Guest guest Posted April 2, 2004 Report Share Posted April 2, 2004 Dear Doctors: Let me give my two bits about why a neurological or orthopedic referral may be necessary early on in a case: to make sure your bill gets timely paid in the event you are still seeing the patient six months down the road. Based upon legal analysis and experience, an attorney might anticipate that a particular case is going to be hotly contested in terms of causation. The time to jump all over a case is right now, within the first 30-60 days. That's why your patient should see an attorney within the first 30-60 days. We don't start preparing for trial after a year when we finally figure out that the insurance company is going to play hard ball. At that point it's a little late. We start preparing for trial the minute that client walks in the door (and believe it or not, by doing that we avoid trial, because the cases are so meticulously prepared that they settle where they should). Anyway, many factors go into the equation as far as recommending an early referral to a Board Certified M.D.: age, pre-existing conditions, prior injuries, minimal damage, and just plain old " feel " and " sixth sense. " Why within the first couple of months? Because that's when the patient is most likely to be undisputably " objectively " injured. You know it's hypesthesia caused by soft tissue swelling or fixation, I think that's probably all it is, but I still want that Board Certified Neurologist or Orthopedist to see it, feel it, confirm it, and write about it. Think about an early referral as your ace in the hole IME. Why wait until a patient is subacute bordering on chronic? By that time your bill is not getting paid and the insurance company will hire one of their whores to conclude that the patient is suffering from nothing other than mileage and psychological overlay. I think you could also use an early referral to build a lasting and respectful working relationship with a doctor, especially if you send the patient with a letter by you that says something like: " Dear Your Royal Highness M.D., Doe was injured in a rearend motor vehicle collision. While there was no damage to his vehicle, his car was knocked forward 6 feet, and he has been having considerable neck pain, intermittent dizziness, and headache for which I am treating him. also has some numbness and tingling in the third and fourth digits in his right hand. Xrays reveal that he does have some minimal degenerative changes at C6-7 consistent with aging as well as loss of cervical lordosis. I believe that his numbness is most likely hypesthesia caused by soft tissue swelling and joint fixation (PLEASE DON " T SAY SUBLUXATION). But do to the intensity of the muscle spasms and hypertonicity, I would appreciate your evaluation to rule out something more ominous. Best Regards, Your Humble, Subservient, and Faithful D.C. " Now, are you eating crow? Kinda. But I'll tell you what, if that patient goes chronic 6 months down the road, the PIP carrier will still be paying your bill. Same goes for MRI's. You know there may be a non surgical disc bulge, I suspect it, and the existence or nonexistence of a disc bulge may not even effect your treatment plan. But I'll tell you what, a disc bulge on an MRI will get your ongoing treatment six months down the road paid, even if it's debatable if the bulge was caused in the collision. Will you get paid because the insurance company believes the patient is really hurt? Heck no! You get paid because the insurance company knows there's no way they can get away with denying payment. I spent three long and lonely years as an insurance adjuster. The mentality is not " let's pay what we owe. " The mentality is " is there anyway under the sun we can possibly deny or reduce payment? If not, then we'll grudgingly have to pay the bill and we'll frown when we make the payment. When your and our cases go smoothly, you get paid, the files are exhaustively documented, and guess what? We get the cases settled with just a few hard swings of the baseball bat. One of the largest hurtles to settlement is an outstanding $ 3,500 medical bill. Your patients who worshipped you while you got them well only care about their own bank account when it comes to settlement: What about me? I'm the one who suffered. Hasn't Dr. D.C. made enough off of me? And all that supportive/non-curative care you gave then that helped them continue functioning? Well it didn't really help me, the pain always returned after a couple of weeks, so why should the doctor get more than me????? Best, G. , Gatti, Gatti, & Crew Attorneys practicing chiropractic > Sorry, forgot to address the letter. > > I have about had it with attorneys who advise our patients to see a > neurologist or other chiropractor for a second opinion during their > initial consultation. It maddens me even further when the attorney > does this while the patient is within the first month of care. I > believe we should start naming these attorneys on this list so we can > steer our patients to more chiropractic friendly legal help. > > This happened last week with an attorney in Corvallis, and when I > advised the patient to see someone else in Albany, that attorney did > the very same thing. I hate to think it is just me. I bet more > attorneys are doing this than we think. After all as one stated to > my patient, chiropractors are not very high up on the medical > hierarchy list. > > I contacted both and expressed my displeasure, stating that if this > patient needed a second opinion I would be the first to send them out > for one, but seeing as they were just in the second week of care at > the time and progressing tremendously, I did not feel it was the > attorney's place to be practicing chiropractic, and assured them I > would not practice law!! > > So, what do you all think, should we begin listing these attorneys on > this forum or not. > > Grice, DC > 821 Elm Street SW > Albany, OR 97321 > > > > > 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. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 2, 2004 Report Share Posted April 2, 2004 Dear : Contrary to your statement that Gatti and Gatti do not participate in this activity, I recently had Dan Gatti do just that. By the way it wasn't for anything that was abnormal other than a second opinion. I have never had this happen with Ron Sayer of their office and have a wonderful relationship with him. But yes, this does happen with them too. It still Pi**es me off though. Grice, DC Albany, OR Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 4, 2004 Report Share Posted April 4, 2004 , Thanks for taking the time to explain that to the listserv. Do most attnys have time to make a quick one-time call to the doctor and explain this rationale? I understand it well having been in business for a few years, but it would go a long way to improving referral bases and communication to do this with new docs or just 1st time referring doctors. Once you've worked with a doc I'm sure they get the routine. Is there a listserv that attorney's share that this could be suggested? It could be that most attnys don't realize that it could be interpreted as insulting to the referring doctor. Thanks for all your work in our profession. Minga Guerrero DC Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 4, 2004 Report Share Posted April 4, 2004 Hi , Thanks for the extra explanation and ideas. It was very informative. Stockton Attorneys practicing chiropractic> Sorry, forgot to address the letter.>> I have about had it with attorneys who advise our patients to see a> neurologist or other chiropractor for a second opinion during their> initial consultation. It maddens me even further when the attorney> does this while the patient is within the first month of care. I> believe we should start naming these attorneys on this list so we can> steer our patients to more chiropractic friendly legal help.>> This happened last week with an attorney in Corvallis, and when I> advised the patient to see someone else in Albany, that attorney did> the very same thing. I hate to think it is just me. I bet more> attorneys are doing this than we think. After all as one stated to> my patient, chiropractors are not very high up on the medical> hierarchy list.>> I contacted both and expressed my displeasure, stating that if this> patient needed a second opinion I would be the first to send them out> for one, but seeing as they were just in the second week of care at> the time and progressing tremendously, I did not feel it was the> attorney's place to be practicing chiropractic, and assured them I> would not practice law!!>> So, what do you all think, should we begin listing these attorneys on> this forum or not.>> Grice, DC> 821 Elm Street SW> Albany, OR 97321>>>>> OregonDCs rules:> 1. Keep correspondence professional; the purpose of the listserve is tofoster communication and collegiality. No personal attacks on listservemembers 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 hisor her consent, unless all personal identifiers have been removed.> Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.