not had referrals from him in the past, but I just started PT on 2

patients referred by him within the past few weeks. Our bills have gone out but

not returned . . .

Is there any reason PT would be denied payment too?

Thanks,

Mark Fellwock, PT, MBA

------------------------------------------------------------

The St. email system added the following official information to this

message.

------------------------------------------------------------NOTICE OF

CONFIDENTIALITY [sTV-NOTIFY-041405]

----------------------------------------------------

The information in this email, including attachments, may be confidential and/or

privileged and may contain confidential health information. This email is

intended to be reviewed only by the individual or organization named as

addressee. If you have received this email in error please notify St.

Health immediately - by return message to the sender or to infosec@...

- and destroy all copies of this message and any attachments. Please note that

any views or opinions presented in this email are solely those of the author and

do not necessarily represent those of St. Health. Confidential health

information is protected by state and federal law, including, but not limited

to, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and

related regulations.

==============================================================================