Gary Lewkovich DC is a pioneer toward understanding the methods insurance companies use to attack hard working DC’s. But we don’t want to make the carriers’ job too easy by engaging in Audit Red Flag activities.

Less Obvious Audit Red Flags

1. Failure to document patient’s progress:
2. Billing a “new” patient level exam,
3. [99204] when the patient is a regular patient in the last three years.
4. Routinely billing 99204 or 99214 when level of service is not being performed.
5. Billing for multiple manual therapies performed on the same day to the same region as the spinal manipulation.
6. No patient progress.

Contact JohnTawlian@shawnsteel.com for the complete article, which is a good read.

Car Accidents and Death

Folsom  Blues : rear-ender No pay.

We are sure the DC did his best. Donna Petty, 24 years old, was rear-ender in Folsom. It looked like a real good case. How can anyone lose a rear-ender? Plus the defendant admitted fault.

All the defendant did was to challenge the chiropractic costs as “excessive”.

Donna testified that she hurt her shoulder, neck and back. No emergency care was given. No other doctors treated her.

Her chiropractic bill was over $6000.

The defendant offered to pay her $6001. [ C C P 998 Offer to Compromise]. She rejected the offer. The jury instead gave an award to Petty for $ 5,123.

Because the award was less than the Offer, Petty might be personally liable for court costs, which would come out of her award.

Sacramento Superior Court Petty vs. Cooper 04 AS 035 11

Practice Tips

1. Any chiropractic bill more than $ 5000.00 always attracts the wrong kind of attention;
2. “simple” neck and back injuries do not play well to skeptical jurors, most of whom have similar complaints.
3. A young person of 24 years probably looked the healthiest in the court room…not a sympathetic figure.