Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 105 I

From the Desk of Dr. Mark Studin
Academy of Chiropractic
Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time.

"Collections Alert"

Over the past 6 weeks, I have presented to over 1100 attorneys and I have heard a recurring theme regarding doctors and payments. In the not-too-distant past, most lawyers went out of their way to protect doctors helping them get paid their fees. Yes, there is always that subset of "scum sucking, lowlife, dirt bag, asshole lawyers" who will always fight to cut your fee at every level. (Was that inflammatory...or just true?) However, the majority of lawyers realize that we are both often fighting the same battle with many cases to come in the future and want to ensure a healthy symbiotic relationship.

Recently, lawyers have vocalized that many of their colleagues have been sued for malpractice and reported to the bar for ethical issues by not primarily representing their clients’ interests. Their clients contended that the lawyers often helped the doctors to overcome defects in faulty liens, letters of protection, assignments and any other instrument required by law for the doctor to get paid from the settlement or verdict. In addition, were many circumstances where doctors were to bill first, second or other third parties before working with a lawyer to secure payment and the lawyers, after the fact, turned a "blind eye" to that oversight and paid the doctor out of the settlement. As a result, most lawyers in today's marketplace no longer consider it their responsibility to correct the doctors’ defects in both required documentation and who should get paid when once the money has been settled into the lawyers’ accounts.

However, lawyers are very eager at the beginning of each and every case to help the doctor triage the billing to the accurate party and ensure that the proper documentation has been rendered. This can only be done easily at the beginning of the case. This actually makes the lawyer's job much easier because there is a clear set of rules of who is to get paid when. As a rule, when you get paid (or not) does not grossly affect the lawyer’s payday. However, should there be a defect in your paperwork, it will create a lot of work and stress for the lawyer in dealing with both you and the client to resolve the issue.

Your job is to hit the "easy button" at every level. When it comes to disbursement, although it is unpleasant for you to fight for every penny with a lawyer, it is also unpleasant for the lawyer to have to fight with you in withholding your payment.

Procedure: At the beginning of every case, you or your staff are to call the attorney of the patient and ask who are the primary and secondary responsible parties. Is there a Medicare, ERISA, managed care, third party, no-fault first party, etc. involved or are there combinations of these? This information must be obtained within the first week of care. This is a non-negotiable step.

For your current patients, it is time to play catch up and call every single lawyer on every single patient and ensure your paperwork and billing triage is accurate. Should you not get paid, the fault is belongs to no one but you.

Lastly, to ensure a fair settlement, read the Lien Settlement System detailed in the consultations. Lien settlements should never be an issue in the future.

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