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Dec 26, 2009, 12:48pm

Chirotalk: The Skeptical Chiropractic Discussion Forum :: General Topics :: The Future of Chiropractic: Should Anyone Become a DC? :: PROOF! Chiropractors DO 'Eat their Young'

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Topic: PROOF! Chiropractors DO 'Eat their Young' (Read 143 times)

IPFreely
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PROOF! Chiropractors DO 'Eat their Young'
« Thread Started on Nov 2, 2009, 4:21pm »

http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=53984

Chiropractors Eating Their Own?

Dear Editor:

It is time someone took a stand against the IPAs and chiropractic networks that are started and run by chiropractors, hired to manage the chiropractic benefit of an insurer, and then underpay and administratively overburden the empanelled DCs. These networks are usually for-profit entities that underbid the contracts to establish a relationship with an insurer.

For example, if an insurer is currently paying $1 per member per month for chiropractic services, the network will come to the insurer and offer to manage the chiropractic benefit for only $.50 per member per month. The network then cuts reimbursements and arbitrarily sets visit limits, usually by finding most care after 3-4 visits "not medically necessary" and making the treating DC's paperwork and appeal processes overly burdensome so they cannot find time to comply with those processes.

Chiropractors are signing these network contracts for one of three reasons: They are just ignorant and do not know what they are signing; they are afraid to lose patients; or they undervalue their own services and sign the contract in order to participate with the network.

We need to take a stand against networks that treat their colleagues this way. These networks need to be exposed as harmful to the profession. DCs need to know that signing participation agreements with these networks not only affects that one insurer, but also reinforces the network's ability to gain more market share; after all, other insurers will no longer want to pay $1 per member, per month once they see it can be done more cheaply. Who cares if that cheaper option is at the expense of the chiropractic panel?

This topic is hot in the sense that we, the chiropractors in the field, are living this every day and our practices are suffering financially as the networks continue to reduce reimbursements to insufferable levels.

(How about $30.53 maximum allowed office visit charge no matter what services you perform - and you cannot balance bill the patient? That's $30.53 for a new-patient consultation and exam and treatment, $30.53 for a re-exam of an existing patient with a new injury and diagnosis, and $30.53 no matter what therapies or counseling you provide during a visit.)

The DCs who started and run these networks are the people responsible for these god-awful contracts that are being offered to members of their own profession. Somehow, we need to stop this practice of DCs eating their own for self-profit. Let's get this information out to the profession and begin the process of reclaiming our dignity and ostracizing chiropractors who would treat their fellow doctors so disrespectfully.

Leslie W. Lange, DC
Rochester, N.Y.

http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=54306

We Have Become Our Own Worst Enemy

Dear Editor:

I recently read a letter to the editor titled "Chiropractors Eating Their Own" . I am glad I did and would like to add to the doctor's comments.

Here in Utah, we have a managed care group owned by chiropractors who have done just what she was talking about. They have undercut our reimbursement to such ridiculous levels that many of us are now struggling to stay alive. (If you live and practice in the intermountain area where they have contracts, you know who I am talking about.)

We had problems several years ago when we were routinely given anywhere from 4-8 visits to treat any and all conditions, no matter how severe or chronic. These limitations were placed on us by chiropractors who review the cases. When asking for extended visits, we were allowed two or three more. We have taken hit after hit as this group continued to agree to lower and lower fee schedules in order to maintain their contracts. The owners of this company (all chiropractors), have reaped the benefits of this; they have become wealthy on the sweat and tears of their fellow DCs.

Since the company holds the contracts for most of the major insurance companies in our area, it is very difficult to not join their group. However, in so doing, they charge you a substantial fee and then they take a 10-15 percent cut of the already significantly reduced fee that you are paid out of every check you receive. As such, we are now reimbursed about 50-60 percent of our submitted fees. This doesn't leave much to pay your bills and support a family.

I don't know what the answer is to this, but I don't think our national associations have done enough to help, and unless there is a major change with national health insurance or with our chiropractic associations taking aim at these groups, I fear you will see many in our ranks going out of business at the hands of our greedy colleagues. Time and again, we have become our own worst enemy.

Name withheld by request

« Last Edit: Nov 2, 2009, 4:25pm by IPFreely »

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