Academy of Chiropractic
Quickie Consult 1268
Compliance 63 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
UPDATE: Carrier's Fraud for Profit Scheme
“Centered” Mark Studin 2020
As I digest more and more lawsuits and better understand the carrier’s tactics, I just want to give you a brief update as to what you need to start focusing on. Shortly I will be getting to you detailed information and training sessions on how to bulletproof your practice from doing nothing wrong, yet finding yourself “looking down the barrel” of a lawsuit that can cost you your entire future.
I don’t want to sound dramatic, and most of us will never be exposed to this. However, I want to ensure that you are part of the “most of us” that will not have to defend yourself over “nuances.” Those nuances are the carrier’s “Fraud for Profit” scheme.
For those of you who have endured a compliance review with me, it is all those “little things” I demanded you do right that will protect you. Additionally, there are some “big things” that must be adhered to WITHOUT COMPROMISE. Here is the shortlist for today:
For every area touched, you MUST have a symptom, clinical finding, and diagnosis. If you are a full spine adjuster, and have biomechanically diagnosed regions without symptoms, call me, and I will explain to you what MUST be done.
NOTE: I am now saying what must be done, no longer what needs to be done.
You must have a documented clinical reason for every diagnostic test and treatment modality ordered.
You must do re-evaluations every 30 days during ongoing care.
I will be creating necessity macros for all current clients based upon the complaints from the carriers to meet their requirements and be clinically accurate. For now, do your best, and if you want me to look at them, email them to me.
Right now, I am focused on protecting you.