Non-co-operative PIP patient

[Guest guest]

Hello all especially PIP attorneys,

I had a patient who was under care for several months. He was referred from a regular patient and both were in the same MVA. Apparently the non-co-operative patient who was the passenger (the driver was at fault, and she has filled out the Insurance PIP application) has not filled out his PIP application.

To date he has not returned our calls or responded to the bill that was sent to him. He is not currently under care. I know my office manager should have been alerted to this sooner. Nevertheless, she has told me that the adjuster has stated that she or he have tried to contact the patient even at his employment, but has not had calls returned or PIP application requests returned.

The patient has signed a Direct Payment Authorization and Notice of Assignment Doctor's Lien form and

Office Policy Regarding Insurance Payment form in which he authorized payment of any medical benefits, or settlement to the physician.

So are these forms good enough where in the PIP carrier Nationwide, or can they not pay because the patient has failed to file PIP application. We have not seen the patient in over 6 weeks. We do have in our file a report request from Feb 28, 2012 from Nationwide's Chiropractic reviewer, but with a note from the claims adjuster on March 14, 2012 stating that that form was no longer required.

Any advice short of taking him to small claims court, of which I dont believe it would be easy to collect from him once a judgment is obtained.

thank you

Elliott Mantell DC

To: Oregon_Chiropractic_Association ; 'Dr Vern Saboe DC' ; oregondcs Sent: Friday, May 11, 2012 3:58 PMSubject: RE: [Oregon_Chiropractic_Association] RE: ODS CCO with GOBI

You have your week planned now.. Dan Beeson

From: Oregon_Chiropractic_Association [mailto:Oregon_Chiropractic_Association ] On Behalf Of Charlie CaughlinSent: Friday, May 11, 2012 12:34 PMTo: Dr Vern Saboe DC; oregondcs ; oregon_chiropractic_association Subject: [Oregon_Chiropractic_Association] RE: ODS CCO with GOBI

The contract is 27 pages long!

Dr. A Caughlin DC CAC155 NW 1st Ave Day, Or. 97845 office fax

From: vsaboe@...To: caughlindrc@...; oregondcs ; oregon_chiropractic_association Subject: RE: ODS CCO with GOBIDate: Fri, 11 May 2012 12:00:28 -0700

No not yet but make sure you sign up Charlie we need to be fully engaged with the CCO networks…..the Admin Rules writing is going well for us thus far….Vern

From: oregondcs [mailto:oregondcs ] On Behalf Of Charlie CaughlinSent: Friday, May 11, 2012 11:25 AMTo: oregondcs ; oregon_chiropractic_association Subject: ODS CCO with GOBI

Anyone else get a contract from ODS requesting your "participation" for the OHP product? ODS has partnered with Greater Oregon Behavioral Health Inc. (GOBI) to become a CCO in my area.

Dr. A Caughlin DC CAC

155 NW 1st Ave

Day, Or. 97845

office

fax