Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 73

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.

"Chiropractic Fees Need to be Legally Defensible"

This “Quickie Consult” is a repeat of the topic coverd in Quickie Consult #6 that I wrote two years ago. In conversation with the majority of doctors nationally, the problem still exists and you are leaving yourself exposed to legal issues should a carrier challenge you. I have spoken to 3 doctors in the past year that have had to hire lawyers over this issue and it cost them $1000’s in legal fees over nonsense.

 

Where do you get you fees from? Do you call 3 friends and use theirs? Do you think about it and then it comes to you? Do you subscribe to a national service?

 

Most doctors get their fees from colleagues in the local area and usually that is enough…However, in today’s environment, that is no longer acceptable. I have been consulted by many doctors that have been challenged by the insurance companies on where their fees have been derived from. In both cases, the doctors could not back up that request with any statistical information and both are having significant legal issues. At the end of the day, both will prevail in their fight with the insurance companies, after they pay the lawyers, lose sleep, lose their focus on their practice, etc. The easiest way to prevent any problems is to use a national publication that lists the fees by geographic location. In these publications, they list 50th, 75th and 95th percentile…You should choose the 95th because you are that good. If challenged, you have a legally defensible answer and the insurance can try to find another avenue to try to take advantage of us, but at least this door is closed.

 

The following is a link to a resource to purchse the book:


https://www.optumcoding.com/Product/41025/

 

If you take care of the small stuff, you can focus on the big stuff.

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