Questions, comments
and suggestions should
be directed to
vcacentral@hughes.net

Contact info:
540-932-3100 (Phone)
540-932-3101 (Fax)

The Virginia Chiropractic Association

The Virginia Chiropractic Association evolved from the Virginia Chiropractors Association, which was founded in 1925 as a vehicle to unite the profession in the Commonwealth of Virginia.

Since that time, the VCA has become the largest and strongest state association and has continued to lead the path for the Chiropractic profession in Virginia.

Today, the VCA leads the Chiropractic profession into the 21st century by being an advocate of chiropractic as a distinct profession integrated into the health care system for the benefits of citizens of the Commonwealth.

Get the full picture of VCA opportunities for education, networking, and fun! See: Education & Events

Find-a-Doctor listing on the web! Trying to locate a Chiropractor in a certain area or by name? This searchable listing features all DC members of the VCA as of July 2008.

Get a glimpse of VCA’s award-winning newsletter, The Virginia Voice. See all back issues in our Members-Only section.

Hot Topics

Updated 06/3/08

Subscribe to DCConsultSM at a Discount and Benefit the VCA at the Same Time

DCConsultSM, the new online chiropractic and alternative health care information resource, has been launched by the Foundation for Chiropractic Education and Research (FCER) as the first iteration of its new Evidence-Based Resource Center. The web site, available by subscription, is the profession’s newest clinician/patient/research information resource, and is cutting edge in its technology and its inclusivity of chiropractic and alternative health care information.

  • Charter subscriptions to DCConsultSM are available at a much-reduced rate until August 31, 2008, at which time the rate will substantially increase to better cover the expense of developing and maintaining the site. Subscribing by August 31st also locks in the discounted rate for the next three years.
     
  • What’s more, the VCA will receive a portion of any DCConsult subscription made using a special link that has been created. Those who subscribe through this link will trigger the benefit to the VCA.

For more information and to subscribe, click on the DCConsult logo:

New VCA Member Discounts on Disability and Business Overhead Insurance

Are you taking advantage of discounts available to you on Disability Income Insurance and Business Overhead Expense Insurance?

If you did not have a chance to meet with VCA's Member Insurance Representative, Dana Harrison, at VCA's Spring Convention in Tyson’s Corner, you can use the form below to request a personalized quote. Dana has negotiated discounts with major insurance carriers, so don’t miss out on this opportunity for VCA members only. Her return fax number is 804-747-8547. To reach her by phone, call 888-324-1602 x 739.

Quote Request Form (members only, login required)

Now sure whether or not you need business overhead insurance? Check out this helpful presentation from Dana. (members only, login required)

Spanish for the Chiropractic Office Now Online

Dr. Nelson Marquina's session on Spanish for the Chiropractic Office at the VCA's Spring Convention, sponsored by USA Laser BioTech, received great reviews. VCA Members can now access this increasingly important presentation and accompanying hand-outs in the members-only section.

Celebrate Wellness!

VCA’s Celebrate Wellness! is an initiative designed to promote chiropractic's positive message throughout Virginia. Our goal is to distribute a new edition of Celebrate Wellness! approximately every month.

Full info

Health Insurance Benefits for VCA Members!

As a VCA member, you now have many health insurance plans available for your consideration, all under one roof. Through our alliance with MassMutual Financial Group and their health insurance division, The Financial Group of Virginia, VCA members have access to professionals who can help with important decisions when it comes to purchasing health insurance. Let them help you choose the type of plan, benefit options, deductible amount and co-pay that best fits you, your family or your employees’ needs. PPOs HMOs, Health Savings Accounts and group plans with tax advantages are all available. Get the health insurance you need while supporting your state association.

Full  info in Members-Only area

Increase Your Purchasing Power!

The VCA has just negotiated an exclusive arrangement with CBG, Chiropractors Buying Group, Inc. Due to CBG’s extensive purchasing power through its many vendor relationships -- including many you probably use already -- all VCA Members can now benefit from dramatic savings on Chiropractic supplies and services. This includes X-Ray Film, Face Paper, Treatment Supplies, Office Supplies and much more.

The VCA has negotiated with CBG to provide the following items absolutely free for all VCA members who enroll CBG:

• Waiver of the annual membership in CBG (a savings of $179!)
• Free package of 100 special greeting cards for patient loyalty, welcome, congratulations, referral thank yous, etc.
• Free product samples
• Free giveaway items for your patients
• Free additional vendor savings coupons and ongoing discount offers

A number of other state chiropractic associations have already launched this benefit with their members with rave reviews, including New York, Pennsylvania, New Hampshire, and Kansas. The Congress of Chiropractic State Associations (COCSA) also endorses the program.

Your CBG membership will be effective immediately upon receipt of your confirmation, which will allow you to receive fax and email specials. Sign and fax back your acknowledgement form to 248-307-0706. Your complete membership packet and free gifts will arrive within 14 days of CBG’s receipt of your enrollment.

CBG ensures that all its vendors understand that their products and services must be top quality, and that their pricing must save DCs money. VCA encourages all members to maximize savings and reduce expenses by utilizing CBG benefits for their supply needs. Keep an eye out for the CBG logo on special fax/email offers. If you have any questions please feel free to call the VCA office at 540-932-3100.

Members only, log in for the CBG signup form.

VCA Partners with Alternative Medicine Integration Group to Expand Outcome-based Chiropractic Value Measurement

The VCA is currently finalizing the details of its business relationship with Alternative Medicine Integration Group (AMI) aimed at supporting and expanding the mutual goals of both organizations to demonstrate the value of chiropractic care to patients and payers alike. Rather than sitting back and allowing managed care to take the lead in establishing the criteria by which we are “managed” and reimbursed (or not!), the VCA has decided to take our destiny in our own hands and advance the outcome-based methodology that best serves the interests of all involved…our doctors, our patients and the companies who pay us to keep their employees and families healthy and productive.

After over two years of significant due diligence, including presentations at VCA General Membership Meetings, Board of Directors Meetings and interviews with states and DCs already involved with AMI, the VCA has decided to join forces with AMI to capture the attention of Virginia companies and send the message that quality chiropractic care results in improved health and reduced costs. An initial summary of our reasons are below:

Alternative Medicine Integration Group is the:

  • 1st to utilize chiropractors as the non-pharmaceutical/non-surgical network component for both treatment and prevention of disease in the first truly integrated IPA for an HMO in Illinois.
  • 1st integrative IPA to consistently provide overall medical cost reductions of 50% since its HMO program began in January 1999.
  • 1st to measure DCs performance on patient outcomes and chiropractic industry standards.
  • 1st to partner with multiple state chiropractic societies to promote a chiropractic outcomes-based model.
  • 1st to obtain CMS waivers to reimburse DCs, MTs and ACcs for treatment of MediCaid patients in a disease management model for State of Florida.

AMI is currently working with the Maryland Chiropractic Assn. (MCA) and CareFirst BCBS of Maryland to support CareFirst’s Quality Assessment and Improvement Initiative. Both parties consider their relationship with AMI a great success and appreciate the gains made in repairing the relationship between them. The MCA now feels that they truly have a “place at the table” of managed care and are in a much more powerful position to control their present and future. Watch for additional information in the coming weeks. In the meantime, please feel free to direct any questions to Dr. Bill Ward, VCA President, phone 540-371-0474 or e-mail wmbward@erols.com.

[6/20/07] CAM-Oriented Primary Care Providers Result in Cost Savings, High Patient Satisfaction, Study Suggests

Patients visiting chiropractors and other holistically-oriented physicians who serve as primary care providers (PCPs) have lower utilization costs and higher patient satisfaction levels than patients treated by conventional medical doctors, according to a study published in the May issue of the Journal of Manipulative and Physiological Therapeutics that tracked data from a unique Independent Physicians Association (IPA) where chiropractors serve as first-contact, primary care physicians.
“The escalation of medical expenditures remains an urgent problem in the United States and it’s becoming quite clear that cost containment strategies by conventional medical providers are failing to achieve even mediocre results,” said study coauthor James Winterstein, DC. “This study confirms that integration of allopathic, chiropractic and other complementary and alternative medicine (CAM) providers can positively impact patient quality of care while limiting overall costs. This approach to patient care has great potential to improve the U.S. healthcare system.”

Led by Richard Sarnat, MD, researchers directly compared cost and clinical utilization data from an integrative CAM Independent Physicians Association (IPA) with conventional medical IPA data from members enrolled in a traditional health maintenance organization (HMO). The recent report analyzes data from 2003 to 2005 and is a follow up to the original report published in 2004, which compared data from 1999 to 2002.

“Our most recent analysis supports earlier findings that patients visiting CAM-orientated primary care physicians (PCP) – primarily chiropractors – experienced fewer hospitalizations, underwent fewer surgeries and used considerably fewer pharmaceuticals than HMO patients who received traditional medical care,” Dr. Winterstein said. “Moreover, doctors of chiropractic succeeded in diagnosing and treating patients at a level nearly equal to medical doctors.”

Researchers found that over the course of the seven-year study, patients visiting chiropractors and other CAM-oriented PCPs had 60 percent fewer hospitalizations, 62 percent fewer outpatient surgical cases, and 85 percent lower pharmaceutical costs when compared with total network HMO utilization rates and costs. The chiropractors and other CAM doctors treated and managed cases ranging from upper respiratory tract infections and allergies to headaches, orthopedic and other medical conditions.
In 2005, the chiropractic PCPs managed 60 percent of their enrolled patients without requiring a referral to a conventional medical specialist. These data mirror the 2001 findings, which also demonstrated that 60 percent of the patient population within the integrative IPA was solely managed by their chiropractic PCPs.

“The most current data from our ongoing study suggests that doctors of chiropractic are well-suited to provide patients with valuable primary-care services,” Dr. Winterstein notes. “We have demonstrated that it is possible to deliver CAM-oriented primary care in a highly regulated environment without compromising either quality or safety.”

Patients reported on the quality of care they received through the use of annual patient satisfaction surveys. On average, data from patients enrolled between 2003 and 2005 demonstrated a high degree of satisfaction (96 percent, 94 percent, and 91 percent, respectively). These findings were similar to data from 1999 through 2002 (100 percent, 89 percent, 91 percent, and 90 percent, respectively). The integrative CAM patients consistently rated their experiences more positively than did members enrolled within the HMO’s conventional medical IPAs.

To receive an electronic copy of the study, contact Angela Kargus at the American Chiropractic Association, akargus@acatoday.org.

The Journal of Manipulative and Physiological Therapeutics, the premier biomedical publication in the chiropractic profession and the official scientific journal of the American Chiropractic Association, provides the latest information on current research developments, as well as clinically oriented research and practical information for use in clinical settings.

[Reprinted with permission from the American Chiropractic Association.]

[2/16/07] Medicare Chiropractic Demonstration Ends March 31, 2007

As you may be aware, for the last two years a number of DCs in central Virginia have been participating in the Medicare Chiropractic Demonstration (mandated by Section 651 of the Medicare Prescription Drug Improvement and Modernization Act of 2003.) This Demonstration provided for expanded coverage of chiropractic services including the following additional services:

Examination
X-ray
Extraspinal manipulation (manipulation of a body part other than the spine)
Physical Medicine (e.g., ultrasound, electrical stimulation, massage)
Muscle testing
Nerve conduction studies
TENS (Transcutaneous electrical nerve stimulation)

The Demonstration will end on March 31, 2007. After that date, these services will no longer be covered by Medicare and will, again, be the financial responsibility of the patient and/or other covering insurance payor. Coverage remains the same for the spinal manipulation services previously covered under Medicare before the demonstration began.

Thank you to all of the Virginia Chiropractors who participated in and supported the Demonstration. The VCA will share CMS' final analysis of this project as soon as it is available.

[1/26/07] DCs Retain Right to Use Term "Physician"

The "definition of physician bill" that had been initiated by the Medical Society of Virginia and introduced by Delegate Harry R. Purkey was officially withdrawn on Monday evening.

HB 1938 proposed to require that no person other than those who have received a degree as a medical doctor or doctor of osteopathy could use the term "physician" in connection with his name or practice. On January 22nd, a subcommittee of the Health, Welfare and Institutions Committee voted to "lay the bill on the table" (measure defeated).

What Does It Cost You to See That Patient?

The following link will open up a calculator that allows any DC to determine exactly how much it costs him or her to see a patient: http://www.list-hosting.net/calc.asp <PASSWORD PROTECTED>

This FREE tool has a number of valuable applications, including helping you to figure out how much it costs you to do business in general.

Dr. Larry Stine, VCA Insurance Committee Chair, suggests using it in conjunction with formulas that determine gross services vs. net collections vs. write-offs: “For example, if your practice is generating $400,000 in gross services, but net collections is $200,000, this is 50% write-offs. To get the same amount of net collections at 25% write-offs, you would only need to produce $266,666.67 in gross services.” Dr. Stine adds that when you start looking at your percentage of collections, you can better evaluate your position in various insurance programs.

The Future of Chiropractic in Virginia… We’re Listening!

Co-Sponsored by:
The Virginia Society of Chiropractic and the Virginia Chiropractic Association

The VCA and VSC need your help in objectively gauging Virginia DCs’ perceptions and priorities regarding their state associations and practicing chiropractic in the state. It is hoped that responses to the survey will help both organizations to gain updated insights into how the doctors they serve feel, identify areas of commonality, and flesh out issues that may possibly be addressed. There are no “right” or “wrong” answers. This is about your opinions and impressions and what’s important to you.

Download the survey form (PDF)

Please fax the completed survey to 540-932-3101 or mail it to VSC/VCA Survey, PO Box 15, Afton, VA 22920
BY MONDAY, APRIL 10.

Questions? Call the VCA at 540-932-3100 or the VSC at 888-639-4872. Thanks for your time and assistance on this important effort!

VCA Surveys Virginia DCs Re: ACN Policies and Procedures

We Need Your Help! Several regulatory agencies would like more information regarding the policies of chiropractic networks. At this time, specific feedback from Virginia chiropractors regarding ACN Group, Inc. (ACN) is needed.

In conjunction with The American Chiropractic Association (ACA), we ask that you please participate in this National Survey to assist both the VCA and ACA in garnering important data addressing concerns relative to ACN. We've been asked to quantify the degree to which the threat of termination, or being placed on a different "tier", causes doctors to alter treatment. Some doctors state that they underreport services to remain in-network and/or to provide the patient with the appropriate care. Since ACN uses “peer statistics” to gauge appropriateness of treatment, the alteration of statistics due to non-reporting has a direct effect on their management of providers.

Please take a few minutes to complete the survey found at the link below. Your participation will help us gather vital information to share with the Virginia Attorney General. Your responses will be catalogued and viewed by VCA and ACA leadership and sent to regulatory agencies investigating these issues. No personal identifying information will be shared with anyone without your permission. Aggregate data will only be shared in terms of percentages. The demographic data requested is only for us to contact you if we see any areas that require clarification.

To complete the survey online, click here http://www.zoomerang.com/survey.zgi?p=WEB225FF6WJJJK. If you have any trouble with this url, try copying and pasting it into your browser. For a fax version, call the VCA office at 540-932-3100 or e-mail your request to vcacentral@hughes.net.

Similar surveys on other chiropractic networks will follow in the near future. In the meantime, thank you in advance for sharing your views and experience. Your participation WILL make a difference.

VCA Establishes CCGPP Best Practices Review Committee

VCA President Dr. Scott Cypher has appointed Dr. John Willis to chair VCA’s new CCGPP Best Practices Review Committee. The complete committee at this time consists of:

Dr. John Willis, Chair Dr. Scott Banks
Dr. Chris Brown Dr. Scott Cypher
Dr. Nelson Gregory Dr. Valerie Hoffman
Dr. Wade Quinn Dr. Nick Rulli
Dr. Jeff Teass Dr. Bill Thesier
Dr. Richard Wells

The Council on Chiropractic Guidelines and Practice Parameters (CCGPP) recently released its lower back best practices chapter draft, the first of seven chapter drafts to be released over the next year. Please visit www.ccgpp.org to review the low back draft in its entirety and provide comments via an online survey.

CCGPP was formed in 1995 at the behest of the Congress of Chiropractic State Assns. (COCSA) and with assistance from the ACA, ACC, CCE, FCLB FCER, ICA, NACA, and other organizations to create an equitable chiropractic practice document. For more information on CCGPP, visit www.ccgpp.org.

Virginia Chiropractic Association Partners with MD On-Line, Inc. to Promote Clearinghouse Services

MD On-Line, a healthcare technology company and a leader in electronic claims processing, has a special offer for VCA members. Try electronic claims processing, and MD On-Line will waive the start up fee ($99.00) and give you two free trial months. That’s a savings of over $190.00…not to mention the savings you’ll realize in time and labor costs.

A pioneer in the clearinghouse industry, MD On-Line already connects over 25,000 providers to payers, and processes more than 1.5 million claims per month. The company is a preferred vendor of the American Chiropractic Association as well, and is very experienced in working with Chiropractic offices. MD On-Line has also been recognized as one of the fastest growing companies in the country, having been named to the Inc. magazine INC 500, and twice named to the Deloitte Fast 500 list.

To take advantage of this special offer, click the MD On-Line link below, or contact MD On-Line directly at 888-499-5465 and identify yourself as a VCA member.
www.vcamdol.com

CC Imaging Interpretation

Ms. Susan McClelland has given the VCA permission to distribute her copyrighted talking points on reporting X-ray reading and reporting as an E&M code to VCA members.

See a copy of these talking points (PDF) (Members Only)

Click here for the latest Member FYIs on valuable benefits and important news. (Members only)

Anthem Lifts DME Restrictions In Response to VCA Insurance Committee

VCA members recently brought to the attention of the VCA Insurance Committee that some Durable Medical Equipment (DME) was not considered to be a covered benefit by Anthem when prescribed by doctors of chiropractic -- but were covered when provided by medical doctors or doctors of osteopathic medicine. The VCA Insurance Committee has looked into this matter and discussed it at length with Anne Randazzo, Anthem’s Provider Representative.

Ms. Randazzo confirmed the above to be Anthem’s current policy when we initially brought this to her attention. We pointed out that our mandated provider law, 38.2-3408, provides for reimbursement of services that may be performed by certain practitioners other than physicians. (A. If an accident and sickness insurance policy provides reimbursement for any service that may be legally performed by a person licensed in this Commonwealth as a chiropractor, optometrist, optician, professional counselor, psychologist, clinical social worker, podiatrist, physical therapist, chiropodist, clinical nurse specialist who renders mental health services, audiologist, speech pathologist, certified nurse midwife, or licensed acupuncturist, reimbursement under the policy shall not be denied because the service is rendered by the licensed practitioner).

We further discussed the PPO law 38.2-3407 on Health benefit programs. (… C. Mandated types of providers set forth in 38.2-3408 and types of providers whose services are required to be made available and that have been specifically contracted for by the holder of any such policy or contract shall, to the extent required by 38.2-3408, have the same opportunity to qualify for payment as a preferred provider as do doctors of medicine).

DME restrictions have been lifted and future claims submitted to Anthem for DMEs will be reimbursed at maximum allowable, on par with medical providers if the DME is within our scope of practice to provide. Should your DMEs be denied, please call Anthem to make sure it is not due to a filing error.

If doctors of chiropractic have had DMEs denied by Anthem due to “provider not allowed to prescribe or bill for DME service”, resubmit your claims for reimbursement. If claims meet timely filing criterion of one year since date of service, then Anthem will retroactively pay the claims. Anthem’s policy on DME is that DME claims should pay @ 100% and the same as when the service is provided or prescribed by other types of providers: MDs, DOs, etc.

VCA Teams Up With ACA and Other State Associations To Fight Managed Care Network Abuses

June 20, 2005

Dear Colleague:

As you know, the VCA recently began collecting data from Virginia doctors regarding their concerns about ACN, ASHN and other carriers’ claims about over utilization and ultimate termination of provider status. The idea was to gain a more accurate sense of the scope of this issue as it relates to DCs in our state and to provide the VCA attorney with data to enable him to develop a strategy. And an initial response from 30 doctors has given us a solid starting point.

At the same time, the American Chiropractic Association (ACA), as part of its ongoing campaign to correct the wrongful practices of certain chiropractic managed care networks, began asking doctors of chiropractic nationwide to provide information that will assist in putting an end to these practices. Among the wrongful practices that that the ACA is gathering information about are the following:

  • Automatic downcoding or limiting physician discretion in the planning of care: The doctor submits the network's forms after examining the patient and is advised of the frequency, duration and type of care that will be covered. Requested treatment is often reduced or denied. Claims are downcoded without the doctor of chiropractic being provided the opportunity to provide any documentation supporting the claim as submitted.
  • Bundling: The submitted CPT code is incorporated into another submitted CPT code.
  • Improper utilization review including refusal to recognize coding modifiers: Managed care organizations sometimes refuse to recognize "modifiers" that chiropractors append to CPT codes to report a service or procedure that has been performed and which has been altered by some specific circumstance.
  • Performance management issues: Managed care networks often disregard the doctor's discretion to diagnose and treat, and limit the number of visits, x-rays and modalities. Doctors say they are reprimanded and threatened with the loss of their contract when the care they prescribe is outside the managed care organization's set standards.

As part of this effort, ACA recently retained the services of Milberg Weiss, one of the nation's largest class action law firms, to assist in the collection and analysis of this information.

Over the past three years, hundreds of doctors of chiropractic have contacted ACA and completed "managed care data collection" forms detailing their troubling experiences with chiropractic networks - and the names of several specific organizations and trends have emerged. According to the data collected by ACA, and echoing the voices of Virginia doctors, doctors of chiropractic are most troubled by the actions of American Chiropractic Network (ACN), American Specialty Health Plans (ASHP) and Landmark Healthcare. These carriers routinely deny requested treatment and improperly reduce and deny reimbursement, putting patients and quality of care at risk, according to doctors who contacted ACA.

The VCA Board feels that the most effective way to strengthen its own campaign to fight the abuses to Virginia doctors is to team up with the national efforts spearheaded by the ACA. In addition to utilizing the expertise of the VCA’s attorney, VCA will assist the ACA in educating Virginia doctors about the data collection campaign and in the collection of this data.

Toward this goal, the VCA requests that Virginia doctors of chiropractic who have experienced problems with ACN, ASHP, and Landmark in the areas of restriction of treatment, downcoding, bundling and improper use of modifiers fill out the data collection form found on ACA's website at http://www.acatoday.com/pdf/managed_care_collection.pdf

and fax it to 703-243-2593, Attention: PDR Department. Your information will be kept in strict confidence and your name will not be released to any managed care network.

You will also find additional information and resources regarding ACA's and VCA’s data collection campaign and what you can do to assist in this effort at http://www.acatoday.com/insurance/managed_care/resourceSheet.shtml.

Should you have any questions or comments, please don’t hesitate to contact the ACA at 1-800-986-4636 or the VCA at 540-932-3100. In the meantime, thanks for helping us to fight the good fight.

N. Ray Tuck, Jr., DC
VCA President

VCA's newest member benefit, an e-mail discussion group for VCA members only called VCAdoctalk, has launched! Click here for more information.