Personal injury question again

[Guest guest]

Hi folks, just looking for some wisdom to guide me through a situation that i have not experienced in my young career. I have a 39yo male who was in an accident in July 2003. Rearended. He had a lapse of insurance coverage during the time of the accident and was NOT covered. However, he has retained an attorney and they are sueing the other driver for the vehicle damage and medical coverage.(case has not been settled as of yet He's still in pain and wants to seek treatment. I'm a bit skidish. Liens, patient out of pocket, health insurance, forget it about the case all together??????? Could some of you whom i know have much experience in this area please help with some guidance? thank you.

doc Joe Medlin

PDX

[Guest guest]

Hi Joe,

This is such a tough one, but we got burned too many times with 3rd party liability claims. You never know what can happen down the line and since the carrier for the party at fault has two years to settle, they usually wait the two years. So we made it a rule that we never wait for payment on any 3rd party liability claims or lawsuits, by the way liens don't always work. Had a patient who's attorney took his settlement and left the country, we both were high and dry. Also some attorneys forget and give the money to the patient, again high and dry. We give these patients a time of service cash discount and an itemized SuperBill to file on their own and supply chart notes when requested. We just explain that it is a high risk deal and on average we only get paid 50% of the time or only at 50% of the bill as the carrier negotiates the fees down and we can't afford to keep our doors open if we take on these cases.

Does this patient have health insurance that covers Chiro with you as the provider? If yes, then he can sign a subrogation clause with his health insurance carrier and you can get paid that way, then the health insurance carrier is on the hook to get reimbursed.

Wish you luck whatever you decide,

Stockton

Personal injury question again

Hi folks, just looking for some wisdom to guide me through a situation that i have not experienced in my young career. I have a 39yo male who was in an accident in July 2003. Rearended. He had a lapse of insurance coverage during the time of the accident and was NOT covered. However, he has retained an attorney and they are sueing the other driver for the vehicle damage and medical coverage.(case has not been settled as of yet He's still in pain and wants to seek treatment. I'm a bit skidish. Liens, patient out of pocket, health insurance, forget it about the case all together??????? Could some of you whom i know have much experience in this area please help with some guidance? thank you.

doc Joe Medlin

PDXOregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

[Guest guest]

Hi ,

Yes, but not with much luck, most claimed bankruptcy as they owed so much in doctor bills, plus how do you collect on an attorney who flees the country. We don't do collections any more as it is never 100% successful, so our rules are very strict and we watch our PIP's very closely to track how close they are too their max and verify everything with the PIP carrier ASAP, so we have no surprises. We haven't needed any collection service for over 3 years now and all our PIP patients know they must pay once the year is up or they meet their max and they don't complain as they value the care they have received and understand the circumstances.

Maybe you have had better collection agency luck then us, but we have tried several agencies and just decided why have collections anyway and have them get a percentage and wait years to get paid. Our gross maybe less but our net profits are higher and that is the ultimate goal.

Thanks,

Personal injury question again

Hi folks, just looking for some wisdom to guide me through a situation that i have not experienced in my young career. I have a 39yo male who was in an accident in July 2003. Rearended. He had a lapse of insurance coverage during the time of the accident and was NOT covered. However, he has retained an attorney and they are sueing the other driver for the vehicle damage and medical coverage.(case has not been settled as of yet He's still in pain and wants to seek treatment. I'm a bit skidish. Liens, patient out of pocket, health insurance, forget it about the case all together??????? Could some of you whom i know have much experience in this area please help with some guidance? thank you.

doc Joe Medlin

PDXOregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

[Guest guest]

I agree with that in all but the most egregious cases of dishonesty or fraud, collections is not a viable option. If you talk to your malpractice carrier, you will find that billing disputes such as a nasty collector is the second leading instigator of malpractice claims: they get pissed about the financial aspect of the patient encounter and then find an excuse on the treatment side for a claim. It's much better to have a tight policy up front and let the idiots that rip you off get their recompense elsewhere, for they truly will be judged for it later. Ron Johansen Portland

On Thu, 18 Mar 2004 07:23:48 -0800 " Stockton" <stockton@...> writes:

Hi ,

Yes, but not with much luck, most claimed bankruptcy as they owed so much in doctor bills, plus how do you collect on an attorney who flees the country. We don't do collections any more as it is never 100% successful, so our rules are very strict and we watch our PIP's very closely to track how close they are too their max and verify everything with the PIP carrier ASAP, so we have no surprises. We haven't needed any collection service for over 3 years now and all our PIP patients know they must pay once the year is up or they meet their max and they don't complain as they value the care they have received and understand the circumstances.

Maybe you have had better collection agency luck then us, but we have tried several agencies and just decided why have collections anyway and have them get a percentage and wait years to get paid. Our gross maybe less but our net profits are higher and that is the ultimate goal.

Thanks,

Personal injury question again

Hi folks, just looking for some wisdom to guide me through a situation that i have not experienced in my young career. I have a 39yo male who was in an accident in July 2003. Rearended. He had a lapse of insurance coverage during the time of the accident and was NOT covered. However, he has retained an attorney and they are sueing the other driver for the vehicle damage and medical coverage.(case has not been settled as of yet He's still in pain and wants to seek treatment. I'm a bit skidish. Liens, patient out of pocket, health insurance, forget it about the case all together??????? Could some of you whom i know have much experience in this area please help with some guidance? thank you.

doc Joe Medlin

PDXOregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

[Guest guest]

Any attorney who pays the patient is no friend of the docs, and should be told in writing that if another patient is seeing the attorney that they will be informed that the lawyer ripped you off in your last encounter and that you recommend another attorney. If the attorney pays the patient but not the doc after acknowledging the doctor's lien then he or she should be reported to the bar. If an attorney gives you any crap about not being able to protect your bill then send the patient to an attorney who will do so.

The reason attorneys do this is so they can take their cut out of the total settlement, rather than the settlement after the bills have been paid.

If anyone knows of any attorneys who have not paid them please post their name on the e-list so that DCs in the state can be aware of them.

BTW, none of this is valid if your bills are $20K after 6 months of care. In general, chiropractic bills over $5-6K are looked at a bit askance, and must be justified with a significant diagnosis - disc derangement, etc, otherwise they can be difficult to get paid. There are obvious exceptions to this rule, of course, but that is an attorney's perspective (not that I'm an attorney but I talk to them all the time about these issues). I realize that there is an inequity for chiropractic bills versus what is considered kosher for a PT bill (10's of thousands in some cases) but there you have it.

D Freeman Mailing address: 1165 Union Street NE, Suite 300Salem, Oregon 97301ph 503 586-0127 fax 503 763-3581cell 503 871-0715 drmfreeman@...

-----Original Message-----From: R Johansen [mailto:drjohansen@...]Sent: Thursday, March 18, 2004 9:04 AMstockton@...Cc: Oregondcs ; adesiena@...Subject: Re: Personal injury question again

I agree with that in all but the most egregious cases of dishonesty or fraud, collections is not a viable option. If you talk to your malpractice carrier, you will find that billing disputes such as a nasty collector is the second leading instigator of malpractice claims: they get pissed about the financial aspect of the patient encounter and then find an excuse on the treatment side for a claim. It's much better to have a tight policy up front and let the idiots that rip you off get their recompense elsewhere, for they truly will be judged for it later. Ron Johansen Portland

On Thu, 18 Mar 2004 07:23:48 -0800 " Stockton" <stockton@...> writes:

Hi ,

Yes, but not with much luck, most claimed bankruptcy as they owed so much in doctor bills, plus how do you collect on an attorney who flees the country. We don't do collections any more as it is never 100% successful, so our rules are very strict and we watch our PIP's very closely to track how close they are too their max and verify everything with the PIP carrier ASAP, so we have no surprises. We haven't needed any collection service for over 3 years now and all our PIP patients know they must pay once the year is up or they meet their max and they don't complain as they value the care they have received and understand the circumstances.

Maybe you have had better collection agency luck then us, but we have tried several agencies and just decided why have collections anyway and have them get a percentage and wait years to get paid. Our gross maybe less but our net profits are higher and that is the ultimate goal.

Thanks,

Personal injury question again

Hi folks, just looking for some wisdom to guide me through a situation that i have not experienced in my young career. I have a 39yo male who was in an accident in July 2003. Rearended. He had a lapse of insurance coverage during the time of the accident and was NOT covered. However, he has retained an attorney and they are sueing the other driver for the vehicle damage and medical coverage.(case has not been settled as of yet He's still in pain and wants to seek treatment. I'm a bit skidish. Liens, patient out of pocket, health insurance, forget it about the case all together??????? Could some of you whom i know have much experience in this area please help with some guidance? thank you.

doc Joe Medlin

PDXOregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

[Guest guest]

I believe that the answer to those who have problems with not getting paid on the back end of any PIP claim is the doctors lack of communication with the attorney throughout the course of a case. Certainly everyone who handles PI cases should be connected with several attorneys so that you control the vast majority of your patient's choice of legal representation. Many patients are not in the position to lay out money for care after their PIP is exhausted, especially if they have been incapacitatd to any significant extent by their injuries, are unemployed, etc, etc. I have a problem sending people who are not done with care on their way because they can't afford to pay. Refer the patients to the people you know are going to look out for you.

If a patient has an attorney already get on the phone after your initial visit and check them out, make a date to meet, and ask them if they are going to protect your bill. Get a sense for their trustworthiness. Tell them your horror story (hopefully you only have one and learned your lesson) and let them know that if they take care of your patient and get your bill paid before disbursing funds then you will be thinking of them when that next legal needing patient is in your office waiting for you to provide direction. (I mean be on a friendly basis with them; ie, have lunch, go golfing, skiing, boating or whatever you might have in common, or just go to their office and visit about cases, but make it personal).

Even better drop them a short progress note, a letter of introduction and don't charge. This might be an opportunity to kindle a good business relationship. I hope this helps those less experienced. . There are a bunch of trustworthy attorneys out their and they are the ones who should be representing your patients. Get to know some.

Sherman

Personal injury question again

Hi folks, just looking for some wisdom to guide me through a situation that i have not experienced in my young career. I have a 39yo male who was in an accident in July 2003. Rearended. He had a lapse of insurance coverage during the time of the accident and was NOT covered. However, he has retained an attorney and they are sueing the other driver for the vehicle damage and medical coverage.(case has not been settled as of yet He's still in pain and wants to seek treatment. I'm a bit skidish. Liens, patient out of pocket, health insurance, forget it about the case all together??????? Could some of you whom i know have much experience in this area please help with some guidance? thank you.

doc Joe Medlin

PDXOregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

[Guest guest]

Hi ,

It isn't uncommon for us to see several patients a year who already have attorney's before they came to us and many times they are from other states as the accident didn't occur here, so we can't get them an attorney we know. It is these patients that we can have the most problems or patients who insist on using a friend for their lawyer, who knows little about PIP. For us the bottom line, is that it can take just such a long time to get paid, even if they have a great attorney (Gatti's cases are taking close to 9 months now and every carrier has been forcing a trial with no arbitration, our law doesn't require they arbitrate). The large carriers have all hired full time attorneys on staff, so they just refuse to go into arbitration or offer any settlement, they aren't required by law to offer the patient anything. They can force you into trial, even with a bogus IME and since it cost a minimum of $4,000 to go to trial, most patients won't risk it, so you get that call asking you to take less. With our practicing being 35% PIP we just can't afford to put too many in that waiting pot.

Besides working with DC's I have also worked for over 10 years with MD's, PT's and DMD's, plus I have several friends that work in those types of practices too and none of them have ever waited for a settlement, all require payment up front and in full at anytime there is no more coverage. So I wonder why it is expected that DC's have to do the waiting? I have found in 20 years working as an office manager, that even in hardships cases, if a patient has to make a small monthly payment they are more inclined to work diligently with the attorney, as most attorneys will let the small cases ride it out until the very end and don't act unless the patient presses them.

In my opinion, the litigation process has become a lot more difficult in the past year or two and it isn't going to be as easy as it once was to get those nice settlement checks. Right now the top attorneys in Oregon are struggling with this issue and are encouraging all the DC's to do a stellar job of documenting and watching their PIP's closely , as the rules have been changed and it is only gong to get worse as Farmers works on the follow-up to HB 3668, which prevented all insured's from suing their PIP carrier and forces Doc's into arbitration, with no patient liability. That was their plan last March and most of that HB got merged with 3668. Check it out-http://www.leg.state.or.us/03reg/measures/hb3300.dir/hb3364.intro.html , so everyone just watch your back and do the best you can to protect your practice and get your patient's well too. If you plan to take on a lot of exhausted PIP or 3rd Party Settlements, don't just rely on your office staff to do all the follow-up, like suggest, the DC should get involved in these cases and make sure your staff knows what you expect for follow-up. I have seen a lot of Doc's loose out as their staff didn't know how to stay on top of them, but even if they do, you have to plan on that a certain percentage will be at a loss, that is the risk everyone has to accept.

Good luck to all,

Stockton

Personal injury question again

Hi folks, just looking for some wisdom to guide me through a situation that i have not experienced in my young career. I have a 39yo male who was in an accident in July 2003. Rearended. He had a lapse of insurance coverage during the time of the accident and was NOT covered. However, he has retained an attorney and they are sueing the other driver for the vehicle damage and medical coverage.(case has not been settled as of yet He's still in pain and wants to seek treatment. I'm a bit skidish. Liens, patient out of pocket, health insurance, forget it about the case all together??????? Could some of you whom i know have much experience in this area please help with some guidance? thank you.

doc Joe Medlin

PDXOregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. OregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.