answers will be published next issue
Are you curious about how PI works for other doctors? So are we. Give us 90 seconds to answer 3 questions and we will publish the results in our next issue. All individual results are strictly confidential. The survey is anonymous. Take the short survey by clicking on the link below:
MVA: Part One
| This form should be given to each of your new PI Patients: | ||
| 1. | Not getting complete info at the scene. | |
| 2. | Not taking iPhone pics of everything. | |
| 3. | Giving insurance too much info. | |
| 4. | Not seeking care immediately. | |
| 5. | Relying on only meds for early recovery. | |
| 6. | Not seeing your DC ASAP | |
For a copy and full explanations of each point e-mail: johntawlian@shawnsteel.com
A Silicone Valley DC recently told us she was subpoenaed for all prior billing records regarding her MVA patient. The insurance co was fishing for her prior “rates of services” and “documents accepting reduced rates, with any “health insurance plans, attorneys, patients…” The insurance co demanded prior rates for the following codes:
| o | CPT 99203 initial exam | |
| o | CPT 98943 Manipulation | |
| o | CPT 97014 Electrical Stim |
This is hugely burdensome and can severely impeach your PI billing practices. This information must be carefully reviewed with the PI attorney and to see which defenses may be raised to limit the scope of the subpoena.
Presented by
Shawn Steel, Chiropractic Attorney
Are you really in charge? If you control the PI Case – Odds are better to get paid.
✓ Does your report and notes justify the care you give? Three goals to meet justification.
✓ Showing improvement, flare ups and setbacks = getting paid.
✓ When will you know your case will go to court.
✓ 5 examples to prepare your office to handle litigated cases and increase your odds of getting paid.
Tomorrow, May 27, 2015
6:30 PM Mixer – 7:00 PM Meeting
Buca Di Beppo
17500 Ventura Blvd., Encino, CA 91316
Cost Including Dinner: $20 – Check or Cash
RSVP to John Tawlian at (949) 551-9000
E-mail: johntawlian@shawnsteel.com
Farmers takes a big hit in Orange County
Nicole Cheatham filed an uninsured motorist claim against her own insurance company Farmers. Farmers refused to settle.
Farmers admitted its own customer was innocent. Farmers simple believed their client was exaggerating her purported injuries. Basically they accused their own customer as a liar.
Nicole suffered cervical herniations at C5 and C6 and a lumber disc herniation at L5-SI. Despite aggressive care, including chiropractic and epidural injections she still suffers severe pain and radiculopathy. Her doctors argued she would need a two level anterior cervical discectomy and fusion.
Farmers “doctors’ testified Cheatham suffered cervical sprains superimposed on her fibromyalgia. That her disc herniations were pre-existing. And, she would not need any future surgery.
Cheatham claims some $60,000 in medical bills and a $100,000 in future bills.
Farmers offered on the eve of Arbitration $75,000. Nicole Cheatham demanded $255,000 the policy limits.
Judge James Alfano [Ret] adjudicated and gave the award of $255,000 to Nicole Cheatham inviting a Bad Faith case against Farmers.
Cheatham v. Farmers, Jan 17, 2015
PRACTICE TIP:
| ✓ | Uninsured Motorist claims used to be easy to settle, but the Big Six Insurance carriers treat their own customers like the enemy. |
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| ✓ | Pre-existing issues is a top defense tactic to reduce your patient’s claims |
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| ✓ | Future surgery can be compelling and radically drive up the value. |
