Insurance conundrum - comments appreciated

Re: Insurance conundrum - comments appreciated

salome2001 — Mon, 07 Jun 2010 21:28:36 GMT

If I didn't do it, I don't sign it. End of story. Might p*ss off clients (especially those who've been told by the OOH provider that "your regular vet will sign it all") but at the end of the day, it's my MRCVS on the line.

Re: Insurance conundrum - comments appreciated

Richard Allport — Thu, 27 May 2010 22:43:57 GMT

Vets who use homoeopathy (such as myself) are under exactly the same obligations as any other vet to abide by ethical and legal rules. I will only treat patients if I have the agreement of a referring veterinary practice and copies of the clinical notes.

If a client does not live within reasonable travelling distance of a vet practising homoeopathy I will occasionally treat without actually seeing the patient, but only if I have a telephone or e mail consultation with the owner, and again only with the agreement of a referring practice and full clinical notes. I always make the client aware this is not likely to be as satisfactory as seeing the patient, but if the alternative is the pet being 'treated' by a lay, non veterinary homoeopath, then I believe my intervention is preferable.

I always complete any insurance claims for my treatment myself, and wouldn't expect the referring practice to do so.

Naturally I can't speak for other vets who practice homoeopathy, but I believe this would be the stance of the vast majority of my homoeopathic colleagues.

Occasionally a 'non client' will call and ask to purchase a particular homoeopathic product 'over the counter'. Since these are available OTC from pharmacies and direct from manufacturers anyway, and are not POMs, I see no difficulty in selling the product in question, but will not provide details such as dose rates or usage, and would not fill in an insurance form in such a case.

And finally, fees. £60 sounds a bit of a homoeopathically tiny fee to me, I can't be a true homoeopath because my fees are far more than that!

Re: Insurance conundrum - comments appreciated

Niall Taylor — Wed, 26 May 2010 19:21:25 GMT

[quote user="alex gough"]it is probably ethical and required of me, if this other vet is treating a patient I am seeing, that I inform him of the history and current treatment.[/quote]

Well, the 'other vet' is supposed to ask you for the history, it's not up to you to track him/her down to ask if (s)he'd like one after the event!

Niall

Re: Insurance conundrum - comments appreciated

Alex Gough — Wed, 26 May 2010 16:33:07 GMT

Well it is probably ethical and required of me, if this other vet is treating a patient I am seeing, that I inform him of the history and current treatment. I sent him a letter dated today giving a short history and saying that I am happy for him to see the dog for treatment with any complementary medicine that he thinks would be helpful. I was going to use the word effective rather than helpful, but thought that might unfairly restrict his options!

Alex

Re: Insurance conundrum - comments appreciated

Hannah Wynne Richards — Wed, 26 May 2010 13:55:27 GMT

Alex I wouldn't even do that,If the client asks you in future to refer to a homeopathic veterinarian, then obviously you can do so, if you feel that that would be in the patient's interest-but in this case, since they chose to refer behind your back, and the homeopathic veterinarian chose to behave unethically, then all you can possibly do is say the truth-that it was nothing to do with you-if you lose the client-do you really need/want someone who goes to another veterinary surgeon behind your back ?

Wynne

Re: Insurance conundrum - comments appreciated

Bob Russell — Wed, 26 May 2010 12:05:06 GMT

I can do magic water and sugar pills for £55 if there are any takers. I do not have any special training or proof they work but I can stick a stamp on a jiffy bag and know that my placebovet will 'help' about a third of animals according to their owners and will cure up to 100% of temporary minor ailments!

My phone number is 02380................. and I take cheques, credit cards and cash.

I will complete a claims form for £5.00 extra! Oops that makes it £60!!!!!!

Am I a lonely old cynic?

Re: Insurance conundrum - comments appreciated

Alex Gough — Wed, 26 May 2010 11:54:57 GMT

Thanks for the advice, but dont worry, if I wouldnt sign an insurance form for someone else's treatment, I certainly wouldnt falsify a referral letter! i was intending to write something along the lines of a case history, and I am happy for the other vet to also see the case for alternative therapy if the client wishes, but I wasnt going to apply anything retrospectively! Really it's the client's and the homeopath's problem, not mine, and the client fortunately understands this.

Alex

Re: Insurance conundrum - comments appreciated

Kate Richardson — Wed, 26 May 2010 11:12:16 GMT

[quote user="Niall Taylor"]

There was a case a few years ago where homeopath Chris Day was charged with causing a dog unnecessary suffering after treating it long term with homeopathy for exsema when he had only seen it once at the begining of the treatment (the rest was done by telephone). The dog ended up in quite a state apparently and the RSPCA took him to court. He was acquitted "without a stain on his character" according to the judge and as far as I know the RCVS never made a response, so apparently homeopaths are allowed a far greated degree of laxity than other practitioners regarding what constitutes an animal "under their care".

[/quote]

God bless the RCVS.....

Re: Insurance conundrum - comments appreciated

Laurence Webb — Wed, 26 May 2010 10:55:24 GMT

[quote user="Peter Ding"]

Is your MRCVS only worth £60?

Without wishing to sound harsh, is this not only false certification but also fraud?

Might i suggest in any "referral letter" that you should clearly indicate that you did not refer the case at the time as the vet failed to follow normal ethical guidelines , but had you been asked you would, in all probability, have been happy to do so.

If that is the case of course!

In any case why do you now need to write a referral letter?

To cover the backside of the other vet, or to facilitate a claim? I doubt insurance companies would repay two vets fees if both were treating the same condition completely unaware that it was under treatment elsewhere.

Make sure you charge an appropriate fee if you do decide to assist the owner!

[/quote][quote user="Peter Ding"]

Make sure you charge an appropriate fee if you do decide to assist the owner!

[/quote]

I reackon about £60 should cover it

I do agree that, whist you may choose to write a referral letter so the client can get future homeopathy treatment covered by insurance, I can't see how you can do it in retrospect. It sounds like you're being asked to cover the arse of the other vet who failed to contact you about seeing the case, failed to take a history or examine the dog and now is failing to take adequate responsibility for the case.

Re: Insurance conundrum - comments appreciated

Peter Ding — Wed, 26 May 2010 08:56:15 GMT

Is your MRCVS only worth £60?

Without wishing to sound harsh, is this not only false certification but also fraud?

If that is the case of course!

In any case why do you now need to write a referral letter?

Make sure you charge an appropriate fee if you do decide to assist the owner!

Re: Insurance conundrum - comments appreciated

Vikki Halliday LLB — Wed, 26 May 2010 08:46:36 GMT

But you didn't refer the animal, therefore to write one after the event is a falsification!

Re: Insurance conundrum - comments appreciated

Niall Taylor — Wed, 26 May 2010 08:46:33 GMT

[quote user="Peter Ding"]Can vets dispense homeopathic remedies without examining the patient and avoid an accusation of professional negligence?[/quote]

The problem with the disciplinary process as it stands is that charges must be brought by the owners of the animal in cases of negligence; it is not possible for a VS having seen an animal caused suffering through having been treated homeopathically to bring this to the attention of the RCVS without the cooperation and consent of the owner. And of course by the time such a prosecution might be warranted the homeopath has spun a fabrication about homeopathic "aggravations" or "suppression" by allopathic medicines and persuaded the owner that there is no case to answer.

Niall

Re: Insurance conundrum - comments appreciated

Alex Gough — Wed, 26 May 2010 08:06:48 GMT

Well, client has now agreed that homeopath should sign the form. I have to write a referral letter which slightly goes against the grain, but should sort the situation.

Re: Insurance conundrum - comments appreciated

Gillian Mostyn — Tue, 25 May 2010 22:15:32 GMT

I would just get the client to ring their insurance company and discuss the circumstances. I doubt they would expect or want you to claim for it - and that will hopefully solve the problem...

Re: Insurance conundrum - comments appreciated

Kate Richardson — Tue, 25 May 2010 22:03:04 GMT

If thats the case why won't the homeopathic 'vet' sign the insurance form?

Re: Insurance conundrum - comments appreciated

Alex Gough — Tue, 25 May 2010 21:52:20 GMT

As I understand it, a vet is allowed to supply GSL products to animals not under his care, and homeopathy comes under GSL. Or have I got that wrong? It may be dubious ethically to do so, but it still falls within the letter of the law right?

Re: Insurance conundrum - comments appreciated

Alex Gough — Tue, 25 May 2010 21:48:40 GMT

[quote user="Mike Martin"]

Out of interest, how much was the homeopathic treatments, that the owner wishes to claim?

[/quote]

I think it was in the region of 60 pounds? Nothing huge.

Re: Insurance conundrum - comments appreciated

Peter Ding — Tue, 25 May 2010 17:55:40 GMT

As far as I am aware you are only obliged to assist the client in reclaiming the cost of veterinary fees. if the client wishes to purchase thier own choice of GSL Glucosamine from somewhere else e.g the internet or a shop then there is no claim.The client does not need you and can purchase it anyway as many do.

It is therefore not a veterinary expense. If you write a prescription it is then sanctioned by you and it becomes a veterinary expense.

Re: Insurance conundrum - comments appreciated

Vikki Halliday LLB — Tue, 25 May 2010 17:43:21 GMT

[quote user="robloxley"]How many people have clients buying glucosamine on the internet and wanting to claim on their insurance, where no prescription is needed but the vet is required to sign off the claim? [/quote]

None. If they want to claim it I prescribe Synoquin, or a similar named glucosamine marketed for animals. If they want to buy it from the internet, I will give a prescription, but again for a named brand. I would never sign off a claim for owner purchased, dubious source, internet glucosamine.

Re: Insurance conundrum - comments appreciated

Rob Loxley — Tue, 25 May 2010 17:39:38 GMT

[quote user="Laurence Webb"]I can't remember the correspondance, but there is a difference between a vet supplying a written prescription for medication, then helping to submit a claim for the cost of the medication and a vet submitting a claim for medication that he has neither prescribed or recommended.[/quote]

How many people have clients buying glucosamine on the internet and wanting to claim on their insurance, where no prescription is needed but the vet is required to sign off the claim? A similar situation, again I can't remember the exact wording of the RCVS comment at the time, but thought it might be relevent to look up, or as I suggested contact the RCVS for specific advice in this instance.

If the issue comes down to the insurance company wanting to know who recommended this treatment, and Alex didn't, then it seems that it's for the other vet to sign the claim form as having recommended the treatment.

FWIW I've had little joy from the RCVS with regards to homeopathic vets not examining animals before dispensing remedies.

Re: Insurance conundrum - comments appreciated

Laurence Webb — Tue, 25 May 2010 14:49:36 GMT

[quote user="robloxley"]Did something similar not come up about a year ago in the letters pages of the Vet Record with regards to signing insurance forms for internet-supplied medicines, but I can't immediately remember what the RCVS exact reply was.

[/quote]

I can't remember the correspondance, but there is a difference between a vet supplying a written prescription for medication, then helping to submit a claim for the cost of the medication and a vet submitting a claim for medication that he has neither prescribed or recommended.

Re: Insurance conundrum - comments appreciated

Rob Loxley — Tue, 25 May 2010 13:50:55 GMT

Did something similar not come up about a year ago in the letters pages of the Vet Record with regards to signing insurance forms for internet-supplied medicines, but I can't immediately remember what the RCVS exact reply was.

Would however agree in this case that the 2nd vet should fill in his own insurance claims, on his own time, not yours. I'd agree that if the animal needed to be 'under his care' to fill in the form, then surely it needed to be 'under his care' to make a diagnosis and provide treatment??

Maybe you need to get in contact with the RCVS for some advice?

Re: Insurance conundrum - comments appreciated

Stephen Ashman — Tue, 25 May 2010 13:22:29 GMT

[quote user="Evelyn Barbour-Hill"]Then I fear you have to explain tactfully to the owner that this is nothing to do with you and you cannot "sign for" the homeopath's treatment...... that would actually be false certification. The owner may accuse you of refusing to sign because you are anti-homeopathy, and it will be uncomfortable perhaps, but if the owner gets cross with anyone for not signing it should be with the homeopath.[/quote]

I agree with this. It may help to say that you would not sign for someone else's treatment whether homeopathic or not, if it comes up.

Re: Insurance conundrum - comments appreciated

Mike Martin — Tue, 25 May 2010 13:16:49 GMT

Out of interest, how much was the homeopathic treatments, that the owner wishes to claim?

Re: Insurance conundrum - comments appreciated

Vikki Halliday LLB — Tue, 25 May 2010 12:36:22 GMT

I'd have to agree with Peter on this if this Homeopath is a vet, they are guilty of supercession and I would have nothing to do with a claim on the insurance for homeopathic remedies.

If he is admitting he has not seen the dog, he could be in very hot water indeed!