Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 582
Compliance 45 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. 

“Federal RICO Violations”

I have been sharing with you for years that if you do not document and bill properly that you can be subject to federal RICO violations, which carry terrible damages and other stiff penalties. The carriers use the courts as a collections tool and can be very aggressive. 

 
Therefore when I share with you that some recommendations are “NON-NEGOTIABLE”  this is what can happen when you fail to heed the advice. This is not one of our doctors, but read below carefully when the article says they used the US Mail, thereby triggering RICO and gives them leverage to seek re-payment for $1.8 million while vacating over $1 million in outstanding claims. In addition, Geico claimed that the oral surgeon’s unnecessary care was on low speed crashes, something that cannot cause injury, which we know to be pure rhetoric and not based on any truth.
 
This is about greed and the carriers are the greediest. 

 
My NON-NEGOTIABLE previous and current suggestion is the EMR Macro’s that Dr. Owens created (www.EMRMacros.com). These have over 250 compliance and necessity statements to be imported into your EMR system that are referenced that help to make you bulletproof and prevent this from happening to you. He charges $50 per month and updates them regularly by scouring over 5,000 journals monthly. For those of you “cheap bastards” who don’t want to get “ripped off” with another money making scheme of $50 monthly (I can hear you now) I am telling you that you now need to do it yourself. Simply sticking your head in the sand and saying I’ve been doing my way for 5– 10 – 20 years and I haven’t had a problem confirms this is nonsense.

 
That was the same argument one of our doctors gave me last week who was audited by a carrier. He requested I help him (after the fact) because they found defects in dozens of charts and now refuse to pay him with the specter of a RICO violation over his head. It is not business as usual for us because the carrier sees us as their next big payday.
 
I know the Oral Surgeon in the article below. He is ethical, clinically excellent and at the top of his game. We discussed utilizing necessity macros is documentation, the only problem is apparently he did not heed my advice.

 
Just as a note Dr. Owens at $50 per month barely makes any money and does this to cover his costs because he has to do it for his own practices as well.
 
 
 
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


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