The American Chiropractic Association convened a meeting toward the end of last year between chiropractors and independent insurers to tackle persistent problems in claims processing. The Claims Solution Work Group provided, for the first time, a forum for insurers to discuss their concerns regarding chiropractic claims in areas such as health, workers' comp and auto insurance. The meeting of 20 participants focused on topics such as treatment guidelines, fraud and abuse, coding, new technology, documentation and scope of practice. Addressing the insurance representatives, the vice president of ACA's Office of Professional Development, Patricia Johnson, remarked, "We want to hear about your obstacles, and we want to support solutions that will enable your reimbursement processes to run more smoothly, with less time and expense. This is the same goal of our members." One of the areas of concern cited by the insurance representatives was the perceived lack of treatment guidelines in chiropractic. The insurance representatives stated that they desperately need widely-accepted, research-based guidelines—preferably cutting across all types of insurance—to determine when to leave a claim alone and when to question it. Without a benchmark, all chiropractors are hurt unnecessarily when too many claims Continued on page 41... ...tac NeWs conned from page 12 National College of Chiropractic to Achieve University Status are reviewed, one of the insurance representatives observed. Fraud and abuse in health care disciplines, including chiropractic, was another reason insurers supported the development of these guidelines and the use of standardized forms. Many pointed out that having minimal guidelines and proper documentation would help with this issue. The consensus among all participants is that, without fraud identifiers, too many chiropractic claims are subject to a review; with them, only the outliers need attention. In response to the stated needs for guidelines and standardized documentation, the ACA representatives agreed to formally recommend to the association's leadership that their development become a priority. Organizers plan to convene more of these work groups in the future to continue the dialogue and cooperation. Additionally, an e-mail list will be set up to continue on-going communication and problem-solving among the participants. At its annual meeting in mid-November 1999, the Board of Trustees of National College of Chiropractic decided to change the name of that institution to NATIONAL UNIVERSITY OF HEALTH SCIENCE. This name change is expected to become official on September 1, 2000, in preparation for the college's expansion to university status. Within the new university, there are projected to be three colleges: College of Professional Studies, including: Doctor of Chiropractic Program Master of Acupuncture (near future) Doctor of Naturophatic Medicine (approximately 2002) Lincoln College of Post-professional, Graduate and Continuing Education, offering: Residency Programs Diplomate Programs Future Graduate Programs (e.g., Master's in Anatomy) Continuing Eduacation Programs College of Allied Health Sciences, with instruction for: Massage Therapy Chiropractic Assistants Bachelor in Human Biology These changes have been planned and developed with the primary purpose in mind that the various members of the complementary medicine community must learn, at the outset, to appreciate each other for their various skill sets and to work in an integrated fashion for the best interest of the patients whom they all serve. It is the position of NCC/NUHS that this outcome is most likely to be met if they begin the process of integration at the level of the educational experience. Thus, it is intended that, to the degree it is feasible and appropriate, future students in these various programs will study together and, in some instances, will pursue dual degrees. Naturally, all matriculatns into any of NUHS' professional degree programs will be required to have completed their baccalaureate studies prior to entry. ♦♦♦
