FCA Member News
ICD-10 becomes effective in October of 2014. While you should be able to count on your EHR or practice management software seller for help in the transition, you need to understand the basics of ICD-10. The FCA is here to assist with your understanding through webinars, helpful articles and ongoing classes that will take place at all FCA conventions in 2014. The first training tool is a convenient webinar for complimentary member viewing at any time on fcachiro.org. Dr. Ronald Wellikoff, who has assisted thousands of Florida DC's with ICD-9 coding, steps up to provide a foundation for your understanding of ICD-10.
(From an 08/14/2013 ACA Insurance Relations Dept. Update) Aetna instituted a policy effective March 1st stating that Manual Therapy (CPT code 97140) would not be recommended for separate payment when billed with Chiropractic Manipulative Treatment (CMT). It also stated that Modifiers 25 and 59 would not override to allow reimbursement. ACA first obtained agreement that claims could be appealed after being denied, with submission of proper documentation showing 97140 was performed to a separate region. After further discussion, ACA and Aetna reached a mutually beneficial solution allowing documentation to be submitted with the initial claim for review, so that there is no need for denial - a true example of successful cooperation between ACA and insurance companies. In this way, both Aetna and providers only handle the claim once. At this time, Aetna has changed its computer system to allow for documentation to be submitted on medically necessary claims that demonstrate that 97140 was performed on the same date of service as CMT, and that 97140 was performed in a region other than the region in which the CMT was performed.
Aetna has overridden its systems to make this a manual process, so it is possible that a few claims may process in the former manner while claims departments become accustomed to this new system. If any claims are denied, they should be appealed with documentation and sent to the local Aetna Appeals Center (not the Claims Center). As your partner in practice, ACA has created an Appeal Template Letter to make this process as smooth as possible. Providers who submit billings electronically are encouraged to call Aetna to ascertain whether documentation can be submitted electronically as well. Please contact ACA's Insurance Relations Department at firstname.lastname@example.org with any questions.
Get your best bargain for the entire office when you pre-register online by midnight today. Remember to log in as a member to access the half-price member rates!
Still need a reservation at the Peabody? Use the convenient online reservations link or call (800) 946-0350 for the discounted group rate.
The Spa at the Peabody Orlando is offering the ultimate in relaxation and great discounts to its FCA National Convention guests. A 20% early bird special discount on all services during FCA National expired on August 3rd. But FCA convention attendees staying at the Peabody still have time to take advantage of a 15% discount being offered for appointments made between August 4th-17th. If you won't know your schedule until you arrive, an on-site special 10% discount will also be provided. Visit the "Location" tab on the National Convention page for a link to these special offers and information on how to make your reservations.
Special afternoon and multi-day Disney® tickets are being offered at substantial discounts when purchased prior to arrival in Orlando. These offers are available to pre-registered National Convention attendees until 9pm on Thursday, August 22, 2013, through a special link that was provided in your FCA pre-registration confirmation e-mail and are not available at the park gate or any other location. After 2pm, After 4pm, and multi-day tickets are available through this special discounted Disney® source for FCA National attendees and their accompanying families or guests. The multi-day tickets include a complimentary bonus visit to your choice of one of several Disney experiences, a terrific value!
Still available for your viewing pleasure is the National Convention section of fcachiro.org. Registrations have crossed the 2,000 mark and are still pouring in from the online system. Check the listings of an unprecedented 112 different class opportunities for DCs, CCPAs, CAs, CRTs, LMTs. You will find insights into every aspect of chiropractic practice, as well as purely business topics, a complete module of the Chiropractic Internist Diplomate course, NRCME/DOT Training, "Foundation Friday," and new clinical topics too numerous to list here. Just click on the "ENLIGHTEN" ad on the home page to read more about it.
Whatever your interests or concerns may be, there are insights galore for you and your team at this spectacular event. Make your reservations now and pre-register online before midnight tonight for discounted rates. Don't forget the fabulous buy-one-get-one registration discounts for staff (CAs, CCPAs, RCAs, CRTs) when registering with their doctor. Make this a team-building opportunity for improved practice performance. It's time to shine!
You have until September 23, 2013 to be compliant with new HIPAA Regulations that took effect on March 23, 2013.
The FCA is making it easy to comply by making a basic compliance manual available at www.fcachiro.org, at no cost to FCA members. The manual may be accessed on the members only portion of the web site and is now posted in Word format so that you can easily download and customize it to your practice. (Be sure you log in as a member to read this story and access the link to the manual.) Only about an hour will be required to train staff and learn to take steps to be compliant with the new regulations.
The manual has all forms needed for compliance, including a new Notice of Privacy and Business Associate Agreement that meet the new regulations. Each established patient and new patient must be furnished a Notice of Privacy form for signature.
The Office of Civil Rights enforces HIPAA regulations and promises vigorous enforcement of the new regulations. Fines for failure to comply with the new regulations or breach of a patient’s confidential protected information are raised to a minimum of $50,000-1.5 million from the current maximum of $25,000.
Classes covering various aspects of compliance and new regulations will be offered throughout the National Convention. Recent articles addressing HIPAA regulations and compliance are published in the most recent edition of the FCA Journal and posted at fcachiro.org.
Get your best bargain for the entire staff when your pre-registration is received by Friday, August 17th. Use the printable PDF form and these rates to register by mail or use the convenient online option. If you choose the online option, remember to log in as a member to access the half-price member rates!
The Bureau of Medicaid Services (BMS) is offering training on the Florida Medicaid Provider General Handbook, Chapter 5: Medicaid Abuse and Fraud. The training session will be conducted via webinar on Thursday, August 15, 2013, at 3:00 p.m. By attending this training participants will increase their knowledge about Medicaid provider’s responsibilities regarding claims submission and prevention of fraud and abuse of the Medicaid program. Access the complete BMS notice on fcachiro.org.
(CARMICHAEL, Calif. – August 5, 2013) The Foundation for Chiropractic Progress (F4CP) is pleased to debut to the chiropractic profession – prior to public launch in late 2013 – its new program, Athletic TIPS: Toward Injury Prevention in Sports (TIPS). Drawing upon input from a multi-disciplinary, blue ribbon advisory board, TIPS serves student and amateur athletes by providing educational resources, such as workshops presented exclusively by TIPS-certified doctors of chiropractic (D.C.s), to coaches, trainers, educators and parents in communities nationwide.
“TIPS focuses on the recognition, treatment and prevention of sports-related injuries, as well as general health and performance enhancement,” states Spencer Baron, D.C., chairman, TIPS advisory board and team chiropractor, Miami Dolphins. “A cornerstone of the program is its parent/coach workshops, which utilize and depend upon the expertise and engagement of doctors of chiropractic nationwide. In 2014, TIPS will begin to offer certification courses to train D.C.s on guidelines for conducting workshops.”
In anticipation of high interest in the TIPS certification courses, introductory presentations will be made at the following functions:
* Life Chiropractic College West (The Wave): August 1-3, 2013
* Palmer Davenport Homecoming: August 8-10, 2013
* Florida Chiropractic Association’s National Convention & Expo: August 22-25, 2013
* Congress of Chiropractic State Associations (COCSA): November 7-10, 2013
“Attendees will learn the importance of TIPS and its mission, as well as how to capitalize on this program for individual practice growth,” adds Dr. Baron, who notes that the workshops will be most significant since they present an opportunity to better serve and connect with local communities. “TIPS is an innovative approach to sports healthcare, and a guaranteed game-changer for athletes and doctors of chiropractic nationwide.”
About Foundation for Chiropractic Progress
A not-for-profit organization, the Foundation for Chiropractic Progress aims to inform and educate the general public about the many benefits associated with chiropractic care. The FCA supports the work of the Foundation, contributing $30,000 annually. To learn more about the Foundation, visit www.yes2chiropractic.com or call 866-901-F4CP (3427).
About Athletic TIPS
A not-for-profit organization, Athletic TIPS drives expanded awareness and education around the role of multi-disciplinary care in prevention, recognition and treatment of sports-related injuries as well as opportunities for optimized health and performance enhancement. To learn more about the TIPS, call 201.641.1911x14.
The FCA National Convention will feature 96 of the brightest minds in chiropractic, and their lectures are all accessible to you. That’s a ton of information. DC’s who attend for more than just required courses at FCA events are constantly amazed by how much they learn when they choose to attend courses for enrichment. Take a look at the course catalogue on fcachiro.org and plan to check out several classes. Print out the finalized quick glance planner the week of the event to help you navigate through the convention weekend. Watch your mail for information on some additional specialized course offerings. Your colleagues know the value of resources available to you at FCA events. Take advantage of them!
More bright ideas to change and grow your practice are at your fingertips in the latest edition of the FCA Journal. See the highlights of the upcoming FCA National Convention, with its all-star speaker line-up, classes and special tracks for the entire staff and 400-exhibit expo. Enjoy these articles by convention speakers, in addition to the usual great departments and the ever-popular classified section:
· Dr. Michael Megehee discusses the many practice positives for DCs who become NRCME certified to perform DOT exams in “Commercial Driver Physicians: A Bigger Opportunity Than Expected.”
· Dr. William Kleber provides a great reference article for best assessment practices in “Cardiovascular Diagnostics.”
· Paul Lambert, J.D. provides a helpful introduction to the new HIPAA regulations coming onlineSeptember 26, 2013 in “2013 HIPAA Regulations Give New Protections” on page 39.
· Don Cross, D.C. begins a series to discuss what we must do to “be compliant” in small offices, in “Compliance Concerns Part 1: It’s All About the Numbers” on page 40
· David Seaman, D.C. brings you the latest on “How Excess Body Weight Promotes Pian by Chronic Inflammation” on page 42.
· Steven Weiniger, D.C. describes cutting edge patient education methods in “Building Posture Consciousness with Concepts and an App” on page 44.
The American Chiropractic Association (ACA) announced this week that Cancer Treatment Centers of America (CTCA) – a pioneer in integrative care, incorporating chiropractic services and other supportive therapies into its advanced, evidenced-based cancer treatments – is the focus of the cover story in the August 2013 issue of ACA News. At CTCA's five regional hospitals, chiropractic physicians work on teams alongside surgeons and oncologists to support cancer patients during their treatment. Continue reading.
CTCA is sponsoring a program at the upcoming FCA National Convention on Friday, August 23 and Sunday, August 25. In “Effectiveness of Chiropractic in an Integrative Oncology Setting,” Jeffrey Sklar, D.C. will focus on having chiropractors working in a hospital setting and more specifically with cancer patients. See the National Convention DC and CCPA Course Catalog posted on the “schedule” tab for more details.
Registrations are pouring in for the upcoming FCA National Convention, August 22-25 at the Peabody Orlando. And attendees have shown a definite preference for online registration: As pre-registrations build toward the 2,000 mark, some 80% of pre-registrations to date have been placed through the secure online system. View the complete program and information on attraction and spa discounts, use the easy Peabody reservations link and take advantage of pre-registration discounts: It’s all at your fingertips on fcachiro.org!
Leon County Circuit Judge Terry Lewis granted the Plaintiffs' Motion for Temporary Injunction in March 2013, finding that the Emergency Medical Condition limitation and the denial of LMT and acupuncture services in the new PIP law, violated Floridian's access rights to the courts, in violation of the Florida Constitution. Since that time, some auto carriers have been abiding by this injunction, while many others have not and have been denying bills after $2,500.
The state appealed Judge Lewis' order to the First District Court of Appeals.
The First District Court of Appeal has just set this case for oral argument on September 17, 2013, beginning at 9:00 a.m. During oral argument, each side has 15 minutes to argue their side of the case.
The Florida Chiropractic Association filed an Amicus ("friend of the court") brief in support of the injunction. However, those filing Amicus briefs are not granted the right to oral argument.
The FCA will continue to keep you apprised of any action occurring in this case.
(July 26, 2013) The ACA has a lawsuit pending against ASHN & CIGNA and a separate lawsuit pending against UnitedHealthCare. Below are updates on the status of the lawsuits and an explanation of how individual chiropractors may help with data and information. More on the ACA's legal actions and a way to send information about claims processing complaints can be found in theirChiropractic Networks Action Center.
ACA vs. ASHN & CIGNA
The ACA sued ASHN & CIGNA. The release which follows explains the basis of the lawsuit. We are awaiting a ruling on a pending motion to dismiss the lawsuit which motion was filed by ASHN & CIGNA. In the meanwhile, the ACA is gathering evidence on claims processing procedures and policies used by ASHN & CIGNA for use in prosecuting the lawsuit, if the motion to dismiss is denied.
FCA members are complaining to the FCA about those claims processing policies and procedures, asking for the FCA to take some sort of action. The ACA asks that individual state associations refrain from taking judicial action, allowing the ACA's lawsuit to develop without distraction of similar suits. Instead, the ACA asks for individual chiropractors to transmit communications, claims denials or delays, reduction of payments or any other action ASHN & CIGNA takes to avoid full payment of reasonable fees.
ACA vs. UnitedHealthCare
The federal judge recently denied UnitedHealthcare's motion to dismiss the pending lawsuit opening the way for the ACA to proceed in discovery and preparation for trial. Following is a release by the ACA fully explaining the basis of the lawsuit and the involvement by the ACA & COCSA.
Saturday morning's plenary sessions will feature "Clinical Elements to Build a Successful Practice," where some of the brightest minds in chiropractic will shine a light on their area of clinical focus and its best application for building a successful practice.
The first hour will feature a panel giving 10-minute snapshots to challenge your thinking, followed by a feature presentation on "Research: The Ultimate Confidence Builder." Prolific clinical researcher Greg Kawchuk, D.C., Ph.D. will engage you by showing you how evidence-based practice, properly applied, will aid your success. Says Dr. Kawchuk, "For most chiropractors, 'practice success' usually conjures up thoughts of marketing, coaching, products and patient traffic and almost never thoughts of research or evidence-based practice. Is 'research' the kryptonite of 'practice SUCCESS' or can these two elements co-exist? Join us in exploring how 'evidence-based' and 'a successful' can both be used with the word 'practice' to reduce risk, improve patient satisfaction, enhance patient care and help your practice succeed."