Academy of Chiropractic
Quickie Consult 1267
Compliance 62 CA
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
Carriers Fraud for Profit Alert
“The mirror doesn't lie” Mark Studin 2020
My month-long research has revealed and confirmed the carriers are aggregating statistics of your care and using patterns of diagnosing and care against you. I am also in contact with lawyers representing the largest carriers in the nation to confirm these tactics are continuing today, and they are.
To continue this conversation, I am adding a section from a lawyer who is in agreement with everything I have been saying (maybe hopefully he read my stuff?). Please heed his advice. Next week I will be expanding greatly on each of the 3 subjects below.
Please read the entire article: http://go.pardot.com/e/839333/ds-according-to-auto-insurers-/2m98v/40469365?h=H7YRs1P1oLMI03A6N-lm0tYAaiP1HbRuen39uy6Z7jM
There are 3 steps that can be taken to protect yourself from the fraud funnel.
Make your records more detailed. Tell the story of your treatment and its reasoning. You can only truly protect yourself by creating detailed records which prevent anyone from undermining the credibility of your care.
Understand that insurance adjusters will never see you as anything other than an indicator of fraud. Do not make the mistake of providing them access to your office or your business records or any other documents to which they are not immediately entitled by the terms of your patient’s authorization. You cannot convince them to like you. To them, you are nothing more than a ledger entry.
Never offer a statement to an insurer without counsel. The insurer’s only purposes are to get information which they can use to characterize you as a fraud and/or deny payment for your services. They will employ questioning you are not prepared for and may respond to inaccurately. You cannot walk back a statement made under oath once made, so protect yourself with seasoned counsel who understands the purpose of every inquiry.