PI Email Alert - Jan. 31, 2018
 Shawn Steel & John Tawlian
In This Issue
How much do Insurance Carriers pay for your patient's disabilities?

 

--Auto Club will pay $500 for pain and suffering for each month of care.

 

--Mercury will pay $500 for any mention of any ADL.

 

--State Farm has paid $150.00 for each month for Lost Household Services.

 

--Some carriers pay $350.00 for each month of provable "shortened life" from expected lifespan.

 

--Most carriers will pay the "gross" loss of earnings, before taxes, for time not able to work.

 

--Some carriers will pay $1,000 for each % point of Permanent Impairment up to 9%, if the doctor mentions this in the PI Report.

 

All these additional value-added benefits ought to be part of your PI Report. Each fact stated, will increase your likely hood of getting paid in full.


SHAWN IS SPEAKING AT

CCA-Districts:

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
How Many "Modalities" Raise the RED Flag for Each Visit?

Sam Collins tackles a common question. Will the DC get audited if he uses too many modalities per visit?
 
Yes. Too many modalities are scrutinized and punished by carriers. Collins outlines suggestions to avoid audit and to get paid.
 
  • Passive modalities are most effective during the acute phase.
  • Aetna, BCBS and Cigna state that a visit with one or two modalities are reasonable. But more than two raises a RED flag.
  • Active care is very useful during rehabilitation. Such codes as 97110 therapeutic activities 97530 will help reduce swelling and inflammation.
  • Active care with manipulation carriers will pay for one service.
 
Email johntawlian@shawnsteel.com to get your complete article by Collins.
 
Sad case of the unproven Concussion Claim. Harsh in San Francisco!
A San Francisco jury punished a patient who claimed he suffered a concussion.
 
Caroline Jeannnot was rear-ended on the 101.  She claimed concussion and cervical strain. Her car was not towed. There were no emergency services provided.  She received a few weeks of chiropractic care. Of her $8000 bill, she claimed $6,000 for charges for a neuropsychological report.
 
Caroline demanded $250,000. Defendant State Farm offered $10,000. The jury did not award Caroline any money. After the verdict, State Farm sued Caroline demanding $56,000 for costs including $49,000 for expert witness fees.
 
Jeannot vs Jackson, San Francisco Superior Court, Judge Andrew Cheng, May 8, 2017.
CGC 16 550 882 

 
PRACTICE TIPS

--The patient relied on one expensive neuropsych to prove her "concussion."
 

--She did not have sufficient care with the DC.

 

--She did not have a neurologist referring her to a neuropsych.

 

--Hopefully her PI attorney warned her that she would be exposed to huge costs if she lost her case.

 

--Of course, her DC wasn't paid either.

 


 
WHAT TO DO WHEN THE 'NEW' ATTORNEY WON'T PAY YOUR PI LIEN

It's always dangerous for your lien with your patient fires their first attorney and hires a new one. Your lien is only good with the attorney who signed. The new attorney, unfortunately, has not legal duty to honor your lien. And that's too bad. Dishonoring your lien is not ethical but, sadly, it is legal.
 
This happened to a Riverside DC and we suggested the following:
 
  • Always ask the new attorney to sign your lien in writing at least twice and cc your patient.
  • If the attorney refuses to sign the lien, contact the patient and inform him/her that all charges are due and payable immediately.
  • Bill your patient. [You should always bill all your PI patients monthly]
  • If the case settles without having a signed attorney lien. And your bill is not paid, you will need to sue your patient in small claims.
Shawn Steel Law Firm, 3010 Old Ranch PKWY, Suite 260, Seal Beach, CA 90740
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