Tuesday, August 25, 2015

What You Need To Know Before You Get An X-ray If You’re Pregnant.

What You Need To Know Before You Get An X-ray If You’re Pregnant.


Radiation poisoning can
cause birth defects, brain damage, and even death. Radiation is even more
dangerous to unborn babies, but how dangerous is the question. The idea of
getting exposed to any type of radiation while pregnant, no matter how little,
is often not only a concern but a huge source of fear and anxiety. 

As a structurally based chiropractic
office it is essential to have a full series of structural radiographs to
determine any abnormal spinal shift, which in turn is necessary to form an
accurate and effective treatment plan. As a result, it's not uncommon for us to
have to answer questions about radiation exposure. We have even had male
patients so afraid of the radiation from the necessary structural radiographs that
they refuse to even consider structurally focused care.

The ugly truth is that
even physicians have been known to avoid using x-ray diagnostics because of the
negative stigma associated with birth defects and radiation. Fear of
litigation, warranted or not, from angry parents can be pretty intimidating.
Because of the negative association with x-rays, it's not uncommon to make the
jump to automatically blaming radiation as the cause of any abnormal congenital
issues that happen to arise with their newborn child.

Are these fears
warranted though? According to the CDC there are different times during
pregnancy that an unborn baby is more sensitive than others.

Weeks 2-18: Large
radiation doses (above the dose received from 500 chest x-rays at one time) to the fetus during the more
sensitive stages of development (between weeks 2 and 18 of pregnancy) can cause
birth defects…

Weeks 18-25: radiation-induced
health effects are unlikely unless the fetus receives an extremely large dose
of radiation (5000 chest x-rays at one
time
). 

Week 26-birth: no more
sensitive to the effects of radiation than are newborns.



To put that in
perspective, you would have to take roughly 35 lumbar spine x-rays at one time
to equal 500 chest x-rays or 350 lumbar spine x-rays to equate 5000 chest
x-rays! Now the message here is not that x-ray bears no risk.  But don’t forget that these exposures are for
radiation pointed right at the baby as opposed to a cervical (neck) x-ray on a
pregnant mother with the proper lead apron protection reducing any scatter radiation
to the unborn child to a VERY low rate.

Friday, July 31, 2015

NC Insurance: Are you getting what you pay for?


Insurance Claim Form
Corrective Chiropractic Insurance Claims
Describing a company that is supposed to help keep your chiropractic healthcare costs reasonable, as a cartel seems extreme.  After all we’re not talking about people who are selling weapons on the black market. None the less, HNS (Health Network Solutions) who states that they “partner with payors (your insurance), employers and healthcare professionals (your chiropractor) to provide innovative services and solutions to make healthcare more accessible, more effective and more affordable for everyone” are in fact facing a lawsuit for making it more difficult get the chiropractic care coverage that they paid for.
Even more alarming is that this is not just a problem for people buying insurance, which thanks to Obamacare everyone is legally required to do under threat of fines. All tax paying citizens are paying the price literally when our tax dollars are going to allow chiropractic care to be covered for all state employees but because Health Network Solutions has become a “gatekeeper” in North Carolina to the patients covered by the insurers they are often not getting what we are paying for.
In fact it is such a problem a large number of North Carolina Chiropractors have filed a Class Action Lawsuit against Blue Cross and Blue Shield, Cigna, Medcost and HNS Management Group in an effort to protect not just the chiropractic profession but the patients in North Carolina who are no longer given a real choice of what healthcare they want to utilize..
According to a current lawsuit, “HNS is a cartel that bullies chiropractors and patients with their Utilization Review Process…. The Utilization Review Process had the effect of restraining covered services to patients, damaging (chiropractors and patients) by denying the agreed compensation for covered services, by restricting service (chiropractors) may provide, and by denying access to covered patients unless (chiropractors) comply with the average cost per patient levels arbitrarily established by HNS in consultation with the Insurers.”
So what does that mean?
  1. If I want to be an in-network chiropractor I am required to be a bill through a third party (HNS) who has created monopoly with BCBS, Cigna, Medocst and other insurers who are under contract to allow chiropractors ONLY under HNS to be in-network.
  2. If I am in-network (billing through HNS), I cannot see patients beyond a certain number of visits based on HNS “average patient visits” which are currently at approximately 6 visits, regardless of medical necessity and the allowed visits available (usually 30) for chiropractic care.
    1. Meaning if you pay for 30 visits a year HNS will require your provider to only allow you 6 or they will threaten to or will terminate the chiropractor from the network!
  3. Bonuses are given from HNS to chiropractors who treat patients at or below HNS’s arbitrary “average patient visits”
    1. Instead of creating better quality care they are encouraging care based on number of visits and not medical necessity.
If you ‘re looking for healthcare, do you want to go to the doctor who treats as little as possible to get paid better or the doctor who does everything absolutely necessary to get you healthy?  Most people would prefer the later, especially because they are under the impression that since they have 30 visits or more of chiropractic coverage they will be able to get the care needed to get better.
But is that really the case?  This is why Corrective Chiropractic has stayed out of network for so long.
Now if you, the patient, simple pay the provider and then send in your bill to your insurance, it has been our experience that those patients get reimbursed according to what their insurance covers.  They don’t have to send in their bill through HNS and they are not penalized if they exceed HNS “patient visit average”. Let’s be honest, if you pay for insurance and insurance doesn’t pay you back when they say they will, you’ll stop buying that insurance.  Therefore they have a MUCH higher incentive to treat the patient (their customer) much better than the provider.
Despite all of this, because of patient demand, Corrective Chiropractic is still considering getting in network through HNS.  If you want us to fight the good fight, we will. Ultimately, we just want our patients to be aware of the current state of their insurance coverage in most of North Carolina before we make this transition.
There are three options to choose.  You can only pick TWO:
  1. Quality
  2. Service
  3. Price
For more information see this short video: https://www.youtube.com/watch?v=Sch-5UnFc8c
Or other informative links:

NC Chiropractors Sue Blue Cross and Blue Shield and HNS





Health Network Solutions has become a “gatekeeper” in North Carolina to the patients covered by the insurers, especially since, as the recent lawsuit filed against them states, HNS  is a cartel that bullies chiropractors and patients with their Utilization Review Process.

According to this lawsuit, 
“The Utilization Review Process had the effect of restraining covered services to patients, damaging (chiropractors and patients) by denying the agreed compensation for covered services, by restricting service (chiropractors) may provide, and by denying access to covered patients unless (chiropractors) comply with the average cost per patient levels arbitrarily established by HNS in consultation with the Insurers.”