Serving Chiropractors and Their Patients

Archive for the Medical Payments Category

How to Obtain and Prioritize the Use of a Patient’s Medical Pay Coverage

Chiropractors are often faced with the situation where they are treating a patient who has medical payments coverage under an automobile policy, or similar “personal injury coverage protection” (Often referred to as “PIP”)  During the course of care, either the patient or their attorney will occasionally request that the Doctor bill an insurer other than the medical pay provider.  As a consequence of such a request, the reimbursement rate is frequently unavailable or lower under another form of insurance coverage.   A contributor at this website, David Michel of Petty, Michel, and  Associates, a leading chiropractic consulting group, recently provided insightful information on how to address this situation involving “medical pay”coverage.  Those comments are stated below:

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Letter of Protection … Or Else

Doctors are increasingly facing situations where either the patient or their legal counsel is delaying or deliberately avoiding payment for ongoing treatment charges. This often occurs when the patient is receiving extended care and insurance benefits have been exhausted or their attorney diverts medical payment benefits of an automobile policy to other parties besides the treating chiropractor. (A Blog on this type of action by attorneys was previously presented on March 19, 2013) In these type of situations, there is one reliable option available to the doctor which should be considered to insure future payment for services.

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Preserve Medical Payments For the Treating Chiropractor

Chiropractors have contacted our office lately with concerns relating to their ability to receive payments under a patient’s medical pay coverage of an automobile insurance policy.  As most doctors are aware, many automobile policies contain “med pay” provisions which provide coverage for the health care treatment provided to an insured  under the policy.  The insurerd commonly includes any passengers in an automobile involved in an accident.  Treating chiropractors should always question a patient to determine if this type is coverage is available since the limits of the med pay is typically paid without the types of challenges or discounts often made  to coverage proveded by a health insurer. Some doctors have noticed recently that attorneys representing patients have unilaterally  “invaded” the payment process by either advising the med pay insurer to pay the patient/attorney the limits of coverage or redirect all payments to a provider other than the chiropractor.  Although payments are usually made to whichever proviider first provides the care and submits a claim, many policies have been interpreted by attorneys as allowing the patient to  control and manage the amount of coverage available to them.  There have even been situations where the attorney has expressly told the insurer not

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