Academy of Chiropractic’s Doctors PI Program
Office Systems and Office Systems #27
From the Desk of :
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
I am now totally frustrated, angry, pissed and amazed that 76.47% based on a survey done on 8-31-2016 of you don’t give a rats F---ing ass about getting paid and are willing to let the insurance carriers RAPE you financially. I think I said that right. If any of you are Jewish, you will be re-circumcised once again to let you back into the tribe… OK, that’s enough out my system to let me think clearly..I hope!!!
In former consultations I have shared with you how to both understand and use your state laws in order to get paid and prevent the insurance companies from taking advantage of you by ignoring and subsequently denying your claims. EVERY STATE IN THE US and all US territories, (with the exception of South Carolina, who simply have it better than the other 49) have a LAW that dictates how long the carrier have to pay or deny your claim with a penalty of interest paid to you if not acted on.
First, you must go to your state’s insurance department’s Website and find the law. That means you need to know the section, subsection and chapter and verse of the law. For instance, in New York it is section 65.15 (e)(2) that mandates the carrier pay my claim within 30 days or they are forced to pay 2% interest month WITHOUT me demanding the interest or they are in violation of LAW.
You HAVE to know the law, which are the rules of your game and then when the carrier doesn’t respond, you must threaten to report them, by having a formal system behind the non-payment. Then… you have to report them for infracting the law. The more you do that, the more you get paid because the carriers don’t want their “racket” exposed. The more I complained through proper channels, the more I and all the office I have worked with got paid.
Follow the direction the law prescribes in both deliver to verify claim transmission and then have a system in place to render an immediate complaint via mail. Do not waste your time calling as that is the lowest yield on getting paid. This program does not provide a system for you to enforce the laws on payment, but upon request I can work with your staff to make that happen as I have done that with many offices. However, with these prompts you and your staff (more you) will be armed with the payment laws that gives you the necessary tools to get paid timely.
It starts with learning the rules of the game and that is the insurance collection laws in your state. The carriers know the laws incredibly well and they use them against you because they know that you are ignorant and do nothing but “beg and plead” to get paid with no “teeth” in your requests for payment.
Learn and win!!!