Some people believe wholeheartedly in the benefits of chiropractic medicine. Others are quick to say "pshaw" and limit themselves to medical doctors. Every profession has good apples and bad apples. Choose your Chiropractor with care. Choose your doctors with care. Choose your dentist with care. Choose your car mechanic with care. Choose your banker with care. Choose your real estate and insurance agents with care. The list is endless.

The following article comes from Michael Glandorf, our favorite chiro!

WHAT TO EXPECT FROM YOUR CHIROPRACTOR

Finding a doctor of chiropractic who cares about his patients and is really going to help your condition is like shopping for a new car. There are so many to choose from and a lot of options to consider. When locating a chiropractor for treatment, it is important to find a well-respected doctor near your home or work. This is important because driving in traffic one, two or three times per week can cause unnecessary stress and can be counterproductive when attempting to restore your precious health.

A few things to look for in determining who you should go see are as follows:

Make sure the doctor is in good standing with the state board. This can easily be researched on the Internet.

Find out how long the chiropractor has been in practice. The longer he/she has been in practice, the more experience he or she will likely have. Doctors who do not offer quality care simply do not last long. They close up shop and move on.

Make an attempt to talk to the chiropractor directly before making an appointment. Although not every doctor will be able to talk to you right away, he or she should return your call within a reasonable period of time. If you are unable to talk to the chiropractor before making an appointment, chances are he is too busy to give you the attention you deserve.

The first visit to your chiropractor should be a good experience. You should feel welcomed. Look to see how clean the office is kept. Is the chiropractor organized? Is the office updated? How long did you wait before seeing the doctor? These things usually reflect on the quality of care a doctor will provide.

The office staff should be willing to answer any questions regarding charges for services rendered prior to you being seen by the doctor. If you are not absolutely clear of what will be charged for your visit, ask for clarification. If you are still uneasy, speak directly with the doctor and get answers to your questions from him/her. (On rare occasion, a competent doctor will have a new front office employee.) If talking to him/her does not help your understanding of the billing procedures and amounts, walk out the door.
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When consulting the doctor for the first time, a thorough history should be taken. Along with the history the doctor will perform a detailed examination to your complaint area. The doctor may or may not recommend x-rays. If he/she does want to take x-rays, he/she should be willing to explain why he/she feels they are necessary. Additionally, he/she should explain any procedures he/she will be performing prior to rendering the actual service.

Typical procedures and fees in Southern California are as follows:

New patient evaluation . . . . $80
Adjustment/ office visit . . . . $50
Therapy modality . . . . . . . . $25
X-rays (per series) . . . . . . .$100
Per visit fee . . . . . . . . . . . .$100

Fees will vary by doctor and by geographic location. As is the case with any healthcare provider, your insurance will be billed if you are covered for the service being performed. Ask for a copy of the each appointment billing form; most offices will (and should) provide this copy after each visit.
 
Typical modalities and procedures provided by chiropractors includes, spinal and extremity adjustments, electrical muscle stimulation, various forms of traction, ultrasound, hot packs, ice packs, massage and therapeutic exercises.* Offices vary with regard to what modalities they offer and many chiropractors do not offer any modalities. There is nothing wrong with that because their patients get well, too.

Some doctors will charge for 5-6 modalities and bill a per visit fee in excess of $175. Although additional services may be necessary, we must keep in mind that insurance companies only want to pay for reasonable and necessary care. High per visit fees will raise flags and may jeopardize the payment of your chiropractic bill, leaving you responsible for any unpaid balance.

Treatment plans vary depending on the condition being treated and the type of care being rendered. Types of care may be described as pain relief care, corrective care and maintenance care. The pain relief is usually what brings a patient to the chiropractor. Not too many people think of their chiropractor when they are feeling fine. Once the patient is out of pain, he may elect to undergo a structural care program. This is generally long term care and may last many months. Then there is maintenance care. This type of care is to help the patient maintain their current level of spinal health.

Chiropractors provide effective treatment for soft tissue injures. Some chiropractic doctors will provide care on a lien basis if a lawsuit is pending. This means they agree to provide the necessary treatment and wait to get paid when the case settles. This is usually the situation with personal injury accidents (such as automobile accidents or slip and fall cases.) In such cases, the chiropractor should provide a treatment plan with goals in mind. The treatment plan should be a conservative rehabilitative approach aimed at reducing pain and getting the patient back to his routine daily activities.

It is important that personal injury accident billings should not be aimed at correcting a structural problem such as a reversal of the cervical lordosis. Having a reversed curve in your neck is usually something that took time to develop and not the result of an accident that took place a week or month ago. If your chiropractor is attempting to make changes that were not the result of the recent accident you are being treated for, be aware. You will be under treatment for a longer period of time and run up a larger than expected bill for the treatment of injuries. It is not to say that structural care may not be needed, it may well be. However, it is not the responsibility of the third party insurance to pay for correction of a problem unrelated to original injury. Such a pattern of billing can result in the insurance company balking at ALL charges and taint even the most legitimate accident claim.

When undergoing a treatment plan, make sure you are being formally reexamined every 30 to 45 days. This is how your doctor will determine if you are progressing as expected. Not doing re-exams tends to foster the over utilization of passive care. Additionally, a home exercise program should be provided in conjunction with your treatment program. A home exercise program should consist of both active stretch and strengthening exercises.

Upon completion of your treatment as it relates to a personal injury case, the doctor will provide an itemized bill. This bill is then submitted to the responsible insurance carrier or attorney -- if an attorney is representing the injured person. That final bill should also be sent to the patient. If the patient does not receive a bill, then suspicion should be raised. Remember, the patient who received the care is ultimately responsible for payment of that bill. The doctor may have not been forthcoming with respect to his charges for services rendered. I have seen this time and time again. In many case, doctors were charging up to $300 per visit with charges for services that were never performed.

In summary, there are good and bad in every profession. Choosing a good doctor is essential to obtaining a favorable result from treatment.


Michael J. Glandorf, D.C., QME, FAFICC
Qualified Medical Examiner
Fellow, Academy of Forensic Industrial Chiropractic Consultants

* From FightFraudAmerica.com - Note, the scope of practice for health care providers is defined by the state where the provider is licensed. Some states restrict modalities/treatment to only certain professions. Contact your state Board of Health to confirm the scope of practice for the profession being utilized.