Academy of Chiropractic

Quickie Consult 1209
Office Systems and Getting Paid 116 OS

From the Desk of Dr. Mark Studin
Academy of Chiropractic

Preamble: Many of the issues I bring to you are very 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 more importantly, focus on the bigger issues...a larger practice and more family time. -Mark Studin 2006

"Lawyers not releasing policy limits"


Dr. Studin: Could you explain the issue you just described to me a moment ago?

Guest Dr: Okay. I do see, some local attorneys that I work with, usually the less experienced ones that will tend to let all the medical providers, including myself, run up a fairly high bill. Everything medically necessary but a fairly high bill. And I'm seeing no attention to policy limits to where we get to the end of all the medical treatment and we have these humongous bills in a fairly small policy and we all get screwed. And I guess my question to you is: “is it a good idea to ask them about policy limits? So we don't get these 80% reduction, especially the ones…”

Dr. Studin: There's a couple of things that come into play here. The first is dealing with inexperienced attorneys. I love dealing with inexperienced attorneys because once I educate them, I get to really, you know, I become their source now resource. Now, do you understand what uninsured motorist is?

Guest Dr: Of course.

Dr. Studin: Okay. So, you've got the direct policy, you've got the UN policies, the uninsured motorist policies. There's a lot of policies that come into play. So when you find out that there was a $30,000, and by the way, New Jersey has a 15 PIP cap, but a lot of the policies, so, when you're in Texas and the bubbles, so you know you're in good shape. So, the point is, is that when lawyers say like there's only a $30,000 policy, you have to say, is that all in including uninsured motorist or any other source? And you have to get, you understand, because a lot of the times they're going to say, Oh, it's only a 30 policy, take less. And then after they settle the primary case, then they go after uninsured motorist. They'll get three times the amount and then you, you walk away taking the hit. Okay. That's number one.

Number two, you should always find out what type of policy it is up front. And the way to do that is twofold. Number one, you don't need the lawyer. When a patient comes in, the first thing you do is you should tell the patient I need your insurance information. Oh, it's a car accident. How could you treat someone without none? The game you're working with. How could you do that? It's business suicide and it's a rookie mistake and one that will cost you dearly, your entire career. So when a patient comes in and this has a car accident, great, not a problem. We'd love to take care of you. Can you please bring to me or can you give me right now over the telephone appointments so I could create, fill out your forms. Now that what's in it for the patient. I need your insurance, uh, policy number. You can get that right from your glove compartment. Take out the insurance card. I need the name of the carrier and the policy number. That's all I need. And then we'll do everything else from there. I don't have it with me though. It's great. Let's make an appointment. And could you go to the car and call me right back and give me that information or we'll call you back in an hour. Okay. Cause we need that information before you come in. Not a problem. And now you call the insurance company directly and you find out what their policy is. Now, some lawyers are becoming very savvy and they don't want you to know what's going on cause they're setting you up to be screwed.

So what they're telling their clients is do not tell the doctor to tell their client it has to go through me. Tell them it has to go through me. Not a problem. Did you see the new consult they sent out this week on direct assignments and the writer information?

Guest Dr: Yup. Irrevocable? Yeah.

Dr. Studin: And you have the patient saying I irrevocably authorized my attorney, legal representative insurer, any other party regarding my care case to release financial information about settlements, verdict payments, amount owed, included but not limited to other providers of legal representative liens, billing amounts and balances. That means that then if they will give it to you, they come in and sign that. You then say to the attorney, listen, I have the right to get this information from my patient. I can't be in the dark trading. How do I know if it's a 15 policy and already 19,000 has been built and that was the end of the day you're going to want me to work for 5 cents on a dollar and I'm going to pay you to take to win this case.

The lawyers are going to get pissed at you, you don't want to work with that lawyer anyhow. Now the other thing we're doing, which, you'll like is I am creating a database right now and national database, which you can, it's going to be part of your part of your dues for a period of time and then it will be additional. But how would you like to know what percentage lawyer pays and settlements on cases in your region before going in?

Guest Dr: That's fantastic.

Dr. Studin: So, we're going to be getting a lot of that data on what percentage is lawyers pay and you're going to contribute to that cause you're going to start profiling the lawyers in your region and you're going to start filling that database. And I'm going to have other doctors in Houston do the same thing, gladly. And we're going to start creating a national database. Did I answer all of your questions?

Guest Dr: Yeah. Perfectly good.

Dr. Studin: You have the power provided you set up your billing structure appropriately. Anything else?

Guest Dr: That’s it. Thank you.

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