AllMed Healthcare: Chiropractic Medical Necessity: The Reviewer Perspective
February 21, 2006 — AllMed Healthcare Management Medical Specialist Alan Margolis has recently authored a feature article “Chiropractic Medical Necessity: The Reviewer Perspective” that is featured on the AllMed Healthcare website. The article may be viewed by clicking the following link: http://www.allmedmd.com/resources/articles/chiro.htm
Insurance companies require documentation to support the medical necessity of chiropractic treatment. To maximize the probably that the payor will pay the submitted claim, the chiropractor should submit the following:
- Patient past & present history. These histories must include why the patient sought chiropractic care, the nature of the complaints, the duration of the complaints and whether the patient was involved in a traumatic event.
- A patient consultation form which includes the entire history of circumstances surrounding the patient’s decision to seek chiropractic care.
- The initial examination findings.
- Patient chart notes. Particular attention must be paid to patient improvement & the proscribed treatment plan.
With full and complete documentation that supports medical necessity, the payor can then make an informed decision on whether to pay for chiropractic treatment.
More information on AllMed and the company’s peer review & medical review services can be found on AllMed’s web site at http://www.allmedmd.com/ .
About AllMed Healthcare Management
Founded in 1995, AllMed (http://www.allmedmd.com/ ) is a URAC-accredited Independent Review Organization (IRO) serving insurance payers, providers, TPAs and claims managers nationwide. Reviews are conducted by board-certified physicians in active practice. AllMed’s growing customer base includes premier organizations, such as Educator’s Mutual Life, IMS Managed Care, Tenet Healthcare Corporation, HealthGuard, several Blue Cross Blue Shield organizations, TriWest Healthcare Alliance, Allianz and many other leading healthcare payers.