By now, many of you have been exposed to workers' compensation patients, either as the PTP (primary treating physician) or as the secondary treating physician treating under a prescription from the PTP.
As you know, the type of referral from the primary treating physician allows you to enter the California workers' compensation system without significant impact to your requirements. Essentially, all you have to do is initially report to the carrier and then bill.
With the successes you achieve in management of these injured workers, referrals are a welcome benefit and the foundation of any good broad-based practice. There are other avenues of patient referral, of course, one of which is the subject of this article.
Over the past 15-20 years, there have been groups and companies that marketed themselves as providers of workers' compensation patients to your office for little or no up-front costs, and guaranteed a "per office call" fee or reimbursement for the services you provided. At the completion of care, after completing certain forms requirements, you'd submit a bill for your services and receive a prearranged fee for service. Sounds easy, doesn't it? Just treat, bill and receive payment. But beware!
Not outlined in many of these contracts is the source of the referrals: contested cases in which the carrier has objected to all providers rendering care, resulting in the filing of a "green lien"; applicant cases in which you provide care that is duplicative of other physicians providing the same care; cases of overlapping care, where the injured person was involved in an automobile accident/workers' compensation case; or cases in which you don't know who the primary treating physician is.
Additionally, many companies or groups do not show you the billing sent to the carrier. If you are listed as a private contractor, the billing must list you as the provider and bear your signature. Leaving someone else to do your billing for you and letting them sign documents on your behalf is foolhardy and potentially dangerous.
Finally, these groups/companies will retain management of all your compensation patients for a contracted period and also obtain a percentage of all referrals made to you by the workers already treated.
What seems to be an easy way to get patients on the table has far-reaching consequences. Beware the Trojan horse standing in your waiting room. It may be a nice horse, but its internal workings contain hidden dangers to the unsuspecting practitioner. Just wheel that horse back onto the pavement. No one will know it was you.
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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