Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 129

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.

“Does it Seem that Insurance Payments Have Gone DOWN?”

The answer to the questions in the title is yes and the reason is usually the fault of the doctor…YOU!!! In years gone by, the old adage was, “Throw enough against the wall and lots will stick.” This meant that if you did enough volume, you would get paid because the carriers would pay the majority of your claims. Those days are long over and very dead!


In today’s environment, the carriers are looking for a reason not to pay your claims, as it is only about corporate profits and the easiest target is the “unsuspecting doctor” who is focused on getting patients well. Can you imagine that? Don’t get me started!!!!!


One doctor, just today, asked the question and my first response was, "Do you fill out the application for benefits on your personal injury claims?" His answer was no, he leaves that up to the patients, as the carrier sends them the forms to fill out. Let me be very clear about this...THE PATEINT DOES NOT CARE IF YOU GET PAID. He/she only care if he/she has to pay.


Another doctor accepts all patients because he is a healer. Another pile of crap! He wants to retain me to figure out how to get the carriers to pay him because his payments are very slow. My advice was not to start a patient under care unless he has all of the information, assignments executed and forms filled out completely. THIS IS BECAUSE…THE PATIENT DOES NOT CARE IF YOU GET PAID. The patient only cares if he/she has to pay.


Some states have standard claim forms for accident cases and others have individual forms for each carrier. It doesn’t matter; you need to have a form for every carrier and have the patient fill it out prior to commencing care so that you can file for the application of benefits. If you want to get paid, ensure you have the vehicle to get paid…the correctly filled out paperwork. Do not be afraid to lose a patient who has no information, as the majority of those patients will be treated for free. I have spent a career running after patients who, from the beginning, were non-compliant.


As for sending information such as reports and SOAP notes, that has been well-chronicled and a topic for future consultations. Be smart and run a very tight ship. To be successful in today’s economy, you must be very diligent in dotting all of your i’s.

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