Academy of Chiropractic’s Lawyers PI Program

Infrastructure #139

From the Desk of :
Mark Studin DC, FASBE (C), DAAPM, DAAMLP

“Your Fees: A Critical Area of Exposure”

Your Fees are a critical area that must be handled in a legally defensible manner


Over the last few years I have written many times about for your fees to be legally defensible and are derived from a published source. In conversation with the majority of doctors nationally, the problem still exists and you are leaving yourself exposed to legal issues should a carrier or lawyer challenge you.   

As you get better in collecting your fees from lawyers, this problem becomes acute and the core of accepting lower settlements and possibly lawsuits on overutilization. As a result of legally leveraging those (few) "Scumbag" lawyers who do not want to pay your fee, they are now seeking avenues of exposure to "blackmail" you in to taking lower fees. One area of exposure the lawyers are acutely aware of is that most DC's nationally simply "make up" their fees as are not legally defensible. 

Where do you get you fees from? Do you call 3 friends and use theirs? Do you think about it and then it comes to you? Do you subscribe to a national service?

Most doctors get their fees from colleagues in the local area and that is not enough. I have been consulted by many doctors that have been challenged by the insurance companies on where their fees have been derived from. In most cases, the doctors could not back up that request with any statistical information and now have significant legal issues. At the end of the day most will prevail in their fight with the insurance companies, after they pay the lawyers, lose sleep, lose their focus on their practice, etc. 

Now you have lawyers who will use the courts to leverage you to take significantly less in your settlements than the 1/3 rule we have established unless you can ensure that you have all of the loopholes secured. Your fees are a primary area those few "scumbag" lawyers threaten to report you to the licensure board, or sue you for overutilization. 

The easiest way to prevent any problems is to use a national publication that lists the fees by geographic location. In these publications, they list 50th, 75thand 95thpercentile…You should choose the 95thbecause you are that good. If challenged, you have a legally defensible answer and those lawyers or insurance carriers can try to find another avenue to try to take advantage of you, but at least this door is closed.

The following is a link to a resource to purchase the book National Fee Analyzer. It has geographic modifiers to account for your location and cost of living. In most cases, your fees are lower:


https://www.optumcoding.com/Product/41025/

If you take care of the small stuff, you can focus on the big stuff.