PI Email Alert - Feb. 12, 2018
 Shawn Steel & John Tawlian
In This Issue
How do insurance company reviewers decide which chiropractor to audit?
Among the greatest concerns busy doctors have is the POST payment audit. Dr. Lewkovich tackles the questions what criteria Auditors use to investigate.
Post payment audits is a financial bonanza for carriers. Doctors react too quickly and pay bizarre amounts unnecessarily - without a sober overview. Auditors however, choose targets that are supposed to bring a high rate of return. The Rule is that for every $1.00 spent for auditing, the audit should bring back $5.00.
That's important to know. Auditors will not chase a tough target.
Some of the criteria used by Auditors include: 
  • Unusually high per treatment costs
  • Extreme frequency of care
  • Number of total visits are very high
  • Daily use of E & M codes not appropriate
  • Daily use of cold packs
  • Using 99215
For the complete Problem Treatment Areas CLICK HERE TO EMAIL JOHN
for your copy.
 NEW Shawn Steel PI Survey

Post Payment Audit

1-- How many times in your career have you experienced a post payment audit (including private insurance or PI)?

2-- If you were audited, what percentage were for personal injury cases?

Click button below to take the survey:
Los Angeles: World's Worst Traffic Congestion & Accidents - USA Today

Drivers in and around LA Spend 102 hours battling congestion gridlock during peak hours, for the 6th year in a row. San Francisco bay area is #3 racking up to 79 hours gridlock.
Those peak hours are from 6:00 am to 9:00 am and 3:00 pm to 6:00 pm.
Los Angeles had the worst traffic in the world among the 1,064 cities studied by transportation analytics firm INRIX. The average LA driver wasted 102 hours sitting in gridlock during the busiest commuting times last year and lost $2,408 each in squandered fuel and productivity.
Frustration and erratic stop and go traffic creates constant accident conditions.

USA Today: February 6, 2018

Defendant Driver Strikes Disabled Vehicle; San Bernardino Jury Trial
Jerry and Donna Hunt were stopped and parked on the right side of the road because they ran out of gas. Zachary Tuman was using his cell phone while driving and struck the Hunt car, which was clearly disabled.
Tuman argued the Hunts parked in an unsafe manner and should not have run out of gas.
The Hunts sought care from the highly regarded Dr. Timothy Wallace DC and Kendall Wagner MD a well-respected orthopedist.
The jury awarded a grand total of $95,397. However, the jury always found defendant Tuman was 60% liable and 40% to Jerry Hunt for running out of gas. Meaning the Hunts netted $58,382.
Hunt vs Tuman, Hon. Donald Alvarez presiding, San Bernardino Superior Court



Taking PI cases are always a risk. When your patients contribute to the accident they may get less money IF the jury believes they helped cause the injuries.

--Keep close to the PI attorney to see if he believes he has a "clean" case.

--If not, you might want to put your patient on a partial cash payment plan.


Wed. 2/28/18:
LA Southwest District
2 mandated CE hours
Wed. 3/21/18:
Long Beach District
2 mandated CE hours

All doctors are welcome to join us!

For questions email John Tawlian: 

Contact Us

Phone: (800) 626-0003
Website:  ShawnSteel.com

Shawn Steel Law Firm, 3010 Old Ranch PKWY, Suite 260, Seal Beach, CA 90740
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