Board of Directors
Minutes
The meeting was called to
order at
Motion: Moved by Varish,
seconded by Lysne to approve the minutes of the
ACA Survey Request
The board discussed the
survey request by the ACA and had the following concerns on each question.
How would you rate the amount or level of care
typically approved by your insurer?
In our experience,
chiropractors do not typically share the amount of level of care approved by
the insurer with their patients. Therefore, the response to this question may
not be meaningful unless you go back to the survey respondents and determine if
their answer is based on actual knowledge of how much care was approved by the
insurer. Otherwise, their responses may merely reflect an opinion on the care
rendered by the chiropractor irrespective of the insurer’s approval or lack
thereof.
Within the limits of your insurance plan, do you feel
that you are able to use your insurance benefits when you need them?
The overwhelming percentage
of patients will answer this question “yes”
because of the way the question is phrased. Even the negative responses must be
viewed critically unless you determine the reason care has been denied. For
example, lack of adequate documentation by the chiropractor is a valid reason
for denying care; however, few chiropractors will admit this reason for denial
to their patients.
It may have been better to
ask if a patient has ever been denied access to their chiropractic benefit and
then request the DC to provide the reason behind the denial to determine if it
was an abusive practice by the insurer.
How would you rate the adequacy of the chiropractic
benefits provided by your employer in relation to meeting your need for
chiropractic care?
This question needed to be
broken into two parts. One question for those patients that had self insured
employers and a second for those that did not. Without knowing if the patient’s
employer is self insured, the question is meaningless (quite often the
chiropractor’s staff would not even know this information unless they called the
employer or their insurer).
Even if the patient knows
that their employer is self insured, it is not likely that they would know what
role, if any, the employer had in setting chiropractic benefits limits. And, as
you know, many employers defer to their insurer in setting this limit.
How would you rate your insurer’s reimbursement of
your chiropractic care with regard to:
a. Reimbursement of similar services provided by other
doctors
We have almost 1,400 members
and I do not believe a single one of them would tell me their patients could
provide comparative reimbursement data between chiropractic and other providers.
b.
Timeliness of reimbursement
Not only can patients not
provide meaningful answers to this question, most chirrpactors could not answer
this without asking their staff.
Are you required to complete extra paperwork for your
insurer when you see a doctor of chiropractic?
How would a patient know what
“extra” paperwork is? Some chiropractors require a significant amount of paperwork
based on their own protocols. In addition, responses to this question will not
be meaningful unless the patient is aware of the requirements of different
insurers.
If so, have you had this same requirement of
completing additional paperwork for your insurer when you have seen any other
type of doctor/provider?
The accuracy of responses to
the question is predicated on the patient remembering the paperwork requirements
of other providers, knowing the “extraneous” requirements of the insurer, and
being able to compare the similarities and differences between the providers.
Motion: Moved by Varish,
seconded by Masche to write to the ACA Board of Governors with our concerns
over this survey. Motion carried.
Motion: Moved by Masche,
seconded by McMahon to write to the ACA-PAC with the concerns over supporting
the PAC in light of the fact that the ACA does not have any legislative
proposals before Congress. Motion carried.
American Specialty Health/ACN
The board discussed the
recent dismissal of the California Chiropractic Association’s lawsuit against
American Specialty Health and noted the similarity in the issues in the lawsuit
to the grievances cited against ACN. The discussion reinforced the WCA’s
position that we must have excellent documentation before undergoing the
expense of a lawsuit.
Motion: Moved by Shepherd,
seconded by Masche to retain Greg Fors as a speaker for the Spring Convention.
Motion carried.
Advertising
The board discussed an
advertisement by a chiropractor in which a patient testimonial is used to claim
that chiropractic treatment is effective for patient’s suffering from baldness.
While the advertisement is technically legal, the board expressed significant
concern over the misleading nature of the ad and the potential for profession
to suffer embarrassment if this type of advertising were to become widespread.
AECOM
The board discussed current
work by AECOM to attempt to improve the number of individuals who return to
work or stay at work after being injured.
The meeting adjourned
approximately 1:45 p.m.