Chiropractic Personal Injury Advice
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lawrence dieter, d.c.
1171c
Toro St. San Luis Obispo, CA 93401
1(800)797-2457
Medical-Legal Information for New Doctors If an Attorney Refuses to Sign a Lien, He is Still Liable for the Doctor's Portion of the Bill.In the following case, the patient was injured in a motorcycle accident, was treated at Kaiser. the attorneys refused to sign the lien, then when this California, usa case settled, took his cut and gave the balance to the patient. the patient failed to pay Kaiser so Kaiser took the attorney to court and won. Kaiser vs. Aguiluz 47 Cal. App. 4th 302.
A new doctor from Petaluma, CA, USA emailed me after seeing this site and thanked me for the help for which it has been and asked for further resources, here is my reply which I thought may also benefit others.hello dr. _______
if you go to my links page and click on chiro.org, there is a wealth of info. as for forms, you might try H.J. Ross, he has way more forms than you could possibly use. I particularly liked his case Hx., personal injury, informed consent, and make sure that you get his p.i. lien form and when you use it, have the pt. sign 2 originals, send both to the attorney with a self addressed stamped envelope, he will sign them and return one to you. I learned the hard way: if the attorney refused to sign, dump the lawyer or the case. and in your area, stay away from the firm of Bell and Bell the only way I got my $$ was thorough documentation of each and every conversation, date, time, quotes of what each of us said. and for pending p.i. cases, call the attorney once a month for a verbal progress report. nothing intimidates an attorney more than knowing that you have more information / facts than they do. here is another effective method for getting results with insu. CO's. if you are not getting satisfaction, simply ask for their boss.
fell free to contact me with any other items or questions. if I don't know the answer,
I may be able to point you in the right direction.
take care
dieter
QUESTION: I was browsing through your website because I was looking for some answers about dealing with PI cases. I am a chiropractor and have a case right now where the insurance company only wants to pay a certain percentage of the patient's bill. They claim that they will only pay up to a certain number of visits based on the "average treatment of PI cases in this area". The patient's pain scale was down to a 1/10 for the last 4 visits, however, that is how the patient is feeling at that particular moment....what if he had really bad headache the day before etc etc. The insurance company told me that they need more documentation to reconsider paying more of the bill. I graduated in Dec 1999, even know I am fairly new to the profession it is amazing the amount of insurance problems that I have seen. These patients pay the insurance companies so they have some type of coverage and then the insurance company does everything in there power to not pay or reduce there bill!!!. Any help you could offer would be greatly appreciated.For this particular case we are billing the person's insurance company (Allstate) that hit my patient. I am a chiropractor, my medical background extends to what I learned in Chiropractic school; nothing beyond that. I have examined the patient 3 times, initial thorough exam, secondly after 12 visits and lastly before I released him. I find it hard to imagine that the insurance company call tell my patient when he has had enough treatment; I talked with my patient last week and he still has some residual pain from the accident. I can write a narrative report no problem, put it this way...I don't want to spend a hour writing a narrative report if it is not going to help this case. The insurance company has not specifically asked for a narrative. I need assistance in knowing what extra I can write on the patient that will make the insurance company say OK we will pay for the visits we initially did not want to pay for.
Thanks for the quick response.
Dr. T.H.RESPONSE:
hello dr.
a few questions I would ask when I was not getting satisfaction are:
1. and how much medical training do you have?
2. how many times have you examined Mr./Mrs._______?
3. when you say you need more documentation, you are requesting an additional report, my fee for narrative reports is $75 per page, and average 4 pages. because you have requested this report, I will be expecting payment both for the additional requested report and for the medically necessary documented treatments. if you are too new in your job to authorize this, don't waste my valuable time and connect me with your boss. I will do what ever it takes to cut through your bureaucratic b__ s__, this includes notifying the insurance commissioner of you and xzy insurance co and that you are operating in BAD FAITH.
5. You should tell the adjustor: It was the A.M.A.'s research which came to the conclusion that it takes 6-12 months for the healing/remodeling process to finish after a mild to moderate auto accident. you might do as search on med-line or contact Dr. Croft who wrote the book, in the San Diego area for the actual ref.
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