Guest guest Posted April 13, 2012 Report Share Posted April 13, 2012 Dr. McCabe, Consider sending your patient to me for a second opinion to give my clinical impression, treatment recommendations as well as my opinion as per the “Category of Injury” as per our “Oregon Practice and Utilization Guidelines” which is relative to anticipated length of care which I base on the history, symptoms, your exam findings and my independent examination findings. I would do this before they gain their IME then if an when the IME comes likely provided by a medical physician who has no clue as per these injuries nor our guidelines and cuts off care, we will hammer them beyond recognition with a PIP suit…..filed by your patient’s attorney. Which is my second recommendation having a PIP insurers who is both your patients carrier and the liability carrier means they have a conflict of interest and will not have you patient’s best interests at heart….have you patient get hooked up with one of the excellent plaintiff attorneys that are on this list serve….time we are aggressive on our end…oh and when the IME does cut off care and conflicts directly with my findings and reason….I recommend your patient files a formal complaint with the insurance division which is easy can be done on line or the complaint form printed off can filled out by the consumer (not you) they wish to hear from Oregon consumers who are being trashed…..just my opinion of course! Cheers, Vern Saboe, DC., DACAN., FICC., DABFP., FACOAlbany (Yes, I’m worth the drive!) From: oregondcs [mailto:oregondcs ] On Behalf Of lauren_mccabeSent: Friday, April 13, 2012 3:00 PMTo: oregondcs Subject: Progressive adjuster We saw a patient on Wednesday, April 11, who had been rear ended on the freeway that morning. The patient and the person that hit her both have Progressive insurance.Her adjuster is already calling trying to cut off care and threatening an IME. We've seen her ONCE! She has a moderate cervical and thoracic sprain/strain, which is pretty straightforward and I don't anticipate she will require a lengthy treatment plan. I really think the PIP carriers are getting out of control here. McCabe, DC, DACBSP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 15, 2012 Report Share Posted April 15, 2012 Dr. McCabe - Your message said that both parties were insured by Progressive Insurance. Was the adjuster that called the one handling the PIP (first party side), or was it the "Bodily Injury" or BI adjuster (third party side - at fault). Since both are with Progressive it may not have been apparent. With most carriers PIP and BI are completely separate. In a recent IME the patient related that the BI adjuster had called her, encouraging her to complete care. This was reported to the PIP adjuster who was upset that the BI adjuster would attempt to interfere. Since Progressive has been placed in both positions, it might be difficult to determine which claims person is handling which aspect of the case. If the call was made by the BI adjuster, advise the PIP adjuster since such action would not be right. The BI adjuster may have made a threat of an IME to take advantage of the confusion. Clarify the situation since intra-company procedures might "correct" the problem with a call to the correct adjuster. If it was in fact the PIP adjuster, were the specific concerns shared? Is there something about the case that you do not know? A prior problem patient? A question as to what actually took place? Varying witness accounts? There is usually a reason why an IME is requested. A phone call might clear it up. If there is a concern, call me so we can determine who did what and who within Progressive should be contacted. Tom Freedland, DC Progressive adjuster Posted by: "lauren_mccabe" lauren_mccabe@... lauren_mccabe Fri Apr 13, 2012 3:00 pm (PDT) Progressive adjuster We saw a patient on Wednesday, April 11, who had been rear ended on the freewaythat morning. The patient and the person that hit her both have Progressiveinsurance.Her adjuster is already calling trying to cut off care and threatening an IME.We've seen her ONCE! She has a moderate cervical and thoracic sprain/strain,which is pretty straightforward and I don't anticipate she will require alengthy treatment plan. I really think the PIP carriers are getting out ofcontrol here. McCabe, DC, DACBSP Quote Link to comment Share on other sites More sharing options...
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