11/01/2017

OSCA Addresses MMO's Improper Denial Of Chiropractic Claims

(COLUMBUS, OH) Recently, the OSCA sent correspondence to Medical Mutual of Ohio (MMO) drawing attention to them that they are improperly denying claims submitted by several of OSCA’s members for the provision of Durable Medical Equipment (“DME”). Specifically, claims are being denied for the provision of lumbar support and/or extremity support braces, orthotics and TENS units provided by chiropractors or by chiropractic offices. MMO asserts that DME is not a covered service if it is provided by a chiropractor. These denials are improper because the provision of DME is within the scope of practice of chiropractors in Ohio.

OSCA’s Nicholas Strata demanded “MMO immediately stop improperly denying claims from chiropractors for the provision of DME to their patients.” Additionally, he added “There have also been instances of improper denials of chiropractic services and home medical equipment services when equipment is considered by the Respiratory Care Board to be home medical equipment and the provider has a license to prescribe home medical equipment through the Ohio Respiratory Board.”

On behalf of Ohio’s chiropractors, the OSCA asked that MMO stop denying these claims and work with chiropractors who have had claims denied to rectify the denials.

Should you have any questions please contact Dr. Brandy Spaulding at brandy@oscachiro.org