Ortho Pro Physical Therapy

07/01/2019

Attn:Anthem / Blue Cross Patients

We were informed by Anthem/BC only last week that any PT on or after 7/1/19 would need pre-authorization from their subsidiary AIM.
The AIM "portal" has been in-accessible since last week and through today. We have had to cancel all Anthem/BC patients till this is resolved. Your choice is to pay out of pocket for your visits or simply wait.

The bigger picture is why should your insurance company determine how much therapy you should get? Shouldn't a medical decision be made by a medical professional?

If you want to complain or discuss this here are your options

DMHC - CA Dept of Managed Health Care

DMHC has indicated that the patients should file a complaint against Anthem so they create the necessary paper trail.

So, here is a simple list of what should be done:

Patient Complaints:

Step 1:
Call, Fax or Email DMHC Today:
DMHC Help Line 888-466-2219
DMHC Fax: 888-466-2219
DMHC email: stakeholder@dmhc.ca.org

Key Facts to Relate:
This is URGENT as lack of pre-auth is blocking care
Not receiving care impacts my health negatively
My doctor & therapist believe further care is medically necessary NOW!

Step 2:
File a Formal Complaint to Anthem:
Call customer service number on the back of your card
Call 800-365-0609
866-333-4823 for hearing impaired
Request expedited review process as a delay in decision-making may seriously jeopardize their ability to regain maximum function
Anthem Grievance Process link:

Visit Anthem Blue Cross for group health insurance plans in California

05/23/2019

Thank you to everyone who came to the clinic on monday, but a BIG thank you to Jennifer Sunahara for bringing HOKA ONE ONE to our clinic. We learned a lot about the Hoka shoes, and which shoes would be better for trail running or on the street.
Also thank you, Jeff Waldberg, for a great presentation on how to prevent running injuries.

02/11/2019

"INJURY PREVENTION ON & OFF THE BIKE" Want to become a better, less injured cyclist, optimize you to your bike, and improve your flexibility, strength and fitness? On Wednesday March 6, 2019 6:30 pm I'll be doing a lecture at JRA Bikes and Brew in Thousand Oaks, along with shop owner and bike fitter Vince Gest. I will discuss optimal vs poor bike posture, muscle flexibility and stability and why each is important and show corrections. Vince will discuss the "hows and why's" of optimal bike fitting and how it benefits the rider. There will be a Q & A session at the end of our lectures. More to come..
JRA Bikes & Brew

11/15/2016

New Info on Celebrex – It’s Safe and Effective!

Back in 1999 two new non-steroidal drugs came on the market, Vioxx and Celebrex and they became blockbusters in their usefulness and sales. They were similar to Advil and Aleve but stronger and better and did not cause gastro-intestinal bleeding or ulcers.

But then in 2004 Vioxx was pulled off the market due to findings that it increased the risk of heart attacks. But Celebrex remained available although many have worried that it too had similar unwanted side effects.

For the entire abstract follow this link:
http://orthopropt.com/new-info-on-celebrex-its-safe-and-effective/

Read the full article here: http://www.nytimes.com/2016/11/14/health/celebrex-is-found-to-be-no-riskier-for-hearts-than-other-pain-drugs.html?_r=0

A question has long hung over Celebrex: Did it cause heart attacks? Now, a clinical trial suggests it may be safer than drugs like ibuprofen and naproxen.

11/10/2016

The Latest Research.. Moderate Exercise Could Help Older Adults
In a recent trial, researchers at Yale compared moderate exercise to health education in 1600 participants age 70-89 who were not disabled but were considered sedentary and had some physical disabilities.
The study lasted 3.5 years and the participants were picked because they were unable to walk a quarter mile.
During the 3.5 year period, the research found that compared to the health education program, the moderate exercise program participants had a 25% reduced recovery if they did become disabled and were less likely to become disabled than the other group.
This study further strengthens the argument that exercise not only prevents disability in older adults but shortens their improvement time in case disability or accidents do occur.
(from the Annals of Internal Medicine)

http://orthopropt.com/the-latest-research-moderate-exercise-could-help-older-adults/

11/08/2016

While running is fairly pure, and by that I mean it’s easy to get out and and just “do it”, it is not without injuries.
And yet, while the most important piece of equipment may be your shoes, (and of course how you use them) there are things you can own that will help you fend off injuries.
Follow the link to learn more.
http://orthopropt.com/three-tools-all-runners-should-have/

11/04/2016

I’ll be doing a bike injury clinic later this month.. The date has not been officially set but will be either in the next few weeks or early December.
I’ll be talking about the most common injuries and painful conditions cyclists experience. JRA Bikes & Brew owner Vince will be talking about optimal bike fit and optimal riding form.
I’ll post again when we have an exact date.

11/03/2016

Fall - Time for Leaves to Fall and Patients to Save Money

As I’ve tried to write every fall, this is the time of year to save your medical dollars.

Here’s why..
If you’ve met your deductible your insurance will probably pay at their highest level for your treatment. This means less out-of-pocket money for you. If you wait till January the deductible starts from scratch and you’ll be paying out-of-pocket before your insurance kicks in.

If you are a medicare patient the same is true but the other factor is that medicare only allows a limited number of visits per year. That number starts January 1st and ends December 31st.. And the visits from the current year do not roll over into the next year. If you start your treatment this year you may have more overall treatment visits. (this years and next years)

If you need physical therapy this is the best time of year to use it. Don’t let those visits go to waste and don’t let your medical dollars slip away. Take care of your problem NOW versus waiting till after January 1st.

10/31/2016

No need for tricks we know how to treat you. Come on in! We dare you👻😈🎃 Happy Halloween from the Ortho Pro Family