Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 43 OS 

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.

"Get Paid and Avoid Lawsuits and Audits"

There is a reason my doctors get paid so much higher and get to both keep their money and sleep at night…..

I received this yesterday:

I picked up the fee schedule text you recommended and here's the response I wrote up to send to the auto carriers denying full payment, stating that our fees are too high.  Would you change anything? Or does it look okay to send?

This is my amended response:

Our fees are derived directly from the 2015 Practice Management Information Corporation (PMIC) Text, “Medical Fees – A Comprehensive Listing of Current UCR and Medicare Fees with Relative Value Units.”  We utilize the weighted averages established by the CMS report, “Review of Alternative GPCI Payment Locality Structures – Final Report”, published in 2010 for our geographic location.  Our services/fees are billed at the UCR 90th percentile or less, therefore, your denial of our full payment for services rendered is unsubstantiated. We utilize UCR (Usual, Customary and Reasonable) rates for our region and it is against the law to discriminate against provider type. Payment is now demanded in full with interest as per the Colorado Statute below:

As per ********************************

Because this doctor LISTENED and utilized the recommended published fee guide he has prevented any potential future legal actions and/or defenses.

****The balance of the response is the reason this doctor will get paid with interest. To read the rest of the paragraph, please go to the Web consulting site to “Office systems & Admissibility #24.

Note: Ron… if you can’t find this one, I am going to start calling you “Peetey” and register you for pre-school…

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