Conference 7.286::digital

    
    
    If you can get your primary physician to state that the chiropractic
    care was his/her prescription for your treatment and that it was being
    done under his overall management you might have a case.  Without
    that you are totally out of luck.
    
    fwiw,
    Steve
    

    I've had a similiar situation with an HMO, (Healthsource NH).  
    What I found out the hard way is that your primary care physician
    approval is necessary, but *not sufficient* to get the HMO to pay.
    
    Think of it as a form that requires 3 signitures, and you only got
    one.  What annoys is they keep this a secret.  The only way you
    find out is when they won't pay.  

    Have you called Tufts and discussed this with them; they could tell you
    probably exactly what you need to do.
    
    bc

            -< A little more info >-
    
    Re: Last few.
    
    First of all thanks to all who replied and sent me mail.
    
    Re:.2
    
    Which 3 signatures are you refering to? Primary care physician,
    chiropractor and HMO? Or is my assumption wrong?
    
    I have never bothered (like most of us) to read the fine prints
    in the HMO policies and have always relied on my primary care
    physician knowing all the rules that Tufts plays by. I very clearly
    explained my story to him and he first suggested I go to an orthopedic
    doctor which I did, who recommended me to a chiropractor. I took that
    recommendation to the primary care physician who then gave me the
    referals. So as far as I am concerned, I am all clear to be paid
    for this. What are the possible hitches?
    
    Re:.3
    
    Yes, I did call Tufts customer relations. The woman on the phone
    gave me her standard line saying chiropractors are not covered
    under your policy. I havent gone further.
    
    Thanks all.
    Atul

Some HMO's, such as Fallon, have osteopaths on staff; those doctors include 
forms of chiropractic and even accupuncture to their services. Geography may
make it difficult for you to change HMO's, but Tufts may have a D.O. available
for referral within their service area.

  An osteopath who does chiropractic? That's a new one on me. Historically,
osteopathy, like chiropractic, was considered an unconventional specialty.
Today, although osteopaths are not medical doctors, they are recognized by
most MD's as a conventional specialist. The acceptance of chiropractic by the
medical profession is much lower. I think your chance of finding an osteopath
who does chiropractic is slight, but it's worth pursuing if Tufts refuses to
cover the chiropractor you have been seeing.
  How do HMO's get away with making patients think they are covered for some-
thing when they are not? 

    Perhaps what .5 meant was the osteopaths do a type of treatment similar
    to the chiropractor. I belong to Fallon and haven't seen any osteopaths
    listed in their list of staff. I go to one of the only osteopaths in
    the Worcester area and would like to pay $3 rather than $70 per visit.
    How do I find out about these osteopaths with Fallon?
    
    Debbie
    

    hi,

    i noticed there seem to be lots of DECeees with some kind of
    chiropractor problems, so i was sitting thinking why? do you think
    it might have to do with the nature of our work? i mean office
    work in front of the terminal can make your back hurt (especially
    if the chair is not the right one and high), do you think office
    computer workers are more susceptible to chiropractor problems than
    in say different types of jobs? do you think if we were not in computer
    work this problem might not have been as severe? do you think stress
    level can also lead to chiropractor problems ? 

    i also noticed my right hand wriest sometimes hurts when i type too much,
    do you think this is also a chiropractor problem?

    one time i saw an ad. for a free chiropractor  evaluations, i went
    there and the nice doctor started telling me i have all these problems
    and all and i need to go see them on regular basis to fix me for like
    the whole next year , i never went to the place again. that was 6 years ago.

    \nasser

    I was a member of Health Source, NH. and my Primary Care Physician
    authorized 20 visits to a chiropractor with no problem. This was a
    couple of years ago so maybe things have changed since then.
    
    
    Mark

re: .8

Nasser,

The reason that it seems to you that so many office workers have chiropractic
problems is because only office workers are writing in this notes file.
Ask some carpenters, plumbers, brick masons etc. about their back problems.

See your facility nurse about your wrist.  It could be a symptom of carpal
tunnel syndrome.  If it is, and you let it go, you could end up requiring
surgury.

Mac

    
    Re: .9
    
    My wife has Healthsource, NH and they have changed a lot over the last
    two years, little of it for the better in hers and my opinion.  Let
    me put it this way, my wife is a nurse at the Concord (NH) Hospital. 
    The founder of Healthsource is a local doctor affiliated with Concord
    Hospital.  Concord Hospital is considering dropping Healthsource as one
    of the provider options for their employees.  'Nuff said I would guess.
    
    Steve
    

           How 'bout your non-typical chiropractic things like asthma and
           other non-back problems?  You'd probably have a slim chance in
           having HMO pay for that, huh?
           
           Steve

    I just had 21 visits authorized by Healthsource for my
    chiropractor.  I have cronic back trouble as a result of
    an accident, however, I also have asthma.  I had no
    trouble getting the visits.  I just told my PCP that I
    respond better to chiropractic care.
    
    With the lawsuit that chiropractors are bringing against
    the AMA, you may find some plans becoming more lenient 
    about chiropractic care.  
    
    Mary-Michael

             -< How to find an Osteopath? >-
    
    I went thru my Tufts physicians directory but cant find doctors
    listed as Osteopaths. I was told they are listed as PCP's. How
    does one go about locating one? I called Tufts customer relations
    and they were no help at all.
    
    Thanks
    Atul

Try the yellow pages under Physicians & Surgeons -- Osteopathic D.O.

                  -< Easier said than done >-
     
    Re:.15
    
    I found a list of names and then tried to look them up in the latest
    Tufts Physicians directory. Guess what...none are on the approved
    list out of about 20 in the Boston/West Suburban area.
    
    Frustrated with this process (and aching in my chair), I called my
    PCP. They have now sent me off to another round of Orthopedic doctor
    who specializes in back care. Will find out a week later and keep
    you posted.
    
    The story goes on.....
    Atul

    
    I switched to Tufts. When I read their material, it was there, very
    clear and plan, that they do not cover this service.
    
    

    Wow, people who've had their HMO pay for the chiropractor! I've always
    paid out of pocket. I felt I wasted the $5.00 co-payment having the
    primary care doctor tell me to "stay in bed for 3 days and the pain
    will subside". Oh, now, there is a long term solution. Six visits to my
    chiropractor and everything was all better. HMO's do not always care what
    has worked sucessfully in the past, you keep paying the $5.00 for 
    service they want to give you. This was Mathew Thornton. 

    Fwiw
    
    The Digital Health scheme for the UK is run by Sun Alliance; the
    booklet states:
    
    Benifits will be paid for treatment in the United Kingdom for:
    .....
    *Treatment by registered chiropractors, osteopaths, and
    physiotherapists where you have been referred directly to
    the specialist by your GP or the company doctor or nurse.
    .....
    
    Damn! The UK *is* is fine country to live in!!! =8-)
    
    Flying Dutchman
    

    
    Even better, when I had a back injury a few years ago, the
    Physio used to come into the REO office & give treatment.
    Saved us wasting time travelling to a clinic.  Does DEC
    still offer that service I wonder?

    Colin
    

>    Even better, when I had a back injury a few years ago, the
>    Physio used to come into the REO office & give treatment.
>    Saved us wasting time travelling to a clinic.  Does DEC
>    still offer that service I wonder?


	No, and the coverage for physio treatment is limited to 250 quid a year.
	And nothing for appliances. 

	Heather - currently having treatment for a whiplash injury.