Minutes

Unified VCA

Insurance Committee Meeting

Thursday, July 24, 2014

1:05pm –2:15pm

Members Present: Dr. Misra; Dr. Busch; Dr. Walter; Dr Carlsen; Susan McClelland; Dale Jackson.

  1. Call to Order
  • Dr. Misracalled the meeting to order at 1:05 pm.
  • There were no questions or changes to last meeting’s minutes.
  1. Insurance Audit Tool
  • Dale reported that there were no new complaints.
  1. Update on Medicare Probe
  • Susan reported that the Medicare Probe is finished, but the findings haven’t been published and there’s still no information on the appeals. She projects there is a 9-10 month delay due to so many appeals.
  • Palmetto has been giving conflicting information and teaching incorrect material to providers. Susan suggested that we need to verify with them what their requirements are and what they want from us.
  • Dr. Walter mentioned that there is still a problem with inaccurate information regarding the patient’s responsibility on EOBs.
  • It was decided that the Insurance Committee will have a conference call before contacting Palmetto on these issues.
  • Dale will send an email to the call participants with further details.
  1. CAC Update
  • Dr. Carlsen attended the CAC meeting in Richmond last Thursday. July 17th. Dr. Walter reported that there were three Medical Directors in attendance and chiropractic was mentioned during discussion a couple of times at the meeting.
  • After the meeting Dr. Carlsen had some discussion with the Palmetto representative and feels there is a genuine interest on Palmetto’s part to work with chiropractors on documentation problems. Palmetto volunteered to come to the UVCA convention to talk about these issues.
  1. WCRI Update and Progress on WC Course and Inroads to Companies
  • There was discussion about the WCRI Representative position. Dale will contact Julie for more information.
  • The next step on the Workers’ Compensation Course is to review the material provided by Dr. Swere to get a better understanding of what we want. After reviewing the material, Drs. Misra and Busch will set up a call with Dr.Swerein October for further discussion. A plan will be ready for presentation at the Fall Convention.
  1. Insurance Tips
  • Dale reported that 468 out of 661 members receiving the July Insurance Tip have opened the email. (71%)
  • Dr. Misra expressed concern that members may not take the time to read the September Tip because it consists of 5 pages.
  • It was decided that Dale will work with Elaine to see if we can add some features that will allow members to view the main headings in a one-page format and pick and choose which parts of the Tip they want to read.
  • There was also discussion about how to monitor member viewing of the Tip. Dale will check with Julie/Elaine to see if this possible now or will be in the future.
  1. HB 1655(Assignment of Benefits Statutory Changes)
  • This item was removed from the agenda.
  1. Update on Progress with Anthem BCBS (Dry Needling and PCP Referral Issues)
  • Dale reported that the Dry Needling Complaint was sent to the BOI, Dr. Schukman and Mr. Tim Miller of Anthem Virginia, and Dr. Rosenberg at WellPoint.
  • Dr. Misra suggested we send a copy to K. Marshall Cook, who is the attorney who initially put us in contact with Dr. Schukman to discuss the Dry Needling issue.
  • Dale will draft a cover email to Mr. Cook under Dr. Misra’s cover.
  1. Update on Aetna’s Denials of Code 97140-59 when used with 98940
  • There was general discussion on the need to teach doctors how to use the 97140 and other codes appropriately to get the same outcome.
  1. Coding Concepts Seminar
  • Dr. Busch reported that we need to brainstorm on this idea and how to structure the course.
  1. Update on Contact Information for Insurance Reps
  • Dr. Busch reported that the contact information CARE Medical Billing has been working on is completed and will be ready for us next week.
  1. New Business
  • There was no new business.
  1. Meeting adjourned at 2:15p.m.

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