Diagnostic Testing & Personal Injury Cases Who is the real INJURED PARTY?

I iist and foremost, neuromuscular diagnos­tic testing, including Nerve Conduction Velocities (NCV). Somatosensory Evoked Potentials (SEP). Der-matomal Evoked Poten­tials (DEP). and Spinal Ultrasound, are vital diagnostic tools, which assist chiropractors to better diagnose and develop proper treatment programs for their patients involved in personal injury (PI) cases. These tests have proven to be a significant factor in effectively documenting the soft-tissue injuries of these patients. However, these tests are never to be performed on all patients for the sake of just gen­erating revenue. Specific criteria must be met. prior to performing neuromus-cular diagnostic tests. Recently, some chiropractors who utilize these tests for PI cases have experienced resistance from insur- ance carriers such as State Farm, Allstate, and others. This resis­tance is due. in part, to the indis­criminate use of these tests and the ridiculous fees that some unethical chiropractors and diagnostic test­ing companies are charging. Quite honestly. I don't blame the carriers lor their resistance to reimburse. Nor do I blame them lor the actions they are taking against those unethical prac­titioners and diagnostics companies. Carriers are paying millions of dollars out each year for unnecessary tests. Unfortunately, those chiropractors who utilize these tests properly are being lumped in with the bad apples. Utilizing these tests properly means appropriately qualifying the patients who receive the tests. Ncuromuscular diagnostic testing should not be per­formed immediately after you see the patient for the first time, even if the patient's symptoms seem to war­rant it. In order to appro­priately perform diagnos­tic testing, you must first develop a treatment pro­gram according to the findings of your initial neurological and orthope­dic examinations. Con­servative care should then be applied for a period of two to three weeks. You will find that many of your patients will show a sig­nificant recovery response to your con­servative care and that diagnostic test­ing, at this point, is unnecessary. This is one reason why testing immediately after the first visit is not warranted. If, after the initial few weeks of treatment, your patient hasn't responded satisfac­torily, you should re-evaluate the pos­sibility of performing some of these tests. Another reason for holding off on testing until after three weeks fol- lowing an injury is the fact that a sig­nificant alteration in the function of the nerves being tested will not be measur­able until three weeks post-trauma. Other important considerations for proper utilization of diagnostic tests concern the qualifications of the pro­fessionals performing and interpreting the tests. The technicians performing the tests in your facility must be Board-Certified, or Board-Eligible, by the American Association of Elec-troneurodiagnostic Technologists (AAET). Only Board-Certified Neu- ;>>!>^_isis or Physiatrists should per­form the interpretation of the test results. When outsourcing your diagnostic testing procedures, be sure that the lease arrangement that the company uses is Stark. OIG and H1PAA compli­ant. The company should be willing to produce documentation of this compli­ance. Finally, the lees charged for the testing procedures should be reason­able and customary, and at the low end of the fee schedule. Remember, the primary reason for performing these tests is to obtain the vital diagnostic information they provide and not merely to increase your financial bot­tom line. Many chiropractors think they're doing everything correctly with their outsourced diagnostic testing: but. in many cases, after a thorough review, they discover that they're not. They have been either duped or mislead by an unscrupulous diagnostic testing company. Some companies will tell you things that simply aren't true. just to get you to use their ser­vices. In other cases, the diagnos­tics company doesn't take the time, or go to the expense of per­forming the required research, in order to provide you with accurate information about their testing procedures. There are hundreds of diagnostics companies throughout the country: but there are only a few quali­ty companies that act with ethical intentions, operate legally, and care about you (the chiropractor), your patients, and your profession. Other problems can arise from over-ambi­tious equipment salespersons. Remember, a salesman's area of expertise is the equipment he is selling, not the legal issues facing the chiro­practor purchasing the equipment. In many cases, the salesperson is unaware of the legal requirements for perform- ing the diagnostic tests. They just want to sell equipment. These are just a couple of reasons why PI insurance companies are intensifying the scrutiny of diagnostic testing. They realize that a large number of unneces­sary and illegal diagnostic tests are being performed, and they're tired of subsidiz­ing this unethical practice. Wouldn't you be? I have been asked by a number of insurance companies to share my opinion concerning the current state of the diag­nostics industry. I am happy to say that, together, we are making great strides toward resolving many of these issues. My goal is to continue to work with the insurance companies, in order to create a national standards and protocols pro­gram, which will include a special certi­fication and fee schedule for neuromus-cular diagnostic testing. These changes will ensure the proper implementation and utilization of diagnostic tests. Insurance companies support the use of diagnostic tests when applied appro­priately. I call on the insurance compa- nies to work with me to develop utiliza­tion standards that will protect the ability of doctors to employ these tools, when caring for their patients in the years to come. Together, we can make a signifi­cant impact on the issues confronting both the insurance companies and doc­tors across the country. I will gladly offer my time to speak with any doctor who is concerned with these PI issues. If you wish to contact me for more information. I will also be happy to discuss any of the legal issues concerning diagnostic testing. If you would like assistance with either choos­ing the proper company to work with, or evaluating a company that you are cur­rently working with, please call me at (800) 848-8910 or email me at check­er® adv-diag.com. You can also visit our website at www.adv-diag.com. Glenn A. Becker is the Presisdent and CEO of Advanced Diagnostics Group. Inc., a leading provider of neuroskeletal diagnostic and healthcare services to the chiropractic professions