Guest guest Posted June 20, 2009 Report Share Posted June 20, 2009 Hi, I was wondering if anyone knows if its ok to bill insurance companies for treating family members/spouses? I asked a customer service agent at AETNA and she said there was no rule against it from AETNA but mentioned that there may be an ethical standard in the profession. Anyone know? I treat my husband all the time and so it would be nice to be paid for it. Thanks! Laura Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 20, 2009 Report Share Posted June 20, 2009 Laura, That issue has come up on another group, in which an attorney had mentioned that it is not legal to do so. i believe that he also mentioned that it could not be another member within your group practice either. Part of this comes down to what you said about treating them all the time, so why would the insurance company need to pay you when you treat them anyway? Michael W. Bowser, DC, LAc Chinese Medicine heylaurag Sat, 20 Jun 2009 03:33:55 +0000 Spouse/insurance Hi, I was wondering if anyone knows if its ok to bill insurance companies for treating family members/spouses? I asked a customer service agent at AETNA and she said there was no rule against it from AETNA but mentioned that there may be an ethical standard in the profession. Anyone know? I treat my husband all the time and so it would be nice to be paid for it. Thanks! Laura _______________ Microsoft brings you a new way to search the web. Try Bing™ now http://www.bing.com?form=MFEHPG & publ=WLHMTAG & crea=TEXT_MFEHPG_Core_tagline_try bing_1x1 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 20, 2009 Report Share Posted June 20, 2009 Medical professional ethics dictate that we should not treat family members unless it is in an emergency or short-term situation where no other care provider is available. There is a great online course about our medical professional ethics at Blue Poppy that details all the reasons why (too long for an email here) as well as all the other professional ethics to which we are bound. Btw, this isn't just about LAc's. This is any doctor in any field not treating family members. We (meaning all licensed health care providers) are bound by both legal and professional ethics. Violations in either arena are grounds for disciplinary action that could result in the loss of licensure. I'm not saying that people don't treat their own family members, just that professional ethics state that we should not (or is it " must " not?). J On Fri, Jun 19, 2009 at 8:33 PM, heylaurag <heylaurag wrote: > Hi, I was wondering if anyone knows if its ok to bill insurance companies > for treating family members/spouses? I asked a customer service agent at > AETNA and she said there was no rule against it from AETNA but mentioned > that there may be an ethical standard in the profession. Anyone know? I > treat my husband all the time and so it would be nice to be paid for it. > > Thanks! > > Laura > > ________ Joy Keller, LAc, Dipl.OM Ramona Acupuncture & Integrative Medicine Clinic Phone: (760) 654-1040 Fax: (760) 654-4019 www.RamonaAcupuncture.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 22, 2009 Report Share Posted June 22, 2009 Joy, The arena where this comes into play is for billing insurance. There is no problem if you treat a family member and do not get paid for it. Michael W. Bowser, DC, LAc Chinese Medicine JKellerLAc Fri, 19 Jun 2009 23:23:30 -0700 Re: Spouse/insurance Medical professional ethics dictate that we should not treat family members unless it is in an emergency or short-term situation where no other care provider is available. There is a great online course about our medical professional ethics at Blue Poppy that details all the reasons why (too long for an email here) as well as all the other professional ethics to which we are bound. Btw, this isn't just about LAc's. This is any doctor in any field not treating family members. We (meaning all licensed health care providers) are bound by both legal and professional ethics. Violations in either arena are grounds for disciplinary action that could result in the loss of licensure. I'm not saying that people don't treat their own family members, just that professional ethics state that we should not (or is it " must " not?). J On Fri, Jun 19, 2009 at 8:33 PM, heylaurag <heylaurag wrote: > Hi, I was wondering if anyone knows if its ok to bill insurance companies > for treating family members/spouses? I asked a customer service agent at > AETNA and she said there was no rule against it from AETNA but mentioned > that there may be an ethical standard in the profession. Anyone know? I > treat my husband all the time and so it would be nice to be paid for it. > > Thanks! > > Laura > > ________ Joy Keller, LAc, Dipl.OM Ramona Acupuncture & Integrative Medicine Clinic Phone: (760) 654-1040 Fax: (760) 654-4019 www.RamonaAcupuncture.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 22, 2009 Report Share Posted June 22, 2009 I respectfully disagree and refer you to the aforementioned Blue Poppy distance-learning course on Ethics. The issue of payment (or not) for rendered services to family members is not the issue when it comes to treating family members. There are professional ethics which we should be adhering to, among those is regarding the treatment of family members. As I said, I'm sure many LAc's/DC's/etc treat their family and while I did not say it was " wrong, " it is clearing against medical professional ethics. For this reason, I would especially not bill insurance because that becomes a legal record of the fact. If we want to be considered on-par with other medical professionals, we should hold ourselves to the same ethical standards. J On Sun, Jun 21, 2009 at 6:28 PM, mike Bowser <naturaldoc1wrote: > > Joy, > The arena where this comes into play is for billing insurance. There is no > problem if you treat a family member and do not get paid for it. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 23, 2009 Report Share Posted June 23, 2009 Joy, The reimbursement is what will most likely get you in trouble as third party payors will definitely frown on that one and most likely be the ones to file a board complaint. As for the idea of generally treating family members, here is some info from the AMA on this issue. Please note that they found that many of their members do it and that they do leave it mostly up to physician discretion. " Do we physicians treat our family members? Apparently, we do. A 1991 study showed that 99% of 465 physicians surveyed had requests from family members for medical advice, diagnosis and treatment. Family members included spouses, children, parents, siblings, nieces, nephews, in-laws, aunts, uncles and cousins. Eighty-three percent of physicians had prescribed medication for a family member, 80% had diagnosed medical illnesses, 72% had performed physical examinations, 15% had acted as a family member's primary doctor, and 9% had performed surgery on a family member. Family members of physicians have the same rights as any patient, including the right to informed consent, meaning that the patient must hear all appropriate information about the nature of a procedure, its risks, benefits and side effects and reasonable alternatives to the suggested treatment. Any patient, even a family member, then has the right to ask questions, to refuse the physician's recommendation and to understand the consequences of his or her choices. The informed consent dialogue might very likely be nonexistent or subpar if a physician were to treat a family member. While Opinion 8.19 of the " Code of Medical Ethics " advises that " physicians generally should not treat themselves or members of their immediate families, " it also states that " in emergency settings or isolated settings where there is no other qualified physician available, physicians should not hesitate to treat themselves or family members until another physician becomes available. " And even though physicians should not be the primary care physician for a family member, sometimes routine care is acceptable for short-term, minor problems. This opinion language leaves room for interpretation, so discernment on the part of the physician is essential in such circumstances. " I get a kick out the clause about self-treatment. Can they be in violation of the ethical codes for self-treatment? Michael W. Bowser, DC, LAc Chinese Medicine JKellerLAc Sun, 21 Jun 2009 19:56:41 -0700 Re: Spouse/insurance I respectfully disagree and refer you to the aforementioned Blue Poppy distance-learning course on Ethics. The issue of payment (or not) for rendered services to family members is not the issue when it comes to treating family members. There are professional ethics which we should be adhering to, among those is regarding the treatment of family members. As I said, I'm sure many LAc's/DC's/etc treat their family and while I did not say it was " wrong, " it is clearing against medical professional ethics. For this reason, I would especially not bill insurance because that becomes a legal record of the fact. If we want to be considered on-par with other medical professionals, we should hold ourselves to the same ethical standards. J On Sun, Jun 21, 2009 at 6:28 PM, mike Bowser <naturaldoc1wrote: > > Joy, > The arena where this comes into play is for billing insurance. There is no > problem if you treat a family member and do not get paid for it. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 23, 2009 Report Share Posted June 23, 2009 I dont think that is a Chinese traditional position..What is Blue poppy say about traditional non western position on this 400 29th St. Suite 419 Oakland Ca 94609 alonmarcus Quote Link to comment Share on other sites More sharing options...
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