Short North Accident Injury Care

Whiplash Accidents Injuries Treated, Liability & Labor Disability Injuries Treated, Short North Columbus, Ohio

Call 614 299 9797 to make an appointment.
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Mark van Hemert, DC, DACS

The design of this article is to give the chiropractic profession an introduction into the value and usefulness of clinical outcome assessment procedures. Using outcome assessment methods of case management gives the chiropractic profession an effective way to document the need for care.

This results in receiving the compensation for services they rendered.
In today’s environment of manage care, the attending clinician’s care is constantly being reviewed and challenged.

The chief areas of concern for the third-party payers is over-utilization and costs. Over-utilization is a problem in chiropractic, whether it be real or only perceived by outside reviewers.

This perception can only be overcome on a case by case basis by objectively proving that care provided was reasonable and necessary. Á Due to the acceptance of the Mercy guidelines

(Guidelines for Chiropractic Quality Assurance and Practice Parameters) by the insurance industry, the document is the authoritative reference to counter the insurance industry’s attempt to limit quality and the quantity of care.

The primary reason the Mercy guidelines carry a high level of acceptance and credibility by the insurance industry, is because its ratings are based on scientific evidence.

A synopsis of today’s situation reveals that the care rendered by the attending clinician is constantly being challenged by the third-party carriers. IME opinions of excessive care or no permanent impairment are detrimental to the patient’s medical/legal case.

Cases that involve acute injury with associated liability frequently require the intervention of the court system or workers’ compensation system to resolve the case.

This inherent intervention leaves the door wide open for the probing eyes and opinions of the IME. Due to a lack of knowledge and documentation by the attending physician, patients receive inadequate medical care and inferior documentation of their injury, rational for therapeutic care, determination of maximum improvement, and final impairment.

Third-party carriers are aggressive in their review of care to determine the point of maximum improvement. Many clinicians feel that if patient care is within the guideline numbers, their fees will be paid.

However, the therapeutic necessity of care is frequently being challenged. A lack of knowledge of the practice guidelines does not substantiate the patient’s contractual right to receive care to the maximum ability of the injury to respond to active care and improved function.

power… the 1980s witnessed a shift in power from the providers of health care to the payers of it … and those practitioners whose services are labeled worthless could face financial ruin … chiropractors are especially vulnerable.”

Whiplash Accidents Injuries Treated, Liability & Labor Disability Injuries Treated, Short North Columbus, Ohio

Call 614 299 9797 to make an appointment.

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