Issue enrolling in the MPN? Any other action? (California)

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Issue enrolling in the MPN? Any other action? (California)

Postby paduanow@yahoo.com on Thu Apr 16, 2009 7:10 am

I bill for several types of Doctors; Chrios, Acup, Ortho, MD, psychs... Most of them are on Blue Cross/Shield and members of many other insurance provider plans for years. SCIF, Employers, Liberty Mutual/Wausau, SCMA as denied membership to every doctor that we applied. It seems doctors that cannot get on these MPN are better-off getting denied cases and hoping for good C&R results.

Reasons:

1. Not adding our type of services at this time.
2. Too many of our type of doctors in your area.

The doctors are trying to follow the L.C. guidelines, but they cannot even get started. When a doctor does get on a MPN, the have to follow the strict guidelines and take a reduced fee from an already low OMFS. Some of the guideline put a dollar amount cap per day for a chiro visit or PT visit which is well below the OMFS.

SCIF being a state run insurance company should allow a California license doctor to practice in California Worker's Comp.

Is there anything we can do?
paduanow@yahoo.com
 
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