Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 576
Compliance & Audits 43 CA

From the Desk of Dr. Mark Studin
Academy of Chiropractic
Preamble: many of these issues I bring are 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 focus on the larger issues… a larger, more profitable practice along with more family time. 

“Examination Under Oath - The Deposition you LOSE Sleep Over”

I just got off the phone with my 3rd doctor this week who was subpoenaed for a deposition with the insurance carrier. In one instance the doctor claims the staff was improperly coding his initial evaluations and that insurance company wants a full deposition on exactly what he does during the evaluations as they claim his documentation does not support the codes rendered. The doctor blames his staff for not coding it properly, which is the cause of the defect.

 
The second doctor blames his EMR system for not transcribing or typing out completely when he checked off in the system after evaluating the patient. The carriers are contending that the evaluation was not performed properly as evidenced by the documentation and has subpoenaed this Dr. for a deposition or examination under oath so the doctor can certify what was and/or was not done. This carrier will then subpoena the patient to verify that the doctor’s words are true as that is how they function.

 
The third doctor did not do a complete history, omitted past history, omitted review of systems, omitted family and social history and did not diagnose areas treated. This Dr. just received both a record request for this patient and once done, I can guarantee that 30 other patients for this carrier will be requested and I am sure the next step will be a deposition with a request for a large check to be written back to the insurance company.

 
In each of the above cases the doctors had to hire very expensive defense lawyers (your malpractice carriers will potentially not cover this because it is fraud defense) and had to spend countless hours in reviewing and “sanitizing” when possible all of their records. In each case the doctor blamed staff or their EMR system as to why they are in this predicament. NOT!!!!!

 
In every instance, these depositions were all avoidable and are 100% created by a doctor’s lack of attention to detail in his/her office. All that was required was for the Dr. to review their notes and billing and to follow the recommendations I have been giving for years. You must review all of your documentation and coding prior to it being sent to the insurance carriers. Unless the doctor intended on committing fraud to make money, but I choose to believe that no one does that, it makes me feel better.

 
I also know factually that the carriers will attempt to file RICOH charges whenever possible as it is a good legal leverage tactic that scares the crap out of doctors and it makes the lawyers and carriers money. When I make recommendations, it is to protect you from very aggressive predators; the carriers, all of whom want your money!!! 


 
Respectfully,



Mark Studin DC, FASBE(C), DAAPM, DAAMLP

Adjunct Assistant Professor of Chiropractic, University of Bridgeport, College of Chiropractic
Adjunct Professor, Division of Clinical Sciences, Texas Chiropractic College
Educational Presenter, Accreditation Council for Continuing Medical Education Joint Partnership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences 

 
Academy of Chiropractic
US Chiropractic Directory
631-786-4253
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