Receipts for insurance claims

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I am in a state of fury.

A new patient of mine has had my receipt rejected by their insurance company, because they do not cover podiatry (only chiropody) and because they do not know who the HPC are.

The kicker is this: they *do* accept receipts from non-hpc chiropodists, so my patient has declined my future services, and has decided to go back to the non-HPC registered practitioner, so that his receipts may be honored.

Why do I pay my insurance? Why am I HPC registered? I wish I hadn't ever bothered, to be honest. Especially as this patient now thinks I'm a bit dodgy and not the real thing.

I may as well have bought some instruments off the internet, and trained myself...I'd have saved a bundle on insurance, and wouldn't have wasted 3 years at University.

I phoned the HPC, who said 'what do you want us to do about it?'

 

I can understand your frustration, try and contact the insurance company involved.

 

I phoned them today, and they say they have never heard of the HPC.

Unbelievable.

 

I would have thought that this a perfect case for the Society to take up and pursue.

 

Well, the HPC aren't interested, so I guess the only place I can go is the Society.

 

In fairness to the HPC, I agree with them. It has nothing to do with them. The Society should take this up, not specifically your specific case, but the issue genericaly with the insurance company as it potentially impacts on the dealing of all clients of that insurance company with us. The Society do not know if this is a problem or not unless it is raised with them (it may well already be known to them?)

 

Yes, I'll certainly get them involved now, as I have run out of options. It would have been nice if the HPC could have dropped the insurance company a line, just to let them know the importance of HPC registration. Why spend all that money on public campaigns, if you aren't going to let insurers know who you are too?

My patient (now ex-patient) is totally confuzzled by the whole thing, and thinks I am not fully qualified.

 

Here is another insurance company probably don’t know the legal term of CHIROPODY TREATMENT or the existence of HPC.

HEALTHSHIELD from 1st Jan 07
Under the heading of CHIROPODY TREATMENT accepted qualifications are foothealth profession, foothealth professional, well according to HPC’s rule implying or providing chiropody/podiatry treatment is against the law.

Now what are HPC doing? I guess nothing; the HPC is quick on allegations those who are registered with them.

 

Hi victoriah

There is no such thing

If that is in their paperwork, it is illegal under advertising standard at the very least as you cannot insure someone for treatment by a non existent practitioner.

The HPC should put the insurance company right on that one.

I have had my "premises" knocked back by an insurance company !!

The were not interested in who was the practitioner but told the patient "as my premises was not registered with them they would not cover the claim"

I have given up getting involved now and just tell the patient to check with their insurance company before making the appointment with me.

I either see them or not as the case may be.

I usually tell the patients beforehand "you will probably find you are insured for everything, except making a claim"

Nothing new there then

Cheers

Derek

 

This is the thing, though: there are several non-HPC 'foot care' folk in the local area, who call themselves chiropodists, but who are not HPC-registered. That they get their receipts honored, and that I don't (because I call myself a podiatrist), is a real insult.

ETA: It does make me wonder what criteria the insurance companies look for when processing receipts. As it happens, my HPC number counts for nothing at all. As I said before...what's the point of being registered?

 

Victoria

If you have written proof of that then the HPC have no choice but to act, Those concerned are breaking the law.

Neither did mine, they were only interested in my PREMISES not being registered.

Look back at many threads in this forum and others. You will see many of us feel the same way

Perhaps a review of the situation from our side ??

Podologist seems a good word ,and has no Taurean Excrement attached like the HPC

Cheers
Derek

 

This is exactly why I am confused. As I understood it, if you use a blade, you *have* to be HPC registered, and you have to call yourself a podiatrist. I thought chiropody was an outmoded term.

Yet my local phone book is full-to-bursting with folk called Chiropodists, many not HPC registered, and many of whom use blades. Indeed most use the 'SRCh' after their names. I thought the name 'State registered chiropodist' was a total misnomer: there being no State registration, and no such thing as chiropody.

And now this insurance business has really taken the biscuit. I'm as confused as my ex-patient!

 

Hi Victoria

The protected titles are Podiatrist AND Chiropodist

Any practitioner using either or both these titles MUST be registered with the HPC.

The SRCh is the "old guard" that wont let go of the terminology which is in fact defunct, as is the term "State Reigistered Chiropodist"

If this is as you state, please notify the HPC in writing and let us all know the outcome.

They make the bloody rules lets see if they enforce a blatant breach of them??

Cheers
Derek

 

Hi Victoria
I have every sympathy with you- the whole situation is a farce.
The names chiropodist and podiatrist are interchangeable- another problem that will never be sorted! The public are totally confused over that one!

i think you will find that foothealth professionals are quite entitled to use a blade , its just that a lot of them do not, probably due to lack of training or confidence? I have had patients in the past that have had corns filed!

Please do report misuse of title to the HPC-it will take them a long time to reply and I gather that they have yet to bring a successful case against the offender. but it does give one a good feeling to blow the whistle in the cause!

Regardng insurance-heres a good one. I do nail surgery and believed I was covered by Bupa- it turns out I am only partly registered with them, not sure which part of me that applies to- I cannot carry out nail surggery unless the patient has been referred by a consultant orthopoedic surgeon!
A GP referral does not count. The joke is that orthopoedic surgeons will carry out the op themselves at a vastly inflated price! The other option is that the consultant watches over me while I do it! I dont think so huh?

I agree with the suggestion that you contact the society and let them take it up.
regards
heather

 

Hi Heather et al

I de registered with them for the same reason

One minute we were then we were not then we were temporarily.

In the finish I told them to cancel any registration with them because the work and confusion involved did not merit the financial outcome.

They are like "direct Line etc" they have their own repairers (practitioners) who work at a set rate.

The free market does not apply

I should say "I have not missed or regretted leaving them".

Their loss not mine

Cheers
Derek

 

Hi All
Some insurance companies will pay for podiatry and some wont. Depends on the policy limitations. Patients must always enquire first and be referred by their GP , sometimes they also require procedures are confirmed by medical or surgical consultants , depending on the condition. The podiatrist must also be registered with the insurance companies to stop fraud. BUPA have a requirement of 5 years post registration.. The work must be undertaken by a consultant podiatrist, or you must be working with a consultant.

HSA and other orgs that pay for routine podiatry, dental optical , differ from health ins companies as these are only part funding treatment usually up to about £300 a year, and pay for 50% of the expences. HPC registration is normally a requirement, if you know otherwise please let us know at the society of Chiropodists and Podiatrists..

We are trying to expand cover by BUPA PPP etc, however it is a slow process, but we are in talks..

More people that let us know they have problems the more push we have with the insurance companies..

Michael O`Neill

 

Hi Michael

.

I actually do work with a Doctor "clinical associate specialist" in A & E who ran the regional toe clinic ,trained pods in nail surgery for over 20 years.

He does my nail surgery which has worked well for 20 years.

BUPA covered us ( we do post op repairs for them) for a long time and suddenly they had a reorganisation and we got into the now you are now your not situation.

If as it would appear you are suggesting that any nail surgery can only be done by " A Consultant Podiatrist" ( whatever one of those are ) (Explain please ?)

Then the world really has gone mad.

Nail surgery is a relatively simple procedure with minimal risk to the patient, BUT required a degree of knowledge and experience to have a successful outcome.

Err we are supposed to be bound by a code of ethics and behavior as laid down by the HPC.

Should our registration # and available check on the HPC web site not be adequate evidence, or do we now have to register with every insurance company in the country many that have been shown here to have no knowledge of the regulatory body or it's principles??

Cheers
Derek

 

the law is protection of title, not function

you can hack away to your heart's content and not be HPC reg provided you don't call yourself a podiatrist or chiropodist

 

[/QUOTE]you can hack away to your heart's content and not be HPC reg provided you don't call yourself a podiatrist or chiropodist[QUOTE]

Just to let you know that I am a Foot Health Practitioner and I have received comprehensive training at the College of Foot Health Practitioners in Blackheath UK. I am a member of the Alliance of Private Sector Practitoners and I am fully insured. I have been qualified to undertake treatments since October 2005, and I have built up a thriving and professional business. I am not some kind of "quack" which seems to be inferred in above comments and elsewhere. You may also be interested to know that the Alliance members include Podiatrists and Chiropodists who have elected to register with this professional body instead of the HPC, for whatever reason.

Anyway, in response to the above views. I have treated many pairs of feet which have in fact been treated in the past by Chiropodists, and my patients have told me that I do a better job and there are some horror stories of Chiropodists work. The same could be said of other practitioners too of course. I suppose the point I am trying to make is that just because someone is not HPC registered does not suggest that they are not qualified and as competent to undertake foot treatments. My exeprience is that they can be better!

Going back to one of original points that was being voiced re: private medical insurance claims. In my experience patients have been unsuccessful in having receipts reimbursed, because I am a Foot Health Practitioner. The Alliance have been fighting this point for some time now and I look forward to a change in the policies of such companies. In my opinion if you are trained/qualified as a professional practitioner then a patient should expect to receive reimbursement from their insurers.

 

Foot Health Practitioner.

As ever with anyone associated with the Alliance you remain anonymous.

Your post adds nothing to this debate. As a FHP, most companies offering reimbursement for fees do not recognise you.

There are two types of 'insurance', BUPA et al who reimburse for recognised treatments with no upper limit on fees, and saving funds like HSA who are like a Christmas saving club.

I think victoriah should name the company she is having problems with.

The HPC can be called to account if non registered practitioners are being reimbursed for Chiropody/ podiatry treatments.

The Society needs IMO to be more proactive.

However the British Podiatry profession does not recognise your qualifications.

What you choose to do is up to you, unfortunately the advent of the HPC did not close function.

Bob Golding

 

Hi Foot Health practitioner

Then they are NOT Chiropodists & Podiatrists as you MUST be registered with the HPC to use those titles.

If they once were practicing under those titles and decided to de-register then the can only use the same title as you ( or similar)

If the Alliance is wording their membership claims on the same lines as you they are in fact breaking the law.
Cheers
Derek

 

I didn't know that! That *anyone* calling themselves a 'foot health professional' can happily hack away with a scalpel (with or without adequate training) is frankly rather scary. What exactly defines a 'foot health professional', anyway? I guess anything from a three year degree to a correspondance course...

 

Thanks, Bob. The company in question is Western Provident Association.

I'd like to thank all for responding to my questions. I felt a bit daft for posting such basic enquiries, and for being so ill-informed about the whole insurance system...but now I'm so very pleased I did!

It's even more of a minefield than I imagined.

 

One of my patients is on the board of the HPC, as one of the leading lights of one of the other HPC professions. She has told me that non-HPC practitioners within her discipline have indeed been sued for misue of their job title.

I wonder why it hasn't yet happened within our's, given the mess it's in?

 

Hi Victoriah

Lack of interest on the part of the HPC I would think ??

They have created a " bag full of holes" when it comes to regulation of this profession

The opportunity was there to " close the door and standardise" but they chose to regulate without the foresight to understand the implication of their actions.

They are the proverbial toothless tiger as anyone can de-regulate call themselves what they wish with no controls whatsoever

Look through this site and you will find numerous threads with the same ultimate conclusion.

Sad innit

Cheers
Derek

 

Need to bring some stability to this thread.

Alliance members do not always seek to remain anonymous, any more than R.E.G (whoever that is!).

Chiropodists and Podiatrists can and do hold Alliance membership, and the Alliance fully represents them (to the HPC and in many other ways) as any other professional body would (and probably better).

It is my understanding that FHPs trained at the College of Foot Health Practitioners receive scalpel training from the only published formalised scalpel training programme specific to work on the foot that is available. Their skills with the scalpel may be higher and better taught than yours.

I would wish to advocate caution to Foot Health Practitioner (and others) against making statements on matters s/he does not understand.

 

Sad, indeed, Derek.

What's worse is that I myself have undertaken time and energy to try to educate patients on the significance of being a podiatrist, and have informed them on our scope of practice...diabetes, biomechanics, rheumatology, and so on. I have had these conversations often several times a day, tiring though it is. I have banged on and on about the importance of HPC registration, even though not a single patient has heard of them.

What's the point of all that, if insurance companies do not acknowledge our expertise? What's the point if any old bod with a blade can be out there practising?

This whole thing is *really* depressing, and I am seriously wondering why I bothered with it at all.

 

I am guessing this programme is not three years in duration?

In which case, given that FHPs have possibly better scalpel skills than myself (first class degree notwithstanding)...perhaps I should have trained as an FHP and not a podiatrist?

 

Hi Johnpod

My point exactly

Cheers
Derek

 

Hi Victoriah

I

But I bet they all know the "cheapest" footcare available in your area ??

Oi !!

A word of advice ( from an oldun) DON'T confuse academic skills with clinical skills the two DON'T necessarily go together

Cheers
Derek

 

Thanks, Derek. First class degree certainly does not guarantee first class dexterity. Neither does an academic degree assure practical abilities in this predominently practical occupation. I might go further and suggest an inverse relationship.

However, to return to the subject of the thread, prior to HPC some insurance companies recognised private sector chiropodists and some required state registration before payout. Nearly all insurance companies used the HPC introduction as an excuse to further restrict numbers of reimbursements and therefore retain greater profit.

By the time a client has paid the insurance premium and then expended effort and postage on a claim form it is doubtful whether the exercise to obtain return of half of our fee is actually worth their while. Do we really need clients who are so poor that they feel they have to do this? Alternatively, ask yourself 'are our fees really so unrealistic that some clients need assistance with meeting our fees?'

 

Hi Johnpod

.

As I said earlier " You are insured for everything, EXCEPT making a claim

Cheers
Derek

 

I think that's a really good point.

ETA: I spoke to the insurance company again today, who state that they will honour the receipt if it has 'chiropody' and not 'podiatry' on it. Even though I am not a chiropodist.

Thunderous silence so far from the Society on this matter, though.

 

I know that this is slightly OT...but I found this quote from andy on a related thread (hope you don't mind me quoting you here, andy):

So I am officially confused again! These folks who are treating my ex-patient (and who have their receipts honored by WPA)...they use a blade, but are non-HPC registered: are they or are they not breaking the law?

From what people have said on *this* thread, it's all about what you call yourself (protection of title), but the above quote suggests differently.

Sorry to need further clarification here, but it seems I may have been misleading many of my patients, and badmouthing non-HPC practitioners for no reason, if they are not in fact practising illegally

 

Does this mean you have left a message and not been acknowledged? I can assure you wheels within the mechanics of SCP are already turning on this one as it is negative PR for the whole profession of Podiatry. I also understand a member of SCP council has tried to contact you privately on this matter. I am sure the other professional bodies have also picked up on this as well and are advising their members accordingly.

It shows how important sharing such information is and I thank you for doing so.

Personally I feel that whoever was dealing with your patient's claim was rather lacking in knowledge, and perhaps the brain cell department, and genuinely had not recognised the word "Podiatry". To avoid this confusion ever causing you loss of custom again, I trust you now realise Chiropody is the UK accepted description of our profession and is wisely included somewhere on all receipts submitted to insurance companies.

This is Andy Miles opinion and not fact. Anyone can buy, sell, use on themselves and on the public a scalpel (for a fee). Only title is protected and not function. Apparently functional closure would limit development of the profession in the future. This is also opinion but not mine.

As far as HPC registration and educating the public goes, how about trying out the word regulation on your patients? They seem to understand regulation and regulatory bodies far better. It has lead onto many very opinionated soap box sessions about The Shipman Enquiry (because this is what initiated the need for increasing regulation to the medical profession) and how the world is going mad. What ever happened to common sense? But it is a great opener to get in about your standards and conditions of practice and why you must charge £35 for your initial assessment because its the law you know. If you don't do this, like this and this you're breaking the law.....

GB

 

Victoria,

Andy's quote may well be a statement of opinion but is not fact.

The legislation under which the HPC operates is clear, it covers the titles Chiropody and Podiatry and more generally people passing them selves off as Chiropodists of Podiatrists.

One could argue that FHPs by performing the acts normally associated with Chiropody are 'passing themselves off' thus acting illegally. This must be tested in Law. I cannot see anyone doing that. It is not the responsibility of the HPC. All bodies other than the SCP are closely associated with FHPs and their trainers. The SCP are unlikely to go to Law for a number of reasons, it would not be a simple case and likely to be very expensive, they, via their support for the NHS use of Foot Care Assistants, are also involved with FHPs, the SCP has a policy of not wishing closure of the profession, ie protection of function.

As far as WPA honouring claims from non Chiropodist, this is illegal, and you are within your rights to ask the HPC to intervene. I know that SMAE warn their FHPs NOT to give such receipts. I have to acknowledge the professional bodies in the main have complied with legislation, SMAE with its new qualifications letters and membership body and the Alliance being only of Private Sector Practitioners (not of what). Do not know what the Institute has done. The Society could be criticised by allowing non registered Associate members to use the letters AChS.

The Society originally did not want to get involved with complaints to the HPC but now encourage individuals to complain to the HPC and advise them of the complaints. The HPC are not obliged to deal with any of the bodies, they are seen in a very different light. Complaints to the HPC are acknowledged but the out comes are not.

Not sure I agree with Johnpod's analysis of his patients finances!

As far as Chiropody vs Podiatry, there is an official SCP press statement that explains this, and the terms have been vigorously debated at the Society ADA, however the general opinion is they are completely interchangeable.

To be pedantic about your title hence making your client's claim ineligible seems nit-picking and unproductive. (No offence meant).

So all in all a fairly messy situation?

Bob

 

"As far as WPA honouring claims from non Chiropodist, this is illegal, and you are within your rights to ask the HPC to intervene" (R.E.G.)

No, REG, it's not illegal at all! WPA could honour claims from whomsoever they wish. However, I agree that claims for chiropody treatment should be accepted only from Chiropodists. Patients attending FHPs could claim for 'Foot Health'. Insurance companies could, if they wished, offer their clients a new benefit!

As for the legality of FHPs delivering chiropody you have to understand that the Health Bill 1999 (from which the present situation springs) allowed 3 options:
1. to stop practising
2. to accept registration and gain legal title to the title(s)
3. to continue under any other title if choosing not to accept registration.
FHP is the 'any other title' that the unregulated have chosen. It represents a remarkable degree of unity.

Interestingly, look how many FHPs have signed into PA in the last 24 hours. They are all around you and will not be going away. Some of them may even belong to the Alliance (anonymously of course)! They're behind yooooo!

 

Thanks, George, for that very informative post. It has cleared up a lot of questions for me.

I have indeed been in contact with an SCP council member via PM on this board...but I haven't had any response to my enquiry directly from the society itself.

 

Thanks, Bob...again I am very pleased to have posted on this matter, and I feel a lot better informed about the situation thanks to responses such as yours.

I genuinely believed that having received a BSc Hons in Podiatry, I should call myself a podiatrist. I assumed (mistakenly) that Chiropody was an outmoded term that would eventually die out, as more and more folk got used to using the term 'Podiatry' instead.

I think it's probably best that I do use the term Chiropody instead from now on...whenever I call myself a podiatrist I nearly always have to go through a lengthy explanation of what that is, why I am not a chiropodist etc. And now I risk kerfuffles from insurance comanies, too...so I agree, for the sake of a quiet life, from now on I will refer to myself as a chiropodist...given that they are one and the same.

I may even coin the phrase 'State Registered Chiropodist'! Well, if you can't beat 'em, join 'em, eh?

 

Johnpod

You say


No, REG, it's not illegal at all! WPA could honour claims from whomsoever they wish.

However, I agree that claims for chiropody treatment should be accepted only from Chiropodists.

So what I said was true?




Patients attending FHPs could claim for 'Foot Health'. Insurance companies could, if they wished, offer their clients a new benefit!

They could but they do not.


As for the legality of FHPs delivering chiropody you have to understand that the Health Bill 1999 (from which the present situation springs) allowed 3 options:

1. to stop practising
2. to accept registration and gain legal title to the title(s)

If they qualified for registration

3. to continue What under any other title if choosing not to accept registration.
I would not have called it an intended option, but a loophole that has been exploited.




FHP is the 'any other title' that the unregulated have chosen. It represents a remarkable degree of unity. This of course is nonsense.

Interestingly, look how many FHPs have signed into PA in the last 24 hours.

This of course is impossible to calculate as this site allows pseudonyms.


They are all around you and will not be going away. Some of them may even belong to the Alliance (anonymously of course)! They're behind yooooo!

OK you do not have to declare your name but how about giving us your qualifications.

Victoria,

You can only call yourself State Registered if at some time you were, however it is frowned upon.