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August 06, 2005

Jacksonville acupuncturist charged with insurance fraud

Being in a state where only 1 in every 300 patients have actual insurance coverage for their Acupuncture treatments, something like this is just baffling to me. The chiropracter I work with has said things like this were rampant in the beginning years when Chiro's first got covered. He said taking insurance is like sending a note to a mystical place loaded with money, and that 30-90 days later it sends you a glorious check. This guy in FL, unfortunately, decided to just keep sending note after note, even if the patient wasn't a patient of his or even if they hadn't come in that week: Link

For those of you who also aren't even familiar with CPT codes and insurance billing, the AAOM task force came up with general guidelines as to what to charge for Acupuncture. Additionally, I have written out a how to for the new CPT at the APA website.

Posted by Admin at August 6, 2005 06:56 PM

Comments

As if our profession doesn't have a hard enough time getting accepted into mainstream medicine and taken seriously as a form a medicine. Something like this just makes us look worse and makes it even harder for people to accept our form of medicine.

Posted by: The Infinite Tao at August 7, 2005 01:10 AM

I gotta say that I think this was bound to happen. We don't make the kind of salary that doc's do and MD's do it ALL the time to make even more money. I remember the first time I treated someone who had Auto Accident insurance (which is covered under Act 6 in PA), my jaw dropped when I got the first check. 3 weeks after the treatment and they paid me 80% of everything I asked.

There's a massive temptation of just sending out a bill if someone cancels, or doesn't show, or if they go to every other week, or if they don't come anymore. Then again, there's a massive temptation to just go straight to the car with your groceries and bypass the checkout line. And this temptation is one that must be fought at all cost!

Posted by: Steve at August 9, 2005 12:33 PM

Curious if there is any prevalence of this to any one group - educated here or out of country, etc.

Posted by: naturaldoc at August 9, 2005 02:52 PM