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Chiropractors - Coalmine Canary?
Old 12-07-2013, 04:14 PM   #1
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Chiropractors - Coalmine Canary?

The linked article comes from our local nespaper. It's about Chiropractors deciding to avoid ACA, by going "cash only"...
Chiropractors consider cash-only option - LaSalle News Tribune - LaSalle, IL

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“The Affordable Care Act will make deductibles so high that people will soon be paying out-of-pocket for chiropractic medicine anyway,” said Dr. William Judge or Judge Chiropractic Center in La Salle.

“So why not go cash-only? This way, I can get rid of the headache of dealing with insurance companies, bring costs down for my patients, and get back to spending more time helping people.”

The Affordable Care Act states insurance companies “shall not discriminate” against any state-licensed health provider, which was supposed to encourage better coverage of chiropractic, homeopathic and naturopathic care.

But there is nothing in the law that defines how much care insurance companies must provide. Most insurance plans whether bought on a government exchange or otherwise offer consumers very limited office visits, say area chiropractors.

Dr. Cindy Becker, a chiropractor in Mendota, said a substantial number of her clients already pay out of pocket, but for differing reasons.

Most quickly exhaust the number of visits their insurance company will cover and are forced to pay with cash or a credit/debit card
... more

Have you heard anything like this... for other practitioners?
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Old 12-07-2013, 04:24 PM   #2
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Originally Posted by imoldernu View Post
The linked article comes from our local nespaper. It's about Chiropractors deciding to avoid ACA, by going "cash only"...
Chiropractors consider cash-only option - LaSalle News Tribune - LaSalle, IL

... more

Have you heard anything like this... for other practitioners?
isn't the thread title a bit overdramatic? I'm still waiting for a post that explains how a Doctor, Hospital or any other general medical practitioner is actually going to determine in real life just how to distinguish between an individual BCBS PPO plan purchased on the exchange with one from a group policy when they both use the same network and have the same essential health benefits. Does the article you link explain that? It's behind a paywall, so no way to tell.
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Old 12-07-2013, 04:28 PM   #3
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I don't think our insurance ever covered chiropractors anyway.
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Old 12-07-2013, 04:38 PM   #4
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There have been an increasing number of doctors, especially GPs, who have been going "cash-only" for several years. Others have been going to a "Concierge Medicine" model (pay an annual fee and gain access to the doc). I think this might become more popular if wait times increase due to restricted provider networks and due to physician preferences if the restrictions on care become too onerous. Most doctors became doctors so they could practice medicine.

A CNN article on the practice.

I'd say it's too soon to tell if the ACA will be responsible for increasing these cash-only businesses. Right now people on both sides are in the "threaten and promise" mode, jockeying for position. Their actions will tell the tale.
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Old 12-07-2013, 04:41 PM   #5
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I don't think our insurance ever covered chiropractors anyway.
Ours did and some small claims were paid, but most went toward the deductible. Medicare does pay them.

This line in the quote is telling
Quote:
The Affordable Care Act will make deductibles so high
Deductibles have been rising steadily for years and have nothing to do the the ACA, but now they are on the front page, and I think people are now realizing that health care and health care insurance in the US are very expensive.
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Old 12-07-2013, 04:51 PM   #6
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Have always paid cash to my chiros.
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Old 12-07-2013, 05:05 PM   #7
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A lot of dentists can relate to this.
My long time dentist doesn't "accept" any insurance.
He takes whatever my insurance covers, then bills me the rest of his invoice, to the penny.
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Old 12-07-2013, 05:28 PM   #8
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I know my health insurance pays for a certain number of chiro appointments annually. I have heard this from co-workers who go regularly and seem to get great relief from the visits.
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Old 12-07-2013, 05:47 PM   #9
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chiropractors and massage therapists have always been on the fringe of the establishment medical industry, and my insurance has rarely covered them. Seems to me this only started to change in the last 10 years. Just this year my FSA decided I did not need a prescription for my massage therapist to get reimbursed from the FSA.
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Old 12-07-2013, 06:10 PM   #10
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isn't the thread title a bit overdramatic? I'm still waiting for a post that explains how a Doctor, Hospital or any other general medical practitioner is actually going to determine in real life just how to distinguish between an individual BCBS PPO plan purchased on the exchange with one from a group policy when they both use the same network and have the same essential health benefits. Does the article you link explain that? It's behind a paywall, so no way to tell.
Provider offices call to verify coverages. If the copays, deductibles, and reimbursement rates are identical, the provider won't/ shouldn't care if it's a group or exchange policy. As this evolves, I think you will see that the providers will be better at collecting copays and deductibles at time of service. I think when you hear that someone says that they aren't going to accept insurance they mean that they aren't going to file, wait 3 months to find out that you haven't met you're deductible and then bill you.
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Old 12-07-2013, 06:13 PM   #11
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Part of health insurance is pre-negociated prices. When a provider communicates they will not accept insurance or is out of network, I am usually headed out the door.
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Old 12-07-2013, 06:16 PM   #12
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isn't the thread title a bit overdramatic? I'm still waiting for a post that explains how a Doctor, Hospital or any other general medical practitioner is actually going to determine in real life just how to distinguish between an individual BCBS PPO plan purchased on the exchange with one from a group policy when they both use the same network and have the same essential health benefits. Does the article you link explain that? It's behind a paywall, so no way to tell.
Yeah... maybe over dramatic. It's just that I haven't seen much in print about a withdrawal from the system. I do know that my own doctor isn't terribly happy about the regulations placed upon her practice, for reporting, conforming and recordkeeping, as well as the mechanics of billing and approvals. While she is quite young... 35, her practice has grown exponentially since beginning it in 2003. From an office of four persons, there are now 9... with some, doing nothing but converting written patient files to computer format.

While the ACA doesn't affect us directly, I do worry about losing our doctor.
I don't blame ACA... I support it wholeheartedly, though I'd prefer a single payer system. In any case, whatever happens in the longer term... I would hope that the controls that the AMA exerts over approved medical schools and acceptance.. ( number of doctors) would be loosened. The current and projected number of available doctors is so low that a growing shortage of doctors may well encourage the more successful ones to venture into private (non medicare) practice.

... and so yes, I do wonder if the chiropractor decisions in our town, could be a bellwether for other medical professionals.
.................................................. ..........

BTW... about the paywall... I guess I don't understand why no access to the link... I'm not a subscriber but have no trouble with the link... sorry for the problem...
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Old 12-07-2013, 06:32 PM   #13
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I do wonder if the chiropractor decisions in our town, could be a bellwether for other medical professionals.
Here in Chicago, there is a particular subset of chiropractors who are switching to strictly a cash basis. These gals, young and scantily dressed, have found that only Illinois politicians have policies that pay for their services without question. Other folks have insurance that generally refuses to pay for the services they offer, hence cash up front before they lay hands on.
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Old 12-07-2013, 06:35 PM   #14
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. I do know that my own doctor isn't terribly happy about the regulations placed upon her practice, for reporting, conforming and recordkeeping, .
It is the percent of doctors that are crooked doctors that have caused all of this to become so extreme. She should put the blame where it belongs.
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Old 12-07-2013, 06:43 PM   #15
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It is the percent of doctors that are crooked doctors that have caused all of this to become so extreme. She should put the blame where it belongs.
The fraud is always surprising. 90 individuals arrested for 225 million in fraudulent charges or 1500 arrested for 5 billion in fraud. Of course, this is Medicare fraud. Private insurers do a little homework before writing billion dollar checks. lol
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Old 12-07-2013, 06:44 PM   #16
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....... I'm still waiting for a post that explains how a Doctor, Hospital or any other general medical practitioner is actually going to determine in real life just how to distinguish between an individual BCBS PPO plan purchased on the exchange with one from a group policy when they both use the same network and have the same essential health benefits......
At least for BCBS in my area, the specific Plans have long been identified by Group #, Plan #, and individual insured's ID #. Office staff inputting that info into their BCBS provider website can tell if their office is a "participating provider" for that specific patient's insurance. My understanding is that Exchange Plans will have their own specific #'s, so process should work much the same.
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Old 12-08-2013, 06:54 AM   #17
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The Affordable Care Act states insurance companies “shall not discriminate” against any state-licensed health provider, which was supposed to encourage better coverage of chiropractic, homeopathic and naturopathic care.
Homeopaths can be covered by ACA policies somewhere? What about faith healers?
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Old 12-08-2013, 07:13 AM   #18
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Homeopaths can be covered by ACA policies somewhere? What about faith healers?
Oooh, Oooh! I sense a business opportunity!
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Old 12-08-2013, 07:45 AM   #19
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...
This line in the quote is telling Deductibles have been rising steadily for years and have nothing to do the the ACA, but now they are on the front page, and I think people are now realizing that health care and health care insurance in the US are very expensive.
That's exactly right.
Premiums have been rising and quality of care has been lagging behind too.

The A.C.A. hasn't caused this. It's only a first, small step in an attempt to adjust a health care system that needs improvement.
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Old 12-08-2013, 08:49 AM   #20
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At least for BCBS in my area, the specific Plans have long been identified by Group #, Plan #, and individual insured's ID #. Office staff inputting that info into their BCBS provider website can tell if their office is a "participating provider" for that specific patient's insurance. My understanding is that Exchange Plans will have their own specific #'s, so process should work much the same.
A provider can see the group and plan numbers, but if an issuer has numerous plans, what distinguishes or identifies a plan offered on an exchange, and why would a provider even care? The provider is interested in reimbursement, not policy issuance. If an issuer uses the same network for different plans, and some of those plans are offered on the exchange, it is basically irrelevant to the provider. This is certainly the case with many BCBS and Humana PPO plans, as they reference the same national networks used for other group plans they issue.

The frequent reports of health care providers being cut out of or not accepting ACA plans sound like providers and insurers are finding it more difficult to negotiate reimbursement. Over more than a decade, prices rose at a double digit annual pace and were simply passed from provider to insurer to insured. That is no longer acceptable affordable. Hopefully this leads to more price stability.
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