VA

[Guest guest]

In a message dated 11/27/2002 12:44:50 PM Pacific Standard Time, rcross@... writes:

Here's a question to all of you. With this new Veterans Administration referral I have received should I try and set the standard for reimbursement by charging let's say $100 per manipulation? I shall do my part to pave the way for my brothers and sisters in chiropractic.

Have a happy holiday.

Rodney J. Cross DC

Dear Dr. Cross,

I don't know you well enough to know if this is a joking question, but my answer would be to charge what your normal fees are. Add anything to the manip fee you think was necessary. Use good documentation with objectives of care listed so they can see how thorough chiropractors are. Send the chart notes with the bill and make sure they're legible and concise. I think that sets the best example. Good luck to you. And thanks for paving the way. Please keep us posted on the outcome.

Minga Guerrero DC

[Guest guest]

I was kidding. Now do you know me better?

Re: VA

In a message dated 11/27/2002 12:44:50 PM Pacific Standard Time, rcross@... writes:

Here's a question to all of you. With this new Veterans Administration referral I have received should I try and set the standard for reimbursement by charging let's say $100 per manipulation? I shall do my part to pave the way for my brothers and sisters in chiropractic. Have a happy holiday. Rodney J. Cross DC Dear Dr. Cross, I don't know you well enough to know if this is a joking question, but my answer would be to charge what your normal fees are. Add anything to the manip fee you think was necessary. Use good documentation with objectives of care listed so they can see how thorough chiropractors are. Send the chart notes with the bill and make sure they're legible and concise. I think that sets the best example. Good luck to you. And thanks for paving the way. Please keep us posted on the outcome. Minga Guerrero DC OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

[Guest guest]

,

I know you asked this question of Vern, but I'd like to give my personal opinion.

I wouldn't assume it's bias. Military protocol has a 'chain of command' order that is set in place to protect military personnel. It's actually quite remarkable that you have been given any Rx to administer chiropractic treatment. There are very few DCs in your position. Please just administer the care, send good chart notes and use your best clinical rationale to explain any need for future care should you think it necessary. Utilizing chiropractic care in the military is still in it's infancy. The chain of command is learning how best to use it and will be educated by these early contacts. If those of us who interact, do so with a feeling of anger, discrimination or disrespect, it may set a tone that disallows future care. My advice would be to use your very best professional judgement, basing decisions on good clinical data that you can relay in a report or chart notes. If you use abbreviations or check list charts that may not be understood by those outside of the chiropractic profession, the information may be more easily received if you put it in typed narrative or shorter outline detailing points of greatest concern. This is my personal opinion after spending many hours in conversation with captains, generals, army/ navy physicians and others who've expressed desire for chiropractic and voiced their concerns. Most of the echoed concerns are that DCs may not understand or be willing to follow chain of command orders. It's also important to realize that we can't treat active military without orders from their commanding medical officer. The reason for this is fairly simple. It's done to keep a unit safe. If the military medical officer doesn't know the various inadequacies of personnel, they may go into battle and put the rest of the unit at risk. The chain of command makes decisions for those of us under them. Even as civilian medical personnel, we have to be respectful of our place in the order of command. Thanks for listening and please understand that I'm on our side and have spent many hours working on getting DC care for the military. I have a big military family and hear from them and their colleagues all asking for help. I'm only expressing my personal opinion, albeit with some extra knowledge in growing up with military and now speaking with the higher chain of command.

Minga Guerrero DC

In a message dated 11/13/2008 4:26:28 P.M. Pacific Standard Time, jkehr@... writes:

Question to Vern,

I have a VA referral for 6 visits, tx 6 times and have requested further treatment. The VA is stating that they will only approve 12 visits per year and will only allow 6 more. Is this standard or just continued bias toward Chiropractic?

Kehr

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[Guest guest]

Hi , I would imagine that when you say: "...a VA referral..." you mean the veteran's VA-PCP referred or authorized the initial 6 visits and then the subsequent 6 correct?

The VA-PCP has control as all chiropractic treatment must go through this filter which has in fact been a great deal of the problem. You are one of the few who actually recieved a referral as the refusal of the MD VA-PCP to refer to chiropractic colleagues is a national problem.

However one positive thing has come up after bugging the Portland VA for nearly 4-years now the have finally hired a full time DC. He is actually a DC, DO a chiropractic colleague originally from Eugene, once practiced with our good colleague Rich Goreman DC. He apparently went back to school and obtained his osteopathic degree. HR-1470 which is now over on the US Senate side would place a chiropractic physician in every major VA facility across the nation.

So getting back to your original question the 12 visit cap is simply something they have come up with on their own as per internal "guidelines" when referring to DCs you should feel "lucky" you got the 12 visits....

Vern Saboe

VA

Question to Vern,

I have a VA referral for 6 visits, tx 6 times and have requested further treatment. The VA is stating that they will only approve 12 visits per year and will only allow 6 more. Is this standard or just continued bias toward Chiropractic?

Kehr

[Guest guest]

All, I want to back up Minga's comments about military protocol.

Arlan Fuhr DC ,cofounder of Activator ,is Chief on Conservative care at the sdale AZ Veterans Medical Center. He got the job because he was a veteran who knows protocol, he uses a documented system approach to treatment, and fits in to their scheme. He tells the story about Qand A in a Medical staff meeting, when asked what do you do about the flu, he replied"send em back to primary care so I don't get it". Whatever your personal philosophy of Chiropractic, you must fit in to their turf. The sdale VA now has two full time DCs with a 3 month waiting list for care. You can see a video clip of the sdale VA by going to Activator.com, and following the rolling link to American Veteran. R Johansen D.C.,DABCOChiropractic Life Center12762 SE Stark StreetPortland Oregon 97233Voice 5032557746,Fax 5032550818-- AboWoman@... wrote:

,

I know you asked this question of Vern, but I'd like to give my personal opinion.

I wouldn't assume it's bias. Military protocol has a 'chain of command' order that is set in place to protect military personnel. It's actually quite remarkable that you have been given any Rx to administer chiropractic treatment. There are very few DCs in your position. Please just administer the care, send good chart notes and use your best clinical rationale to explain any need for future care should you think it necessary. Utilizing chiropractic care in the military is still in it's infancy. The chain of command is learning how best to use it and will be educated by these early contacts. If those of us who interact, do so with a feeling of anger, discrimination or disrespect, it may set a tone that disallows future care. My advice would be to use your very best professional judgement, basing decisions on good clinical data that you can relay in a report or chart notes. If you use abbreviations or check list charts that may not be understood by those outside of the chiropractic profession, the information may be more easily received if you put it in typed narrative or shorter outline detailing points of greatest concern. This is my personal opinion after spending many hours in conversation with captains, generals, army/ navy physicians and others who've expressed desire for chiropractic and voiced their concerns. Most of the echoed concerns are that DCs may not understand or be willing to follow chain of command orders. It's also important to realize that we can't treat active military without orders from their commanding medical officer. The reason for this is fairly simple. It's done to keep a unit safe. If the military medical officer doesn't know the various inadequacies of personnel, they may go into battle and put the rest of the unit at risk. The chain of command makes decisions for those of us under them. Even as civilian medical personnel, we have to be respectful of our place in the order of command. Thanks for listening and please understand that I'm on our side and have spent many hours working on getting DC care for the military. I have a big military family and hear from them and their colleagues all asking for help. I'm only expressing my personal opinion, albeit with some extra knowledge in growing up with military and now speaking with the higher chain of command.

Minga Guerrero DC

In a message dated 11/13/2008 4:26:28 P.M. Pacific Standard Time, jkehr@... writes:

Question to Vern,

I have a VA referral for 6 visits, tx 6 times and have requested further treatment. The VA is stating that they will only approve 12 visits per year and will only allow 6 more. Is this standard or just continued bias toward Chiropractic?

Kehr

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[Guest guest]

I know Stan recently got VA benefits. My husband avoids requesting them

because he says it will take a long time to get them. Of course, if he had

done it a long time ago, it would be done.

Stan, do you remember how long it took and what was involved?

dd

[Guest guest]

DD, you can apply online or at your local clinic, here are the enrollment forms

are more info

http://www.va.gov/healtheligibility/application/

The whole process took me less than a month.  I get my Enbrel and any other RA

drugs thru them.  The max copay is $8, so it really can't be beat.  I actually

really like my VA doc.  YOu have to see a general provider first, he/she will

refer you to rheumatology.  After that, your general person can authorize

refills.  I don't go to VA rheum anymore b/c it's very far for  me.  I see a

private rheum, take my VA general practitioner her notes and he writes me a

year's worth of Enbrel.  Every month I rquest refills and they mail them to me. 

Wow.

Kate F

________________________________

From: " dgd301@... " <dgd301@...>

Sent: Thursday, August 6, 2009 8:39:35 AM

Subject: [ ] VA

 

I know Stan recently got VA benefits. My husband avoids requesting them

because he says it will take a long time to get them. Of course, if he had

done it a long time ago, it would be done.

Stan, do you remember how long it took and what was involved?

dd

[Guest guest]

That's right! 

And Dennis, I'm weighing a job offer with the VA, so I will only become more

bossy if I get to know the system better!  In all seriousness though, I hope

your bottom is better, those biopsies are no fun.

Kate F

________________________________

From: Dennis W <betnden@...>

Sent: Thursday, August 6, 2009 9:59:44 AM

Subject: Re: [ ] VA

 

*whispering: *Don't let Kate see this. She's been mothering me to get the

papers done, and she's a Pit Bull sometimes. LOL

I have mine ready to go and had planned to turn them in to the local office

after a prostate biopsy. By the time I left the doctor's office, I wasn't in

shape to do it. I will do it this month without further excuses.

Dennis in eastexas

On Thu, Aug 6, 2009 at 8:39 AM, <dgd301@...> wrote:

>

>

> I know Stan recently got VA benefits. My husband avoids requesting them

> because he says it will take a long time to get them. Of course, if he had

> done it a long time ago, it would be done.

>

> Stan, do you remember how long it took and what was involved?

>

> dd

>

[Guest guest]

Hi Dennis:

I hope you are feeling better, and that your Biopsy comes out good.

Take care, and rest as much as you can.

Hugs,

Barbara

>

> >

> >

> > I know Stan recently got VA benefits. My husband avoids requesting

them

> > because he says it will take a long time to get them. Of course, if

he had

> > done it a long time ago, it would be done.

> >

> > Stan, do you remember how long it took and what was involved?

> >

> > dd

> >

>

>

>