The Missouri Chiropractor - March 2008

• President’s Message by Edward A. Hengel, DC
• Executive Director Report by Kathleen Wilcoxson, MPA
• Government Report by Mo McCullough
• ACA Successful as UCH Rescinds “Unproven” Treatment Policy By Dr. Jack Kessinger, Missouri Delegate to the ACA
• CA's Corner; ABC’s of Advertising By Mark Charrette, DC
• Feature Article: Becoming Your Community's Auto Safety Advocate by Arthur C. Croft, D.C., M.Sc., M.P.H., F.A.C.O.
• The Five-tool Prospect by Robert Heart
  
• Insurance Report By Margaret Freihaut, DC, Insurance Committee Chair
• Membership Report By Michael Finley, DC, Membership Committee Chair
• The PAC Report By Paul W. Foster, DC, PAC President
• District 1 Report By Michael Finley, DC
• District 2 Report By Ron Manfredi, D.C.
• District 4 Report By Loren Smothers, D.C.
• District 5 Report By Jeremy Thornton, D.C., DABCI
• Insurance Alert
• Classified Ads
  

President's Report

by Edward A. Hengel, DC,  MSCA President

Like David and Goliath

We all know the story of David versus Goliath. A vivid comparison can easily be drawn between the chiropractic profession and David; while Goliath represents any number of entities. These mammoth entities we continue to confront include the insurance industry, federal Medicare rulings, state law interpretation and education for the general public, including the elected representatives in Jefferson City.

Surely the odds makers did not give David much of a chance to win when it came time to face a giant adversary. The same may be true when onlookers are viewing the challenges that our profession is currently battling. Well, we know how it turned out for David; so how have we done lately through the efforts of the MSCA?

Lien law to protect our bills.
Mandate of 26 office visits, minimum.
New Practice Act.
Major victory over HMO carrier in Missouri.
Currently presenting our argument in court against UHC/ACN.

This is just a brief list of our victories as an association over the last five years. What can you do to help? Begin by:

Joining the MSCA.
Become a PAC member.
Contribute to the MSCA Legal Action Fund.
Get involved at some level with your district.

Like David, we have had the courage to fight; we have shown up against supposedly mightier opponents; and we have had the stones to get the job done.

Executive Directors Report

by Kathleen Wilcoxson, MPA

MSCA Seminars: A Win-Win for Chiropractors

We receive many phone calls from doctor’s offices across the state looking for answers to questions about filing insurance, keeping patient records, using codes, and other topics related to daily chiropractic office management. These are good questions, and we do our best to answer them or put them in touch with someone who can. If they are a member of the MSCA, we can even refer them to our attorney or insurance chair to confer on the subject.

Member or not, we ask if the doctor or CA has ever attended one of our Office Management Seminars where we address these topics. Usually we get one of two responses. Either they attend regularly and tout the wealth of information they receive; or they are unaware these seminars cover this type of information so valuable to their practice.

If you are one of the latter, unaware of the invaluable information provided at the MSCA Office Management Seminars, let us fill you in. Some of the topics covered over the past few years include Medicare, coding and documentation, insurance, legal issues and basic accounting. The next seminar scheduled will be one of the most comprehensive ever.

On Saturday, March 29, the MSCA is holding an Open Forum covering five critical topics for chiropractors today: Legal, Legislative, Insurance, Documentation and Licensing. Attendees will hear from experts in each field, then be given the opportunity ask their own specific questions. So get your questions ready, and register today.

Attending MSCA seminars is a great way to support your professional association while, at the same time, gaining information that will help you in your practice. You also attain CE credits required for licensure. It’s a win-win situation. Did I mention MSCA members receive an additional discount on registration as well as the privilege of referral with their legal, legislative, and insurance questions?

Keep track of seminars offered by the MSCA and its districts by going to our website at www.mscainfo.com.

THE GOVERNMENT REPORT

By Mo McCullough, Government Affairs Director

Thirteen Bills Require Attention

The MSCA lobby crew is hard at work this session. We are following thirteen bills that we either need to pass, kill, amend onto or just monitor. Those of most importance at this time are:

HB 1815 (Portwood) which would increase copying fees chiropractors can charge. GOOD!

HB 1871 (Portwood) adding chiropractic care to MO Health Net-subject to appropriations. GOOD!

SB 962 (Champion) which would eliminate the mandate that at least one member of the Missouri Board of Health be a chiropractor. BAD!

SB 1043 (Ridgeway) which would require carriers to cover out-of-network chiropractic services. GOOD!
 
Rep. Portwood is also going to sponsor a bill that would prohibit carriers from considering chiropractic as a specialty. GOOD! This would, among other things, address the exorbitantly high co-pay issue. We are finalizing the language so it has not been filed at this time. 
 
Also, we are monitoring the progress of the Governor's Insure Missouri initiative in which chiropractic is not currently included.      

ACA Successful as UCH Rescinds “Unproven” Treatment Policy

By Dr. Jack Kessinger, Missouri Delegate to the ACA

The following is a press release from the American Chiropractic Association. Sometimes it is hard to see the worker bees behind projects that affect our profession. Do you belong to your state association? Your national association?

UnitedHealthcare Rescinds Headache, Pediatric Policy
Following an unprecedented profession-wide campaign led by the ACA, UnitedHealthcare (UHC) has announced it will rescind its recent policy declaring chiropractic manipulative treatment for headaches and pediatric patients as unproven, and therefore, not a covered service.

“We are pleased that UHC has decided not to implement this policy,” said ACA President Glenn Manceaux, DC.  “We strongly believe that through the actions of ACA, along with the other chiropractic organizations, the profession made a compelling argument as to why this policy should have been rescinded.  We feel that our members, the profession and our patients will be well served by UHC’s recent decision.”

Since September 2007, ACA has maintained a line of communication with UHC to emphasize its members’ concerns over the proposed policy change. Furthermore, ACA joined forces with ACC, CCGPP, COCSA, FCER and ICA to issue a joint letter opposing the "flawed" and "unconscionable" policy and supporting a detailed CCGPP analysis and critique of UHC's stance.

In October, UHC delayed implementation of its flawed policy pending additional review of research and information provided by the ACN Chiropractic Professional Advisory Committee (CPAC) and other chiropractic organizations.

“The ACA is proud to have led this effort, which serves as a very important reminder that there is strength in numbers. When all corners of the profession work together with a single vision and a single voice, there is no limit to what we can accomplish. It also underscores the critical role research and evidence play in the reimbursement world and the need for insurers to consult with the chiropractic profession before implementing changes that negatively affect our patients,” said Dr. Manceaux.

CA’S CORNER

ABC’s of Advertising

By Mark Charrette, DC

Research tells us that the average American consumer is exposed to more than 3000 advertising messages a day.¹ With that many messages going out every day, how will you make sure your message stands out from the crowd? What are you doing to ensure that someone sees your ad, hears your message and takes action? It’s up to you to take charge of your advertisements and there are some important principles to consider before placing your next ad.
 
Everyone wants the same thing—to get noticed (leading to more patients, sales, etc.). Companies of all sizes are trying to reinvent themselves in terms of how they connect with customers and prospects. Advertising is just one component of a marketing strategy designed to drive business. Advertising for health-related services (such as chiropractic) can be even more frustrating than that of typical companies because the consumer may not need the service when they are exposed to the marketing message. Therefore, the intent of many marketing campaigns in healthcare is to build and maintain awareness in the mind of the consumer until they are in need of the service being offered. You will have to work extra hard to make an ad that is memorable so the consumer will remember you when he or she needs help from chiropractic.

Sometimes media works best when used together. A research project called “A Day in the Life: An Ethnographic Study of Media Consumption” tracked the real-time media use of 350 people. What was discovered can unlock the advertising key for your practice if applied correctly. The research showed that consumers often use the Internet at the same time they were watching television or listening to the radio. This research proves that the Web is a powerful tool for increasing the power of ads in other media.²

This study found that “the Web increased the reach of television by a remarkable 51 percent in the morning, 39 percent in the middle of the day, and 42 percent in the afternoon.”² So if you place an ad designed to air on television that sends consumers to your website to take advantage of a sale or special promotion, they are more likely to do this because they are using both forms of media at the same time.

So if you have a website for your practice, try to incorporate it into your ads. Driving consumers and potential patients to your website can only improve the chances that they will remember you when they need chiropractic care. It’s going that extra step that will give you the most return on investment (ROI) for your advertising budget.

Be targeted with your message.
It is better to send out a message to 10 people who are listening than to 100 people who are not. This sounds simple enough, but it can get tricky to know which audience you are reaching with each ad. But knowing your audience is a critical part of putting together an ad.

For example, if your practice works primarily with sports injuries, setting up a booth at a 5K race will get your name in front of more athletes who could use your services than if you just placed an ad in a newspaper. While more people might read the newspaper, it is likely that the athletes at the 5K could directly benefit from your specific knowledge of sports injuries. So remember that targeting your message is a great way to make sure your message is being received by those who will use your services soon.

You may also find that targeted messages save you a lot of money. For instance, if you place a television ad that airs at 2 a.m., the price is probably a lot cheaper than if you had it air during the evening news. But you can use that to your advantage and have that ad focus on those who have trouble sleeping and how your chiropractic practice could help them get the sleep they really want.

Try to find creative ways to target your audience and you’ll be surprised how quickly you see results. Pregnancy magazines are the perfect place to place an ad about how your practice can relieve tension or pain for the mom-to-be and help her during her pregnancy. Contact local hospitals or women’s groups to see if you can speak to a childbirth class where women could use chiropractic to help with their body changes.

Consumers trust other consumers more than they trust you. Most successful chiropractors know that referrals are not only one of the best ways to grow a practice, but they are also extremely cost effective and help to develop the overall brand of the practice. And how are referrals generated? One of the most popular ways is by satisfied people talking to other people. Isn't that always the best form of advertising? Consumers tend to trust the word of other consumers more than they trust that of companies when considering a product or service.

One way to take this concept to the next level is to utilize various online resources. You can actually have your patients go to work for you by talking about you and your practice using blogs, message boards, forums and chat services.

Word of mouth travels fast and people are more likely to tell others about a bad experience than rave about a good one. So ask your patients how they are feeling during the exam and get plenty of feedback about what you could do to make their visit better. Common courtesy can extend farther than any ad you place. If a patient feels well received and taken care of, they will enjoy their chiropractic experience and be more likely to recommend your practice to a friend.
 
Standing out from the crowd isn’t easy, but if you apply these principles you will be surprised how much your advertising will improve. Knowing where to spend your money and how to plan your message are important components in a successful marketing strategy. Be aware of your audience when making advertising decisions and follow these guidelines to watch your practice grow!

References:
1. http://www.inc.com/magazine/20050801/future-of-advertising.html. Inc. Magazine: August 2005. Page: David H. Freedman. Accessed 2/08/08.
2. http://www.online-publishers.org/?pg=press&dt=060606. Accessed 2/08/08

About the Author
Dr. Mark Charrette has taught over one thousand seminars worldwide on extremity adjusting, biomechanics, and spinal adjusting techniques. His seminars emphasize a practical, hands-on approach. Having developed successful practices in California, Nevada, and Iowa, Dr. Charrette currently resides in Irving, Texas.

Feature Article: Becoming Your Community's Auto Safety Advocate

Arthur C. Croft, D.C., M.Sc., M.P.H., F.A.C.O.

Introduction
Last fall I wrote an editorial for Dynamic Chiropractic in which I encouraged doctors to become public safety advocates2. (It is archived on their website.) The message the essay attempted to deliver was that doctors who treat neuromusculoskeletal conditions see a good deal of the motor vehicle trauma in their communities. In our random digit dialing survey of 2500 Americans, we found that chiropractors were the single largest healthcare provider for the treatment of whiplash injuries, treating 36% of the people injured this way. In my view it should be closer to 100% since most other healthcare practitioners don't offer definitive treatment. This might explain why the probability of fully recovering from a rear-impact whiplash injury is only a 50:50 proposition, according to the last 50 years of outcome literature. In any case, it is the doctors who see and manage the results of trauma who are most likely to be taken seriously when it comes to exhortations about safety.
 
In an interesting paper published in JMPT last year, Ron Caplan offered some insight and advice concerning the problems facing the profession of chiropractic1. He noted that DCs have only managed to tap a 10% share in healthcare use in the U.S., and that statistic hasn't changed in 50 years. Part of the problem is that the profession allows its opponents to define it. Because of decades of propaganda, many Americans view DCs as unethical, unscientific, bone-crackers who should be limited to low back conditions, he noted. He added, "In short, chiropractors have a significant branding problem, and they should fix it." His solution was a four-part plan he called REAP. It stands for research, education, alliance-building, and politics.
  
Fixing the Branding Problem
How does the average American feel when she gets a cold call from a strange chiropractor asking her if she'd like an examination, and she finds out that he obtained her recent crash information and contact information from the local police department? As tacky as it sounds, this is legal in some states. This is clearly not the path to positive branding. But there is a way to tap this resource and gain some positive branding at the same time.
 
As a group who daily sees the aftermath of MVC, DCs have a moral and ethical responsibility to share relevant automotive safety information that could affect the health and well being of the members of their community. At the very least, this is information they should be sharing with their own patients. Important areas are those where people either need some solid and reliable information, or simply a firm admonition from an authority figure. Studies have shown, for example, that more than 80% of parents make at least one serious error in the use of child restraint systems (CRS) which could seriously endanger the lives of their children. And some simply don't use them at all. Likewise, 25-30% of adults still don't buckle up. And, as for head restraints, very few are aware of either their importance or how to properly adjust them.
 
So here is the fix for the branding problem. You become an advocate of automotive safety and educate your patients. If you want to take it a step further-and I would heartily encourage all DCs to consider this as a New Year's resolution-you become a community expert in automotive safety: the go-to person for safety. If this sounds out of reach or pie in the sky, you need to step outside that box. I'll offer some ideas here and I'll give you a couple of recent case histories to show how easy it really is.

One of the hottest issues in safety right now is the use of CRS. They certainly can be a bit cumbersome and, to some, downright complicated. However, we are starting to see injuries in infants and children from the CRS itself. This is largely due either to the parent using the wrong type of CRS for the child or, more commonly, incorrect use or improper adjustment of the harness. A training program has been developed featuring a CRS technician instructor for the National Highway Traffic Safety Administration and technical assistance from the Insurance Institute for Highway Safety which includes extensive footage of the correct use of CRS, along with other auto safety features. This was designed with doctors in mind3.
 
There are 3-4-day training programs for becoming a certified CRS Technician. Some doctors have gone through the course themselves or, like me, sent their staff. Conversely, you can hire CRS Techs to help you put on a free CRS clinic in your parking lot on a Saturday. Get a free public service announcement (PSA) on local radio programs. Invite parents to bring their vehicles, CRS, and their kids. You might also check with the local children's hospital and Toys R Us. They may be willing to cosponsor the program by giving you a half dozen CRS which you can offer on a first come, first served basis to needy families.
 
And, there as many approaches to giving these talks as there are licensed drivers. High schools, where you would focus in drinking and driving, service organizations, businesses, you name it. If they have a driver's license, they need to hear your talk. And you really can quickly become the local auto safety expert. Here are a couple of real examples.
 
The Case Histories
Case # 1 Dwayne Truhlsen, DC, lives in Dresser, Wisconsin. Population, about 700. Dwayne started giving brief talks to his patients about automotive safety using the Auto Safety Facts program3. Eventually he was giving talks to larger civic groups, the Fire Department, and EMS services in this town and a neighboring town where he has another practice. In the first quarter of 2007, he saw 60 new patients as a direct result of these talks, and the proceeds enabled him to build a brand new, much larger rehabilitation facility. Today he is regarded as the go-to expert throughout his two communities.
 
Case #2 Scott Smith, DC, of Ft. Walton Beach, Florida. Scott went right to the county medical director and gave him a presentation. The county medical director was impressed with the talk and granted Scott the ability to give continuing education credits to those who attended his lectures. Specifically targeted here were the Fire and Police departments. Scott also now gives his talk to every new paramedic class in the area. It is critically important that the first responders to traffic collisions understand that injuries can and often do occur, but may not become symptomatic for 24-72 hours. And, while EMS personnel are not allowed to make direct referrals to specific providers, they can mention their knowledge of Scott's work or the fact that he treats them. His talks are so popular that he is now asked to give talks to Fire, Ambulance, and Police departments in neighboring cities. He is now approaching hospital emergency departments.
 
Scott also targeted companies that employ drivers. These include delivery drivers, courier services, taxis, pest control technicians, etc. These businesses have to carry insurance policies on their drivers and, depending on the size of the company, these can be very expensive. Scott discovered that if these businesses have established a regular safety training program-say quarterly-they become eligible for up to a 15% discount on their policies. And the agent at one agency provided Scott with a list of their insured companies so he could approach them. A real win-win.

This, of course, is not a business's only incentive to have a safety program. U.S. businesses lose $40 billion annually in lost productivity, retraining, and other costs associated with MVC 4. But, according to Scott, a lot of the referrals he gets from doing this public safety lecture are not related to MVC. He told me that the last time he gave the lecture, a man came up to him and asked him if he treats children with ear infections.
 
Summary
The interesting thing is that both of these doctors have had similar successes and pursued similar avenues. And both have developed solid relationships with the people, the employers, the professionals, and the civic leaders in their communities. They have burnished their reputations while simultaneously elevating the public persona of chiropractic. The nice part is that they didn't need to offer free exams or even ask for new patients. I think Ron Caplan would be quite impressed with these doctors. I am. I hope others will be similarly inspired. I had dinner with Adrian Lund, the President of the Insurance Institute for Highway Safety, two months ago. His institute assisted in the development of Auto Safety Facts. They are highly supportive of this grass roots public safety approach and encourage doctors to get involved in spreading the message of safety.

References
1. Caplan RL. Chiropractic and the changing U.S. health care marketplace: where we are going and what needs to be done. JMPT 2007;30:401-6.
2. Croft AC. American families, auto safety and the role of the health care practitioner Dynamic Chir 2007;25.
3.Croft AC. Auto Safety Facts. 1st ed. San Diego: Spine Research Institute of San Diego, 2006 (http://www.srisd.com/autosafetyfacts.htm).
4. Zaloshnja E, Miller T, Council F, Persaud B. Comprehensive and human capital crash costs by maximum police-reported injury severity within selected crash types. 48th Annual Proceedings of the Association for the Advancement of Automotive Medicine. Key Biscayne, Fl, 2004:251-64.

About the Author
Dr. Arthur C. Croft
Spine Research Institute of San Diego
826 Orange Avenue, Suite 633
Coronado, CA 92118
Phone (619) 423-9867

The Five-tool Prospect

by Robert Heart

In baseball the most highly coveted of all prospects is labeled a “5-tool” prospect. This is because the young ballplayer has all of the desired skills; throwing, fielding, speed, hitting for average and hitting for power. It is the rare player that possesses all of those tools and the 4, and even 3-tool players, are generally still quite successful on a major league level.

So it is with the chiropractic physician. There are many successful doctors who could be considered 3 or 4-tool practitioners, but it is the rare physician who is truly a 5-tool player.

The 5 tools I refer to are communication skills, compassion, organizational skills, treatment skills and a solid belief in the power of the chiropractic adjustment. The good news is that you can develop and strengthen your skills in several of these areas and, as mentioned previously, even if you are forever a 3-tool doctor, you will still likely be successful. Below I briefly outline each of these tools in terms of how they apply to you and your practice.

Philosophy
You must believe in the power of the chiropractic adjustment. You have to know that what you do helps people and can make a very real difference in their lives. It’s hard to “sell” what you don’t believe.

Communication
The importance of being able to effectively convey your caring, your treatment recommendations, your integrity, your chiropractic philosophy and your sincerity using both verbal and non-verbal communication cannot be overstated. To be blunt, a doctor with medium treatment skills who is an excellent communicator always trumps a doctor with phenomenal treatment skills, but only fair communication ability.

Compassion/Caring
The doctor who genuinely cares about her patient’s welfare and demonstrates that concern in her actions and decisions generally has little trouble building a deep rooted practice. The old expression “they don’t care how much you know, until they know how much you care” is especially valid in the chiropractic profession.

Organization
Giving consistently good care is a function of having good systems and procedures to deliver that care. If you don’t have written job descriptions, office policies and an operations manual detailing how to do all of the important functions of your office, you are not doing your job and, most importantly, not providing your patients the high quality attention and care they deserve.

Treatment skill
I suppose that this goes without saying, but you must be able to get people better. You must have good treatment skills and the confidence to deliver that treatment.
My suggestion is that you take an honest assessment of yourself and decide how many of these tools you have mastered. Don’t stop with a self-assessment though, be sure and ask your spouse and your team for their opinion. When you have identified how many tools you possess decide what, if anything, you are willing to do to acquire or strengthen those that you don’t. Remember, it is OK to be a 3-tool doctor and you will probably achieve a degree of success. It’s up to you to decide how many tools you want to master and how successful you would like to be.

Robert Hart is the founder and owner of Hart Consulting. Through seminars and personal coaching he has been assisting Doctors of Chiropractic achieve both their practice and personal goals for the past 18 years. Mr. Hart can be contacted at 480-892-4621, rob@hart-consulting.com, or www.hart-consulting.com.

INSURANCE REPORT

By Margaret Freihaut, DC, Insurance Committee Chair

MEDICARE CHANGES 2008
The proposed Medicare fee cuts have been suspended and are in effect until June 30, 2008. Congress is expected to revisit the matter later this year.
 
Missouri will have a new carrier for Medicare beginning in March, 2008, for the western part of Missouri. The previous carrier was Blue Cross Blue Shield of Kansas City. On June 1 the eastern part of Missouri’s new carrier will be Wisconsin Physician Services. The previous carrier was Pinnacle. There is a draft Medicare policy for chiropractic available on the Wisconsin Physician website and open for comments. I will be meeting with the Jurisdiction 5 CAC representatives from Nebraska, Iowa, Kansas and Missouri in mid February. As soon as it becomes known what changes, if any, we can expect, the MSCA will do all it can to help disseminate the information, in addition to the carrier's educational process.

WPS is sponsoring a teleconference about implementation on March 12, 2008, for Pinnacle providers; and March 13 for the Kansas carrier.
 
Medicare will be rejecting claims effective May 23, 2008, containing legacy numbers. VA claims are exempt from these HIPAA requirements.
If you have any questions about the NPI, information is available at https://www.cms.hhs.gov/NationalProvIdentStand/.
 
The latest update of Remittance Advice Remark Codes used in paper and electronic claims are effective January 1, 2008. For a list of these codes you can go to https://wpc-edi.com/codes.  These codes are updated three times annually.
 
REQUIRED DOCUMENTATION ADVISORY
There has been a recent increase in untimely responses to Additional Documentation Requests (ADR's) related to the submission of medical records.  When a claim suspends for medical review, a letter requesting documentation is mailed to the provider/physician from Medicare’s medical review department. The provider must, in turn, submit the requested documentation within 45 days of the date of the ADR letter.  Per Medicare guidelines, the ADR gives 30 days, however, the review department allows an additional 15 days.  If the documentation is not received, the claim will be denied. Adhering to the timeliness can prevent unnecessary delays and additional provider paperwork and staff time.  Remember to submit only the documentation requested and any additional documentation that may support the services billed and suspended for medical review.

Remember to send the documentation in the color-coded envelope provided.  If the records do not fit in the envelope provided, attach the color-coded envelope to a larger envelope.
 
The Medicare Quality Reporting Initiative will continue in 2008. The ACA has developed a kit for Quality Reporting. There are two quality measures that have been identified applicable to chiropractic; pain assessment prior to treatment and health information technology adoption/use. Visit the ACA's website for more information.
 
UNITED HEALTHCARE
There have been some further reports of terminations from ACN/UHC for various reasons in Missouri. The various reasons cited were ads in the yellow pages; claims on websites regarding treatment for asthma and ear infections stating that claims of symptom improvement must be substantiated by recognized scientific literature; and, lastly, statements made on insurance forms/payment attestation statements. Remember, being terminated with cause can affect your record and future network affiliations. The MSCA recommends you seek legal advice when these issues arise to make sure you understand your rights.
 
LEGAL ACTION FUND:
JOIN TODAY.
Everyday there seems to be some new tactic that the insurance carriers come up with that lowers reimbursements and access to chiropractic. Higher copays, higher deductibles, no out-of- network benefits, jump through this hoop and that. None of it seems to really apply to quality healthcare; and much of it discriminates and discourages our patients from seeing us, all for the sake of the insurance industry's bottom line (currently that bottom line is over $100 billion in administration, and profits are on top of that). Our patients pay more out-of- pocket, and insurance carriers have record profits; we all know it means less access to chiropractic care. We pass laws. They ignore them, or twist and turn their meaning. All the more reason to join the Legal Action Fund.
 
An article in the Los Angeles Times business section headlined, “Health plan faces fines of $1.33 billion.” The article reads that California regulators are expected to announce they are seeking as much as $1.3 billion in penalties from Cypress-based Pacificare as a result of widespread problems stemming from its takeover two years ago by healthcare giant United Healthcare Group, Inc.

MEMBERSHIP REPORT

By Michael Finley, DC
Membership Committee Chair

Equality is the focus of our MSCA 2008 legislation. How are we working to achieve this goal? The MSCA filed two major pieces of legislation. Here’s the basic information on each one and why the MSCA is going for them.

Co-payment Parity: Chiropractors across the state have seen their status with insurance companies suddenly being pushed to “specialty.” This has caused many patients to go from a standard co-pay of $10 to $25 dollars, to specialty co-pay rates of $30 to $50 per visit or greater. This has increased the financial burden to the patients. Why is it after several decades insurance companies changed our status? Simple, to place a financial burden on the patients not to go to you.

Think about it docs. Insurance companies are selling plans to Missourians that have chiropractic benefits. They put on a “specialty” $50 co-pay per visit. Then, the contracted fee schedule allows an adjustment code, and one or two therapy codes, that total less than $50, or maybe a few dollars over. In other words, no benefit!

Insurance companies are now dropping all chiropractic out-of-network benefits (just chiropractic and no other groups), or going to $1,000 plus out-of-network benefits. Remember, they are selling plans and telling people they have chiropractic benefits! This is why the MSCA is proposing the second piece of legislation.

Out-of-Network Benefit Parity: We can’t pass legislation stating how much an insurance company should pay, but we can demand equality! How is it legal that an insurance company offers out-of-network benefits for every other health group except chiropractic? If this is not discrimination, then what is it???

Docs, this is why you join the MSCA, join the MSCA PAC, or go to Legislative Day...or do all three. It’s a battle! What other group is out their fighting for you? As you know, you have to “do to get” what you want.

The PAC Report

by Paul W. Foster, DC, PAC President

We had 12 people in attendance at our January 26 PAC Board of Trustees Meeting.
 
As of this date, we have about $30,000 in the checking account.
 
Mark your calendars - On October 2, 2008 - 1st Annual PAC Golf Tournament at The Landing Golf Course in Chesterfield. Lunch at 12:00, Tee time at 1:30, Banquet at 5:30 - should be on the road by 7:30. Our goal is to have 36 teams at $500 per team.  Teams are not limited to doctors.  Patients, friends, in-laws, out-laws - anyone is welcome to participate.  The plans are to rotate this tournament throughout the state on an annual basis.
 
There will be a PAC membership meeting and reception at convention on Friday evening, August 1, 2008, for all PAC members.
 
Guests attending were Dr. Russ Matthias, Dr. Len Suiter, Dr. John Dennehy, Dr. Michael Michel and Dr. Quinn James.

DISTRICT 1 REPORT

By Michael Finley, DC

District 1 held its annual Winter Holiday Party on Thursday, January 17, at the Ameristar Casino in St. Charles. One of the highlights of the evening was the presentation of a check for $13,062.79 by Dr. David Dolinar of District 1 to the state association. The monies were made by District 1 by holding relicensure seminars throughout the year. Dr. Ed Hengel, president of the MSCA, was on hand to receive the check for the state association. In his presentation speech, Dr. Dolinar noted that many doctors have donated their time by not charging for their expertise as they give seminars sponsored by District 1. Dr. Dolinar made a point by saying, “Without their generous and sacrificial spirit, this donation would not be possible.”

District 1 has all meetings on the fourth Monday at 7:30 at Logan College. Watch emails for details or go to mscainfo.com. Contact me or any of our reps for details.

DISTRICT 2 REPORT

By Ron Manfredi, D.C.

Member chiropractors in Kansas City and its nine surrounding counties of: Benton, Cass, Clay, Henry, Jackson, Johnson, Lafayette, Platte, and Ray are strong and well and united in their support of the chiropractic profession. This unity was evident at the recent board meeting (which is usually held on the first Thursday of every month at the Ararat Shrine Temple, located at “exit 65” on I-435 in KCMO). The board members are all on the same page when it comes to their efforts to increase membership by endeavoring to provide a better product. Speaking of a better product, over 150 doctor attendees were present at our recent 36-hour Early Bird Extravaganza Seminar, February 8, 9 and 10 at Holiday Inn Northeast in Kansas City. Doctors came from as far away as Lafayette, Louisiana, and Crescent, Iowa, to attend District 2’s seminar. We are going to do it again next season with the Holiday Extravaganza Seminar in early December, 2008, and the Early Bird Extravaganza in late February, 2009. If you have any speaker suggestions, or criticisms of the seminar series, please contact me personally.

Be watching your mail and email for District 2’s General Member Meeting sometime this spring, probably in April, 2008, at the Ararat Shrine Temple. We will present new and pertinent Medicare information and be electing new officers and representatives. For registration and seminar attendance please call Dr. Russ Matthias in Blue Springs at 816-228-5113. If you need vender booth information, please call Dr. Linda Buckmiller in Smithville at 816-532-8966 for an application form and information. Some restrictions will apply, and space is limited.

Be eligible for prizes by submitting your family’s best cook book recipes (one or two) for the MSCA District 2 Chiropractors Cookbook of Healthy Alternatives which will be published in time for distribution at next year’s Holiday Extravaganza Seminar. All proceeds go to the Kansas City Chiropractors Legal Action Fund (KCCLAF). Please fax your recipe to 816-358-0040 or email docmanfredi@Yahoo.com. For information regarding the cookbook, call Dr. Linda Buckmiller at 816-532-8966. For other District 2 information, call Dr. Russ Matthias in Blue Springs at 816-228-5113.

DISTRICT 4 REPORT

By Loren Smothers, DC

District 4 is having its district seminar on February 22-23.  We are offering 24 hours of continuing education with only 18 hours of class time.  Lunch will be included for both days. 
 
On Friday night we will have dinner starting at 6 p.m. with Dr Patrick Gentempo present.  There will also be a drawing for a $2,000 seminar to be given away that could change you and your practice. 
 
All Total Solutions grads. We want you to be there as Dr. Gentempo is looking forward to hearing from and talking to you. Be sure to bring at least one friend with you, but you don't have to.
 
The cost of this fabulous seminar is only $150.
 
Call Dr. Loren Smothers at 573-996-2911 to register, or if you have any questions.

DISTRICT 5 REPORT

By Jeremy Thornton, DC, DABCI

The District 5 Seminar Extravaganza will be held March 7-9 at the Holiday Inn North in Springfield, Missouri.  All 24 hours will be offered including 12 general, 12 mandatory, and 12 acupuncture.  Speakers include: Dr. Patrick Kennedy, DC, Dipl.Ac. (NCCAOM); Dan Griffith; Dr. Doran Nicholson, DC, DACBR; Dr. Jeffrey Lewin, DC, CCSP; Dr. Jeremy Thornton, DC, DABCI; Dr. Elaine Carter, DC, FIACA.  Download a brochure and registration at the MSCA website (www.mscainfo.com) or call 417-276-6306. Great fun was had by all at our annual Christmas party.

INSURANCE ALERT

We would like doctors to send us copies of their insurance company contracts so our attorney can review them and help address the many questions we get about:  can I do this?....can I do that?...can I bill this?...do I have to send a claim when?...and so forth. The results will be available on our website for MSCA members.
 
Please send contracts to:
MSCA Insurance Committee 
500 Mae Court
Fenton, MO 63026

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