Arizona Chiropractic Society eNewsletter
Statewide Non-Profit
Chiropractic Association
Breaking News February 17, 2010

The ACS webpage has valuable new health information and links posted  

You have never seen this kind of information from ACS before. In an age of health care reform, chiropractors should lead with the smartest ideas. ACS has posted links to the best on its webpage. Discover them on the Important Reports, Articles and Links page at at www.AZChiropractors.org  You will be delighted at what you will find. Take this information to the public. It's time.


Quick Links
 
February 2010 ACS Newsletter:
 
 
 
Read entire PDF with breaking news about the Board, insurance equality and much more by clicking on this link.
Join Our Mailing List
The Arizona Chiropractic Society is here to serve you!
ARIZONA
CHIROPRACTIC
SOCIETY
ACS Logo


3515 E. Carol Avenue
Phoenix, AZ 85028
VOICE 602.368.9496
FAX 602.368.8954
Dear Arizona Chiropractor and other interested party,

This is a special mid-month update from ACS. Please forward this to any of your fellow Arizona chiropractors or anyone else who would benefit from the information here. Also, please feel free to contact us with any questions or, if you wish to no longer receive these important communications, click the unsubscribe link at the bottom.

Warm regards,
Alan M. Immerman, D.C.
President & Executive Director
602.368.9496

Breaking News!

Ed Wren, ACS Lobbyist 
 
 

Posting of Non-Disciplinary Orders on Internet

 

As all of you know, many chiropractors in Arizona are unfairly treated when the Board places a non-disciplinary ruling on the website and this ruling remains there for an unlimited time. There is no recourse for the chiropractor.

 

Regardless of the nature of the ruling, which you know can be nothing more than inadequate record keeping of a minor nature, this website notice is there for anyone to read and frequently results in a patient, or prospective patient, deciding not to utilize the service of the chiropractor.

 

Ed Wren, our ACS lobbyist, has been working with the Arizona Medical Society and they have informed him that through legislation they were able to reduce the amount of time a non-disciplinary letter is on their website to only five years and the doctor in question is able to post an explanatory letter to the entry. The Medical Society has also gotten dismissals and pending investigations completely off the website.

 

Based on this information, Ed contacted Barry Aarons, the lobbyist for AAC, and they are working together to meet with the Board and strongly request they adopt the same procedure for chiropractors. We expect action as soon as possible on this critically important change.

 

Incidentally, the Board, as well as other boards, can take this action on non-disciplinary proceedings under ARS 1403.01: Licensees, profiles required information; review; civil penalty.

 

(Note: Read all about Ed Wren by going to www.AZChiropractors.org and scrolling down to the bottom of the page. Click on Ed's name for his bio and much more. Ed is the only health care lobbyist representing the chiropractic profession in Arizona.)

 

 

 
CHIROPRACTIC INCLUSION IN AHCCCS LEGISLATION
 

While for the tenth year in a row a bill has been introduced in the Arizona Legislature which could permit chiropractors to be included in AHCCCS, the prospects this year are dim due to the budget crisis and its effect on AHCCCS.

 

Several severe cuts have already been made to hospitals, including elimination of the Graduate Medical Education and Disproportionate share programs (GME and DSH). AHCCCS recently announced that several medical services, which are funded by the agency but are not mandated by the federal government, would be eliminated or restricted. These include emergency dental services, medically necessary dentures, orthotics, insulin pumps, services by a podiatrist, percussive vests, gastric bypass surgery, well exams for adults, bone-anchored hearing aids, cochlear implants, urban non-emergency transportation, physical therapy limited to six visits per year, durable medical equipment, prosthetics and selected limitation on transplants. This would save the state $6,258,300 per year from the general fund.  

 
Legislation, SB 1215, entitled "Integrative Therapies Pilot Program," would establish, within AHCCCS, a pilot program to treat up to 500 patients with a "chronic condition" (defined). It would begin on January 1, 2011 and end on October 1, 2014 and include chiropractic services as a listed medical service. On Wednesday morning, the bill was defeated by a vote of 2 to 5 in the Senate Health Committee. It carried a $200,000 appropriation which in this time of fiscal crisis will never sell and we do not believe the legislation has any chance of passage this year.
 
Comment by Dr. Immerman: "The Chiropractic AHCCCS bill of 2010, SB 1215, was defeated in committee today 2-5. Even some of the most pro-chiropractic members could not justify a 'yes' vote because of the $200,000 price tag considering the state is still in the red almost $1 billion for this fiscal year ending June 30 and about $3 billion for next fiscal year. This is why ACS did not place an AHCCCS bill high on its priority list for 2010. We predicted it would not fly in a year of such deep budget deficits. In keeping with our prediction, it died by a 2-5 vote. ACS will continue to focus on lowering copays and deductibles in health insurance policies which we know is within reach and realistic."
 
THE MOST POPULAR ACS MEMBER BENEFIT
 
                Getting personal help from Dr. Immerman to collect from insurance companies and in personal injury cases is by far the most important and popular member benefit in ACS. Whether by email or phone, doctors frequently contact Dr. Immerman for help when health insurance companies refuse to pay claims and they have tried everything they know but have failed to collect. Dr. Immerman is known to usually have a solution when no one else does. A quick phone call or email often solves the problem.
 
                Doctors also call when they are having trouble collecting on large PI cases. Sometimes an attorney refuses to release funds, or an attorney does not know how to approach a case. Dr. Immerman is frequently involved in litigation cases as an expert and knows many attorneys and so can often help in this area also.
 
                There is a good reason why ACS' membership retention rate is one of the highest in the nation for a state association. It simply pays to be a member of ACS!
 
THE ARIZONA SUCCESSFUL PRACTICE PACKAGE IS READY FOR YOU
 
                This is the full current list of membership benefits delivered to you immediately when you join ACS. If are you are licensed DC in Arizona and you really want to make a living at chiropractic, you will become a member of ACS and read and digest all of the documents listed below. Each is vital to practice in this state.
 
                 Members receive all of the following special membership benefits by email immediately upon joining. Any member may request an additional copy at any time by number. Join today and get the help you need with these unique resources and documents.
 
HEALTH INSURANCE FOR ACS MEMBERS WITH NO MEDICAL QUESTIONS ASKED
 
1 -- CIGNA -- ACS Membership Form.pdf:  Group health insurance for ACS members with guaranteed issue coverage after a 90 day waiting period, no medical underwriting. PPO and HMO plans, statewide.
2 -- CIGNA Health Insurance Info.pdf
3 -- CIGNA Pamphlet.PDF
 
HOW TO GET PAID WHEN AN INSURER DENIES OR REDUCES YOUR CLAIM
 
4 -- Fees allegedly above Usual and Customary.pdf:  How to protest when an insurance company claims your fees were too high.
5 -- Grievance Letters -- The Best Way to Get Insurers to Pay.pdf:  How to use the Arizona grievance law, a powerful tool to bring pressure on an insurer that misbehaves.
6 -- Health Care Appeal Request Form.pdf:  There is a legal process when a claim is denied as not medically necessary. This is a sample request form. #7 contains complete instructions.
7 -- Health Care Appeals Process.pdf:  A three level process. The third level involves review by an independent party chosen by the Arizona Department of Insurance and paid for by the insurance company.
8 -- How to file a complaint with ADOI against an insurer.pdf:  When insurance companies violate laws, complaints must be filed.
9 -- Medical necessity appeal letter.pdf:  An excellent general appeal letter.
10 -- Small Claims and Justice Court Instructions.PDF:  Sometimes the only solution when an insurance company does not pay is a lawsuit. Here are instructions for suing an insurance company.
11 -- Timely Payment of Claims, Adjudication, Adjustments.pdf:  Claims must be paid within a certain time frame, and demands for repayment can only be made within certain guidelines. This document contains the legal details.
 
HOW TO HANDLE AN ERISA SELF INSURED CLAIM DENIAL
 
12 -- ERISA Claims Procedure DOL Rule 29 CFR 2560.503-1.pdf:  Key section of the law which you need to know to get results with your appeals.
13 -- ERISA Letter to File an Appeal.pdf:  Use this letter today to get results when claims are denied.
14 -- ERISA Letter to Request for a Copy of the Summary Plan Description, Claim Appeal Procedure, EOB.pdf:  The first step in an ERISA appeal is to get a copy of the plan document. This is the letter to send.
15 -- ERISA Self-Insured Plans ADOI Letter.pdf:  This is the position of the Arizona Department of Insurance regarding ERISA self-insured plans.
16 -- Understanding ERISA.pdf:  Complicated subject, simple explanation.
17 -- Understanding ERISA Detailed.pdf:  Complicated subject, detailed but understandable explanation.
 
THE MOST EFFECTIVE PLAN TO DEVELOP REFERRALS FROM MDs
 
18 -- The path to medical referrals.pdf:  Key information about how to get referrals from MDs and DOs.
19 -- MD-DC Alignment in Practice.pdf:  An entire book by a DC who once was a drug representative and knows exactly how to get into and talk comfortably with MDs and DOs. This is a blueprint with detailed plans.
 
HOW TO STAY COMPLIANT IN ARIZONA WITH RECORD KEEPING AND DOCUMENTATION
 
20 -- Recordkeeping as Mandated by the Arizona Chiropractic Board.pdf:  Detailed instruction complied and updated by ACS over many years.
21 -- Record Keeping and Documentation Course.pdf:  Outline of course given by lead auditor retained by the Arizona Chiropractic Board.
22 -- Record Keeping 2005.pdf:  Full course notes given by former Board chair. Must request separately since file too large to include with email package.
23 -- Medicare Chiropractic Coverage and Documentation Nov. 2006.pdf:  This is the full document from Medicare and must be requested separately since it is too large.
24 -- CMS Rules for reporting timed codes.pdf:  These are the rules for reporting timed codes which you must follow to be in compliance with the requirements of the Arizona Chiropractic Board for all documentation.
 
COMPLIANCE --  INFORMATION --  COLLECTIONS -- BOARD
 
25 -- Medical Records Protocol 2008.pdf:  Arizona Chiropractic Board requires you have this on file in your office at all times.
26 -- How to search the National Library of Medicine and retrieve articles from a medical library.pdf:  These are the types of journal articles the Arizona Chiropractic Board requires you to have to back up your claims.
27 -- DC Power of Attorney directing payments to doctor.pdf:  Use when an insurance company refuses to honor assignments of benefits.
28 -- DC Power of Attorney Instructions.pdf:  Instructions for #27.
29 -- State Board Investigations and Disciplinary Actions.pdf:  Every doctor with a state license needs to read this background document about boards and discipline. Forewarned is forearmed.
 
PI TOOLS: LIENS, BALANCE BILLING, ETHICS . . .
 
30 -Ethics Opinion 98-06 which requires PI lawyers to pay your bill if they know it exists (constructive knowledge) even if there is no written agreement.
31 - Balance Billing in PI Cases:  Why balance billing to a third party insurer is almost always allowed in PI cases including citations to legal authorities.
32 - PI Attorney's Explanation of Healthcare Provider Liens: Detailed explanation of the law.
33 - Sample form for Notice and Claim of Medical Lien:  Fill in the blanks with your office information.
34 - Sample form for Release of Medical Lien:  Fill in the blanks with your office information.
35 - Arizona Department of Insurance Circular Letter 2000-02 mandating fair investigations of low speed impact automobile accidents. Use to combat insurance company fraud.

 
You want action? You want results? Then join ACS if you are not already a member. Now. You can find a membership application at www.AZChiropractors.org.