Small Business Employer Obligations
The ICS keeps physicians aware of employment laws and regulations that apply to the physician office as an employer.
Read MoreAuthor: Adrienne Hersh, JD, ICS Legal Counsel
ICS Files Department of Insurance Complaint Against UHC/Optum “Per Diem” Reimbursement Model
Many of you recently were notified by United Health Care/Optum that it intends to change its reimbursement model for chiropractic physician providers. In Optum’s own words, “Effective December 1, 2015, OptumHealthCare Solutions, Inc. (Optum) will implement a new chiropractic ‘per visit’ fee schedule for UnitedHealthcare commercial products managed by the Optum™ network.”
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Professional Standards
Physicians must strive to provide the best possible patient care, which is difficult in today’s economic climate where payers want more care for less pay.
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BCBSIL Requests Patient Records
The Patient Protection and Affordable Care Act established health insurance exchanges to sell insurance plans to any citizen, regardless of health status.
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Interviewing Job Applicants
Hiring competent staff is a critical element to the management of any business, but it is particularly important in a small practice.
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Disability Parking Certification
Chiropractic physicians have long been among the medical professionals who are authorized to certify disability for patients who apply for disabled parking privileges. In recent years, the ICS has interacted directly with the Secretary of State’s office on multiple occasions to ensure that all branch offices are correctly instructed to accept certification by chiropractic physicians.
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Calculation of Lien Payments
The ICS has been following a line of court cases regarding the calculation of lien payments to health care providers in injury cases. In some jurisdictions, courts have ruled that plaintiffs (patients) in injury cases may deduct and retain litigation costs from the total settlement or judgment amount BEFORE applying the percentages to pay health care liens. Of course, this formula reduced the amounts available for payment of health care liens and effectively required health care providers to share in the payment of litigation costs.
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HIPAA Breach Notification Requirements
At this point, HIPAA-covered providers know that they are required to keep patients’ protected health information (PHI) private and secure. What they may not know is that they also are required to maintain a HIPAA-compliant breach notification policy in the office and to notify patients if a breach occurs.
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