RE: Some thoughts on ACN and Corporate PT

[Guest guest]

American Chiro Network rep has been calling my office for us to sign up to

accept $75 and $65 reimbursement. Many of the PTPN offices are not accepting

the contract. I also called our CA APTA chapter and I was told not to accept

the ACN contract. After all it is a chiro network telling us PTs how to do

our job. I have difficulty accepting this kind of control from chiros.

So please hold on to the contract and do not accept it. CAPTA has asked us

to go to the chapter website and they have templates of letters to be

written to Senators and also to UHC. Our expenses of running a private

practise is getting harder and harder as years go by. Even to hire a staff

PT is costing approx $38- $40 per hour. Rents are going up.

Let's join to gather to fight this problem as it is going to have a serious

effect to our pocket books.

Hiten Dave' PT

Some thoughts on ACN and Corporate PT

I wanted to step onto my soap box for a minute, and

rant about what large corporate PT practices are doing

to smaller PT-owned practices.

I wrote recently asking of other's experience with

United HealthCare/ACN offering very low reimbursement

rates for PT. Here, in California, ACN/United

Healthcare is offering $75 for an eval and $65 for a

visit " take it or leave it. "

I belong to a PT office managers group and learned

that one of the practices located less than 20 miles

from our office had been offered a contract for $105

per eval and $95 per visit by ACN/UHC, over 25% above

our offer. I called my contact at ACN inquiring if

we, too, could get the same rate.

I was told that in the area 20 miles away, there were

no large, corporate-owned PT clinics. Since this

clinic is in an area that has a certain percentage of

employees covered by UHC, UHC offered this clinic a

better contract; no one else in the area had agreed

to the low rates.

Where we are, we have two corporate owned or managed

PT clinics which signed up immediately for the low

rates.

Had the corporations held out for better rates, we all

would have benefitted.

By the way, did you see the report in the Wall Street

Journal about the CEO of United Health who earns $6M a

year and has $1.6 BILLION in stock options?

Viel, Office Manager

Mt. Eden Physical Therapy

19845 Lake Chabot Road, Suite 205

Castro Valley, CA 94546

mt_eden_pt@...

Please identify yourself, your discipline and your location in all messages

to PTManager.

Sick of working for someone else?

Tired of fighting against POPTS?

Ready to quit the corporate nonsense of large organizations? Visit

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PTManager encourages participation in your professional association. Join

APTA, AOTA or ASHA and participate now!

Please identify yourself, your discipline and your location in all messages

to PTManager.

[Guest guest]

I am one of the few physical therapist in the area who took United

Healthcare in the first place because of there low rates. I just received this

crazy

letter from the ACN about the paper work I have to send in for an eval and

then the aurthorization of treatment for the peanuts they are going to pay. I am

opting out of the insurance and we are not taking that insurance any longer.

In time the employees will complain of the benefits and this will prompt the

company to look for different types of insurance that are reasonable. If no

one wants to take it then how does a network survive. I think this will be the

move as far as dealing with this situation. I would also write a letter to

the senator and congressman as well as the higher up in the company who deal

with the stock holders. The CEO making 6 million is crazy.

Onuwa Terry, PT, DPT

Terry Physical Therapy

[Guest guest]

In Western NY, Independent Health $50 eval , $38.50 follow up

reimbursement,

Worker's comp/ no-fault approx $73 for eval and treatment first visit , $48

for followups.

Would love to have your reimbursement problems.

Mark Milleville Pt

Wheatfield Physical Therapy

New York

[Guest guest]

Once again a series of posts has painted the distressing picture of

third-party control of practice. Please realize, especially as we struggle

for autonomy, that the primary leash is not in the hands of doctors, but

third-party payers.

United HealthCare's use of it's size to lower prices (NOT a market force)

and the detestable CEO salary reported by Viel are, however odious,

actually beside the point here. The forces of note are: 1. Medical care is

taking up an ever greater portion of GDP, and 2. Consumers are searching out

lower insurance premiums (remember that in this world of employer-provided

medical insurance, business is a consumer). Who can be surprised at how

third parties have behaved in this environment?

Dave Hiten says that he has " difficulty accepting this kind of control from

[ACN] " because chiropractors are behind it. But is it any more fair to have

a non-chiro bureaucrat in charge of your practice (or your own personal

health care)? The fact is that it's all rotten, and not because this or that

provider is not satisfied with his piece of the third-party pie. It's rotten

because the power to determine how to take care of oneself has been assigned

by law and regulation to distant third-parties.

This is a mess too large to respond to tinkering. The only fair way to

apportion services is to allow the PATIENT to make the cost-benefit

analysis. Make the current system go away. Support HSAs!

Dave Milano, PT, Director of Rehab Services

Laurel Health System

32-36 Central Ave.

Wellsboro, PA 16901

dmilano@...

Some thoughts on ACN and Corporate PT

I wanted to step onto my soap box for a minute, and

rant about what large corporate PT practices are doing

to smaller PT-owned practices.

I wrote recently asking of other's experience with

United HealthCare/ACN offering very low reimbursement

rates for PT. Here, in California, ACN/United

Healthcare is offering $75 for an eval and $65 for a

visit " take it or leave it. "

I belong to a PT office managers group and learned

that one of the practices located less than 20 miles

from our office had been offered a contract for $105

per eval and $95 per visit by ACN/UHC, over 25% above

our offer. I called my contact at ACN inquiring if

we, too, could get the same rate.

I was told that in the area 20 miles away, there were

no large, corporate-owned PT clinics. Since this

clinic is in an area that has a certain percentage of

employees covered by UHC, UHC offered this clinic a

better contract; no one else in the area had agreed

to the low rates.

Where we are, we have two corporate owned or managed

PT clinics which signed up immediately for the low

rates.

Had the corporations held out for better rates, we all

would have benefitted.

By the way, did you see the report in the Wall Street

Journal about the CEO of United Health who earns $6M a

year and has $1.6 BILLION in stock options?

Viel, Office Manager

Mt. Eden Physical Therapy

19845 Lake Chabot Road, Suite 205

Castro Valley, CA 94546

mt_eden_pt@...

Please identify yourself, your discipline and your location in all messages

to PTManager.

Sick of working for someone else?

Tired of fighting against POPTS?

Ready to quit the corporate nonsense of large organizations? Visit

www.InHomeRehab.com.

PTManager encourages participation in your professional association. Join

APTA, AOTA or ASHA and participate now!

Please identify yourself, your discipline and your location in all messages

to PTManager.

[Guest guest]

This is why I do not accept UHC, do not, will not, never.

Thanks,

Barker F. II

Clinical Director

Lakeway Aquatic Therapy & Wellness Center

P.O. Box 342348

1927 Lohmans Crossing, Suite 100

Austin, TX 78734

-Office Tel.

- Office Fax

- Mobile

www.lakewayaquatics.com

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Some thoughts on ACN and Corporate PT

I wanted to step onto my soap box for a minute, and

rant about what large corporate PT practices are doing

to smaller PT-owned practices.

I wrote recently asking of other's experience with

United HealthCare/ACN offering very low reimbursement

rates for PT. Here, in California, ACN/United

Healthcare is offering $75 for an eval and $65 for a

visit " take it or leave it. "

I belong to a PT office managers group and learned

that one of the practices located less than 20 miles

from our office had been offered a contract for $105

per eval and $95 per visit by ACN/UHC, over 25% above

our offer. I called my contact at ACN inquiring if

we, too, could get the same rate.

I was told that in the area 20 miles away, there were

no large, corporate-owned PT clinics. Since this

clinic is in an area that has a certain percentage of

employees covered by UHC, UHC offered this clinic a

better contract; no one else in the area had agreed

to the low rates.

Where we are, we have two corporate owned or managed

PT clinics which signed up immediately for the low

rates.

Had the corporations held out for better rates, we all

would have benefitted.

By the way, did you see the report in the Wall Street

Journal about the CEO of United Health who earns $6M a

year and has $1.6 BILLION in stock options?

Viel, Office Manager

Mt. Eden Physical Therapy

19845 Lake Chabot Road, Suite 205

Castro Valley, CA 94546

mt_eden_pt@...

Please identify yourself, your discipline and your location in all messages

to PTManager.

Sick of working for someone else?

Tired of fighting against POPTS?

Ready to quit the corporate nonsense of large organizations? Visit

www.InHomeRehab.com.

PTManager encourages participation in your professional association. Join

APTA, AOTA or ASHA and participate now!

Please identify yourself, your discipline and your location in all messages

to PTManager.

[Guest guest]

I would certainly relate with that desire. Unfortunately, many physicians have

told me regularly that they don't have time to keep up with who is on what plan

so they send them to the clinics who are on every plan. I'm with you on your

stance but this is another view from some dependable referral sources.

Doug Sparks

Advanced Physical Therapy Concepts / APTC

www.aptc.biz<http://www.aptc.biz/>

doug@...

Some thoughts on ACN and Corporate PT

I wanted to step onto my soap box for a minute, and

rant about what large corporate PT practices are doing

to smaller PT-owned practices.

I wrote recently asking of other's experience with

United HealthCare/ACN offering very low reimbursement

rates for PT. Here, in California, ACN/United

Healthcare is offering $75 for an eval and $65 for a

visit " take it or leave it. "

I belong to a PT office managers group and learned

that one of the practices located less than 20 miles

from our office had been offered a contract for $105

per eval and $95 per visit by ACN/UHC, over 25% above

our offer. I called my contact at ACN inquiring if

we, too, could get the same rate.

I was told that in the area 20 miles away, there were

no large, corporate-owned PT clinics. Since this

clinic is in an area that has a certain percentage of

employees covered by UHC, UHC offered this clinic a

better contract; no one else in the area had agreed

to the low rates.

Where we are, we have two corporate owned or managed

PT clinics which signed up immediately for the low

rates.

Had the corporations held out for better rates, we all

would have benefitted.

By the way, did you see the report in the Wall Street

Journal about the CEO of United Health who earns $6M a

year and has $1.6 BILLION in stock options?

Viel, Office Manager

Mt. Eden Physical Therapy

19845 Lake Chabot Road, Suite 205

Castro Valley, CA 94546

mt_eden_pt@...

Please identify yourself, your discipline and your location in all messages

to PTManager.

Sick of working for someone else?

Tired of fighting against POPTS?

Ready to quit the corporate nonsense of large organizations? Visit

www.InHomeRehab.com<http://www.inhomerehab.com/>.

PTManager encourages participation in your professional association. Join

APTA, AOTA or ASHA and participate now!

Please identify yourself, your discipline and your location in all messages

to PTManager.

[Guest guest]

Dave,

Appreciated the 'big picture' comments. I'd like to understand more about how

you think HSAs will solve this type of problem.

I'm not convinced HSAs will eliminate some of the frustration expressed, and

here is my reasoning. A person can set up an HSA only if he has a

high-deductible health plan (HDHP), which, of course, is marketed by a third

party payer. As long as the client stays under the HDHP, his liability for any

HSA-paid PT service is dictated by his HDHP policy. So, if a person has an

ACN-based HDHP, he will still be incentivized to go to an ACN-contracted PT

clinic.

Beth Rohrer, PT, DPT

Centreville Physical Therapy

-- " Milano, Dave " wrote:

Once again a series of posts has painted the distressing picture of

third-party control of practice. Please realize, especially as we struggle

for autonomy, that the primary leash is not in the hands of doctors, but

third-party payers.

United HealthCare's use of it's size to lower prices (NOT a market force)

and the detestable CEO salary reported by Viel are, however odious,

actually beside the point here. The forces of note are: 1. Medical care is

taking up an ever greater portion of GDP, and 2. Consumers are searching out

lower insurance premiums (remember that in this world of employer-provided

medical insurance, business is a consumer). Who can be surprised at how

third parties have behaved in this environment?

Dave Hiten says that he has " difficulty accepting this kind of control from

[ACN] " because chiropractors are behind it. But is it any more fair to have

a non-chiro bureaucrat in charge of your practice (or your own personal

health care)? The fact is that it's all rotten, and not because this or that

provider is not satisfied with his piece of the third-party pie. It's rotten

because the power to determine how to take care of oneself has been assigned

by law and regulation to distant third-parties.

This is a mess too large to respond to tinkering. The only fair way to

apportion services is to allow the PATIENT to make the cost-benefit

analysis. Make the current system go away. Support HSAs!

Dave Milano, PT, Director of Rehab Services

Laurel Health System

32-36 Central Ave.

Wellsboro, PA 16901

dmilano@...

Some thoughts on ACN and Corporate PT

I wanted to step onto my soap box for a minute, and

rant about what large corporate PT practices are doing

to smaller PT-owned practices.

I wrote recently asking of other's experience with

United HealthCare/ACN offering very low reimbursement

rates for PT. Here, in California, ACN/United

Healthcare is offering $75 for an eval and $65 for a

visit " take it or leave it. "

I belong to a PT office managers group and learned

that one of the practices located less than 20 miles

from our office had been offered a contract for $105

per eval and $95 per visit by ACN/UHC, over 25% above

our offer. I called my contact at ACN inquiring if

we, too, could get the same rate.

I was told that in the area 20 miles away, there were

no large, corporate-owned PT clinics. Since this

clinic is in an area that has a certain percentage of

employees covered by UHC, UHC offered this clinic a

better contract; no one else in the area had agreed

to the low rates.

Where we are, we have two corporate owned or managed

PT clinics which signed up immediately for the low

rates.

Had the corporations held out for better rates, we all

would have benefitted.

By the way, did you see the report in the Wall Street

Journal about the CEO of United Health who earns $6M a

year and has $1.6 BILLION in stock options?

Viel, Office Manager

Mt. Eden Physical Therapy

19845 Lake Chabot Road, Suite 205

Castro Valley, CA 94546

mt_eden_pt@...

Please identify yourself, your discipline and your location in all messages

to PTManager.

Sick of working for someone else?

Tired of fighting against POPTS?

Ready to quit the corporate nonsense of large organizations? Visit

www.InHomeRehab.com.

PTManager encourages participation in your professional association. Join

APTA, AOTA or ASHA and participate now!

Please identify yourself, your discipline and your location in all messages

to PTManager.

[Guest guest]

HSAs , in general, are not marketed and therefore many of my patients do not

even know about the option they have. HSAs are superior as most are HDHP

whereby the patient has the option to pay for their cough-colds and minor

aches/pain treatments out of pocket. They should bargain a treatment

plan/payment with an MD or a PT office whereby they will pay a reduced

amount for their visit as they are paying cash for their visit. $2000 or

$5000 in deductible will come into picture when they have a catastrophic

illness where they need hospital stay. Our second office is experimenting in

HSAs rather than traditional Blue Cross PPO plan which we provide to our

employees. To begin with, our per employee premium payment expense is

reduced 50%. Most of our employees are young who do not have major

illness...they hardly go to see an MD except for allergies/colds etc..I have

made a deal with a 2 of the MDs in my town to give my employees a discount

since they are paying cash..and they do get it. So here the middle-man

Insurance co is taken out of the equation as now the pt. goes directly to

the provider. My earlier email seems like it was not received in which I

wrote about achieving autonomy by campaigning to get TRUE DIRECT ACCESS for

PTs. In Calif we have Direct Access but we still have the MD involved in the

care..so we do not have a true Direct Access. In my opinion Direct Access

is: A pt. can come directly to the PT without seeing an MD. Also the pt.

has never seen an MD for his/her current musculo-skeletal condition and they

have come into a PT's clinic to receive care. Unless we have Direct Access

we are doomed to be played around by Ins Comp/POPTS. Chiros and Podiatrists

have it why not PTs?! It is true that our malpractice cost might rise and

referring MDs might get upset because now their control is lost, however,

they should benefit from direct access as the MDs will now have another

referral source from PTs. A PT would not treat a pt if he/she feels that an

X-ray or MRI is needed or an MD evaluation is needed before they can

continue with the treatment plan.

Hiten Dave' PT

Some thoughts on ACN and Corporate PT

I wanted to step onto my soap box for a minute, and

rant about what large corporate PT practices are doing

to smaller PT-owned practices.

I wrote recently asking of other's experience with

United HealthCare/ACN offering very low reimbursement

rates for PT. Here, in California, ACN/United

Healthcare is offering $75 for an eval and $65 for a

visit " take it or leave it. "

I belong to a PT office managers group and learned

that one of the practices located less than 20 miles

from our office had been offered a contract for $105

per eval and $95 per visit by ACN/UHC, over 25% above

our offer. I called my contact at ACN inquiring if

we, too, could get the same rate.

I was told that in the area 20 miles away, there were

no large, corporate-owned PT clinics. Since this

clinic is in an area that has a certain percentage of

employees covered by UHC, UHC offered this clinic a

better contract; no one else in the area had agreed

to the low rates.

Where we are, we have two corporate owned or managed

PT clinics which signed up immediately for the low

rates.

Had the corporations held out for better rates, we all

would have benefitted.

By the way, did you see the report in the Wall Street

Journal about the CEO of United Health who earns $6M a

year and has $1.6 BILLION in stock options?

Viel, Office Manager

Mt. Eden Physical Therapy

19845 Lake Chabot Road, Suite 205

Castro Valley, CA 94546

mt_eden_pt@...

Please identify yourself, your discipline and your location in all messages

to PTManager.

Sick of working for someone else?

Tired of fighting against POPTS?

Ready to quit the corporate nonsense of large organizations? Visit

www.InHomeRehab.com.

PTManager encourages participation in your professional association. Join

APTA, AOTA or ASHA and participate now!

Please identify yourself, your discipline and your location in all messages

to PTManager.

[Guest guest]

Beth,

I fear you are correct as I had previously communicated to Dave. These HSA

plans will be marketed as parts of various networks and once again we will

be stuck with the crumbs as dictated by third parties. Until such time as

we are able to simply say " No! " we will likely be at the mercy of others.

As previously mentioned by another poster, the rise of corporate ownership

has to a great degree contributed to our problem by their willingness to

take less and more dubiously do more by extending length of stays and

fraudulently billing for services never rendered. Until we are willing to

take the stand that control equals ownership and vice versa we will continue

to be at the mercy of others. Physicians long ago recognized this by

ensuring sole ownership by licensees as dictated by many if not most if not

all state medical boards.

Regards,

Mark F. Schwall, PT

www.futurephysicaltherapy.com

Some thoughts on ACN and Corporate PT

I wanted to step onto my soap box for a minute, and

rant about what large corporate PT practices are doing

to smaller PT-owned practices.

I wrote recently asking of other's experience with

United HealthCare/ACN offering very low reimbursement

rates for PT. Here, in California, ACN/United

Healthcare is offering $75 for an eval and $65 for a

visit " take it or leave it. "

I belong to a PT office managers group and learned

that one of the practices located less than 20 miles

from our office had been offered a contract for $105

per eval and $95 per visit by ACN/UHC, over 25% above

our offer. I called my contact at ACN inquiring if

we, too, could get the same rate.

I was told that in the area 20 miles away, there were

no large, corporate-owned PT clinics. Since this

clinic is in an area that has a certain percentage of

employees covered by UHC, UHC offered this clinic a

better contract; no one else in the area had agreed

to the low rates.

Where we are, we have two corporate owned or managed

PT clinics which signed up immediately for the low

rates.

Had the corporations held out for better rates, we all

would have benefitted.

By the way, did you see the report in the Wall Street

Journal about the CEO of United Health who earns $6M a

year and has $1.6 BILLION in stock options?

Viel, Office Manager

Mt. Eden Physical Therapy

19845 Lake Chabot Road, Suite 205

Castro Valley, CA 94546

mt_eden_pt@...

Please identify yourself, your discipline and your location in all messages

to PTManager.

Sick of working for someone else?

Tired of fighting against POPTS?

Ready to quit the corporate nonsense of large organizations? Visit

www.InHomeRehab.com.

PTManager encourages participation in your professional association. Join

APTA, AOTA or ASHA and participate now!

Please identify yourself, your discipline and your location in all messages

to PTManager.

[Guest guest]

The following is the latest info on SB899, the CA workers Comp bill. The

following are the changes proposed. I do not see a name of any PT and I am

assuming this is a slight error, hopefully PTs are included in " other

providers " . I am hoping that a PT in private practice who actually treats

patients and not just manages a practice, sits on the review committee. I am

also sending a copy of this info to the CA chapter of APTA and voicing my

concern. I am hoping every PT in Ca should do the same.

Hiten Dave' PT

In Private practice since 1986

Pleasanton PT/Back on Track PT

CA -- Bradshaw Says New Committee Will Tackle Guidelines: General 04/20/06

California Labor Secretary Bradshaw said Wednesday that the

Division of Workers' Compensation will release proposed regulations in about

two weeks that would create a medical review committee to take the state's

utilization-review system beyond American College of Occupational and

Environmental Medicine (ACOEM) treatment guidelines.

Bradshaw made herself available for media interviews in conjunction with the

second anniversary of the signing of Senate Bill 899. She touted the success

of the reform bill and said regulators are taking a careful, deliberate

approach toward further system changes.

One of those steps will be adoption of a more comprehensive set of treatment

guidelines, as mandated by SB 899. The reform bill imposed ACOEM as a

stop-gap until the DWC produced a more thorough set of guidelines.

Bradshaw said the proposed medical review committee will consist of medical

doctors, chiropractors and other providers appointed by the DWC

administrative director.

" The reality is nobody is going to be happy with one set (of guidelines), "

Bradshaw said. " The legislature adapted ACOEM and that was the best at the

time. Now what we are going to do is create the medical review committee to

look at adjustments that need to be made, and (the committee) is going to

constantly evaluate it. "

Carlyle Brakensiek, executive vice president of the California Society of

Industrial Medicine and Surgery, said it sounds like the DWC is on the right

track. He said DWC acting Administrative Director Nevans has

described the medical review committee as a " blue-ribbon panel. "

Brakensiek said one of the problems with the use of ACOEM is they do not

cover the wide range of injuries experienced in industrial medicine, in part

because the panel of experts that crafted them did not include some

specialists. He said no orthopedic surgeon was on the ACOEM panel and only

one chiropractor participated. And he happened to be an employee of

Washington state's monopoly workers' comp insurer, Brakensiek said.

As a result, ACOEM has no guidelines for common industrial ailments, such as

head trauma or even headaches, which are commonly experienced by injured

workers due to exposure to toxic fumes, he said.

Brakensiek said the medical review committee could fill in the gaps.

" We would hope the panel of experts will be able to expand on the number of

injuries over which there will be recognized treating guidelines and expand

the number of modalities that are recognized, " he said.

One common complaint by medical providers and injured-worker advocates is

that claims adjusters routinely deny care because the treatment plan is not

included in ACOEM. Bradshaw said regulations recently sent to the Office of

Administrative Law for final approval should alleviate that problem. The

so-called utilization-review penalty regulations state explicitly that

claims adjusters may not use the absence of mention by ACOEM as a reason for

denying care, and (these regulations) create stiff penalties against

insurers, employers and third-party administrators that show a pattern and

practice of inappropriately denying or delaying medical care.

Some thoughts on ACN and Corporate PT

I wanted to step onto my soap box for a minute, and

rant about what large corporate PT practices are doing

to smaller PT-owned practices.

I wrote recently asking of other's experience with

United HealthCare/ACN offering very low reimbursement

rates for PT. Here, in California, ACN/United

Healthcare is offering $75 for an eval and $65 for a

visit " take it or leave it. "

I belong to a PT office managers group and learned

that one of the practices located less than 20 miles

from our office had been offered a contract for $105

per eval and $95 per visit by ACN/UHC, over 25% above

our offer. I called my contact at ACN inquiring if

we, too, could get the same rate.

I was told that in the area 20 miles away, there were

no large, corporate-owned PT clinics. Since this

clinic is in an area that has a certain percentage of

employees covered by UHC, UHC offered this clinic a

better contract; no one else in the area had agreed

to the low rates.

Where we are, we have two corporate owned or managed

PT clinics which signed up immediately for the low

rates.

Had the corporations held out for better rates, we all

would have benefitted.

By the way, did you see the report in the Wall Street

Journal about the CEO of United Health who earns $6M a

year and has $1.6 BILLION in stock options?

Viel, Office Manager

Mt. Eden Physical Therapy

19845 Lake Chabot Road, Suite 205

Castro Valley, CA 94546

mt_eden_pt@...

Please identify yourself, your discipline and your location in all messages

to PTManager.

Sick of working for someone else?

Tired of fighting against POPTS?

Ready to quit the corporate nonsense of large organizations? Visit

www.InHomeRehab.com.

PTManager encourages participation in your professional association. Join

APTA, AOTA or ASHA and participate now!

Please identify yourself, your discipline and your location in all messages

to PTManager.