Academy of Chiropractic’s Lawyers PI Program
Office Systems #21
From the Desk of :
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
“Studin Top 10 Collections Tips”
1. If you reduce your fee, we will send you a lot more casesJ SUCKER…This is now the oldest newest line of bull crap being used and the carriers are hiring outside companies to sell this line of crap to you.
2. Stick to the settlement formula… Consultations #62 & #63 in “Build Your Infrastructure” gives you the plan. It is still a strong recommendation to follow as doctor’s income keeps spiraling upwards and that statistic along with individual feedback has verified the plan is still working. Do not deviate!
3. Regardless of Rule #2, deviate from the settlement plan as needed. Truthfully the process is as clear as mud in many circumstances. However, you have to pick your relationships and know when to bend. I have fabulous relationships with a handful of lawyers who always honored my liens with rare exception. My hard rule with these attorneys was “on any lien that you’re having a hard time satisfying I will take whatever you give me even if it is zero understanding the past and future of our relationship.” I would never say this to a new lawyer, however in the “real world” things happen in cases and I don’t want to “screw” the lawyers I have good relationships with.
4. Verification, verification, verification: Unless you have a written contract in the form of a lean or letter of protection that the attorney has legally acknowledged via a direct signature, fax back receipt or certified mail receipt of which they sign for you have nothing and do not expect to get paid. This is a hard rule and if you do not get paid because of lack of verification it is your own fault.
5. Evidenced Based: We have been hearing about evidence-based practice for quite some time and many of you have a fully grasped the concept. It simply means that there is scientific verification through published index peer-reviewed literature which certifies your care as falling under the banner of “usual and customary.” It is this statement that will get you paid at a higher level and allow you to care for your patience longer without having an IME or peer-reviewed denying your care. It is for that reason we created the EMR Macros program, which provides paragraphs taken from scientific literature with references supporting your care when clinically indicated. My statistics show that those doctors who include the evidence for macros get paid more on a consistent basis.
6. Diagnosing: Too many of you do not use enough diagnoses to tell the complete story. ICD’s were designed to render a complete picture and are assigned a relative weight for each diagnosis. More diagnoses indicate more pathology and/or bodily injury while telling the complete story, not just a cryptic story. In addition too many of you do not change or diagnosis as the patient progresses through care either by adding or deleting (in addition to changing) diagnosis. By doing so it shows your patient is progressing, which is a key ingredient to allowing more care by the carriers as clinically indicated.
7. reatment Orders: Your care must be documented, which starts with your treatment orders. These must be very specific and each region treated (touched) must have a corresponding diagnoses, clinical finding and complaint. Many claims are being denied as doctors are not being thorough in correlating the above requirements. As a result this is also both grounds for nonpayment and triggering an audience. If this is a pattern it leaves the doctor open to Rico antitrust violations for using a paper instrument to defraud a financial institution.
8. Quarterly phone calls to the attorneys: Every three months you should be calling every attorney who holds either a lean or letter of protection to determine the status of your patients claim. Although we are supposed to be on the same side in helping the patient prevail once the money has been settled you now move across the table from the attorney who fight for every penny they can get. Lawyers are notorious for “plain stupid doctor” and winning. Your office must call to determine if the case has been settled or not as this keeps you in the “face of the attorney” and reminds them that you are vigil and should consider “screwing” a different doctor instead of you.
9. Disbursement Expenses: Lawyers are notorious for taking their expenses off the top before the settlement is paid. This is unacceptable and will not be tolerated by you. You two have disbursements in the form of toilet paper, address paper, postage paper, malpractice insurance, staff expense, electrode pads, conductive gel, etc. and you should never lose sight of the fact that the lawyer will be working on this case for a total of a few hours. You will have worked on this case with this patient multiple times a week for many months and will incur significant more expenses. The settlement figure is off the top not after the attorneys expenses.
10. Verification of lien settlement: you are not to reduce your lien settlement one penny without copies of settlement checks. The disbursement sheet or the word of an attorney is unacceptable because you will often not get the complete picture. They will give you information after their disbursements or any other mechanism may choose to consider valid in the attempt to take money out of your pocket. The lawyer will often give you the argument that it is confidential and they are not allowed based upon the confidentiality clause. Inform the attorney that you understand and you want to work with the lawyer however without physical copy of the settlement check and all disbursement checks your full fee is due and expected as per the contract in the form of lien or letter of protection. However inform the lawyer that your team player and with verifications you are happy to lower your fee in working with the entire team.