Dan Gottry - Blog

Dan Gottry's Blog

Friday, December 01, 2006

Is CIGNA Really Getting What it Pays For?

FYI ... I asked a friend (CPO) who had responded to me about David Sharma about the requirements and the actual situation and he responded with the following:

"David Sharma works at that office independently as the sign on the front door states. More so his name on the sign does not have credentials. It is my understanding this has been the case since their previous Certified Orthotist David Garcia has left Phoenix and was transferred to Yuma."

"We have a patient who was serviced by David Sharma, she was evaluated by him, casted by him, delivered by him, and was back for numerous adjustments by him. I have specifically asked her about this and she said she was never seen by anyone else in that office."

"Per Linkia's own words and per ABC requirements, a resident can only work directly under an ABC certified practitioner. Per my understanding and how I run a business, that does not mean someone in the building or down the road, that means directly under, or side by side, or shadowing, or assisting... in no way do I see independently as appropriate."

"The bold message states "David Sharma is not certified", that means he is a board eligible resident which per law mandates him to residency requirements. Maybe a call to ABC and NCOPE (National Commission of Orthotic Prosthetic Education) to verify this structure is needed. NCOPE's job is to monitor O&P residents and set their formal guidelines. Davis Sharma is not following the residency guidelines."

I agree that there is certainly "intent" in the requirements that is being skirted by Hanger.

I know a little more about this individual's situation. She was sent to my contact by her physical therapist who found that the device that Mr. Sharma created was so poorly fit it was hurting rather than helping her. She did not tell him anything the therapist said to see if they were in agreement ... when he gave her the same information, she then shared what the therapist has told her. Certainly appropriate supervision would have prevented that issue.

posted by Daniel Gottry at 7:22 AM