Tell the facts about chiropractic to your state legislators now to protect insurance benefits

 
With all the talk about national health reform, the fact seems to have been forgotten that in the end most people will retain the same health insurance plans they have today including employer-based plans, individual plans, AHCCCS, Medicare, etc. 
 
In many cases, the terms of the plans will still be under the control of the Arizona State Legislature. This means we need to continue our work of teaching legislators that chiropractic is a clinical and cost effective substitute for medical and surgical care. Bottom line: Chiropractors are part of the solution. That is the title of the ACS 2010 legislative campaign that you need to engage in starting now. 
 
Now is the time to educate your personal legislators - contact all three. Your resource tool is the ACS webpage. First step is to go to www.AZChiropractors.org  and click on the Legislative button and then Arizona State Legislature-How do I find my legislators? Follow the instructions and identify your 2 state representatives and 1 state senator. Make a separate list for home and for office.
 
Once you have know your legislators, copy and paste the following and email it to them. It is as simple as that. Also, refer them to the ACS webpage where the original link and text is posted along with more information. How simple is that? Too simple and easy not too do today. Here are the links and text: http://www.azchiropractors.org/legislative.html

 

Consult the November 2009 ACS newsletter for full directions. It is posted online at www.AZChiropractors.org. You should have received a copy by email. If not, sign up for the ACS mailing list on the webpage. Also, if you have any questions, you are welcome to call Dr. Immerman at 602-368-9496.

 

THE MOST POPULAR ACS MEMBER BENEFIT
 
                Getting personal help from Dr. Immerman to collect from insurance companies and in personal injury cases is by far the most important and popular member benefit in ACS. Whether by email or phone, doctors frequently contact Dr. Immerman for help when health insurance companies refuse to pay claims and they have tried everything they know but have failed to collect. Dr. Immerman is known to usually have a solution when no one else does. A quick phone call or email often solves the problem.
 
                Doctors also call when they are having trouble collecting on large PI cases. Sometimes an attorney refuses to release funds, or an attorney does not know how to approach a case. Dr. Immerman is frequently involved in litigation cases as an expert and knows many attorneys and so can often help in this area also.
 
                There is a good reason why ACS' membership retention rate is one of the highest in the nation for a state association. It simply pays to be a member of ACS!
 
THE ARIZONA SUCCESSFUL PRACTICE PACKAGE IS READY FOR YOU
 
                This is the full current list of membership benefits delivered to you immediately when you join ACS. If are you are licensed DC in Arizona and you really want to make a living at chiropractic, you will become a member of ACS and read and digest all of the documents listed below. Each is vital to practice in this state.
 
                 Members receive all of the following special membership benefits by email immediately upon joining. Any member may request an additional copy at any time by number. Join today and get the help you need with these unique resources and documents.
 
HEALTH INSURANCE FOR ACS MEMBERS WITH NO MEDICAL QUESTIONS ASKED
 
1 -- CIGNA -- ACS Membership Form.pdf:  Group health insurance for ACS members with guaranteed issue coverage after a 90 day waiting period, no medical underwriting. PPO and HMO plans, statewide.
2 -- CIGNA Health Insurance Info.pdf
3 -- CIGNA Pamphlet.PDF
 
HOW TO GET PAID WHEN AN INSURER DENIES OR REDUCES YOUR CLAIM
 
4 -- Fees allegedly above Usual and Customary.pdf:  How to protest when an insurance company claims your fees were too high.
5 -- Grievance Letters -- The Best Way to Get Insurers to Pay.pdf:  How to use the Arizona grievance law, a powerful tool to bring pressure on an insurer that misbehaves.
6 -- Health Care Appeal Request Form.pdf:  There is a legal process when a claim is denied as not medically necessary. This is a sample request form. #7 contains complete instructions.
7 -- Health Care Appeals Process.pdf:  A three level process. The third level involves review by an independent party chosen by the Arizona Department of Insurance and paid for by the insurance company.
8 -- How to file a complaint with ADOI against an insurer.pdf:  When insurance companies violate laws, complaints must be filed.
9 -- Medical necessity appeal letter.pdf:  An excellent general appeal letter.
10 -- Small Claims and Justice Court Instructions.PDF:  Sometimes the only solution when an insurance company does not pay is a lawsuit. Here are instructions for suing an insurance company.
11 -- Timely Payment of Claims, Adjudication, Adjustments.pdf:  Claims must be paid within a certain time frame, and demands for repayment can only be made within certain guidelines. This document contains the legal details.
 
HOW TO HANDLE AN ERISA SELF INSURED CLAIM DENIAL
 
12 -- ERISA Claims Procedure DOL Rule 29 CFR 2560.503-1.pdf:  Key section of the law which you need to know to get results with your appeals.
13 -- ERISA Letter to File an Appeal.pdf:  Use this letter today to get results when claims are denied.
14 -- ERISA Letter to Request for a Copy of the Summary Plan Description, Claim Appeal Procedure, EOB.pdf:  The first step in an ERISA appeal is to get a copy of the plan document. This is the letter to send.
15 -- ERISA Self-Insured Plans ADOI Letter.pdf:  This is the position of the Arizona Department of Insurance regarding ERISA self-insured plans.
16 -- Understanding ERISA.pdf:  Complicated subject, simple explanation.
17 -- Understanding ERISA Detailed.pdf:  Complicated subject, detailed but understandable explanation.
 
THE MOST EFFECTIVE PLAN TO DEVELOP REFERRALS FROM MDs
 
18 -- The path to medical referrals.pdf:  Key information about how to get referrals from MDs and DOs.
19 -- MD-DC Alignment in Practice.pdf:  An entire book by a DC who once was a drug representative and knows exactly how to get into and talk comfortably with MDs and DOs. This is a blueprint with detailed plans.
 
HOW TO STAY COMPLIANT IN ARIZONA WITH RECORD KEEPING AND DOCUMENTATION
 
20 -- Recordkeeping as Mandated by the Arizona Chiropractic Board.pdf:  Detailed instruction complied and updated by ACS over many years.
21 -- Record Keeping and Documentation Course.pdf:  Outline of course given by lead auditor retained by the Arizona Chiropractic Board.
22 -- Record Keeping 2005.pdf:  Full course notes given by former Board chair. Must request separately since file too large to include with email package.
23 -- Medicare Chiropractic Coverage and Documentation Nov. 2006.pdf:  This is the full document from Medicare and must be requested separately since it is too large.
24 -- CMS Rules for reporting timed codes.pdf:  These are the rules for reporting timed codes which you must follow to be in compliance with the requirements of the Arizona Chiropractic Board for all documentation.
 
COMPLIANCE --  INFORMATION --  COLLECTIONS -- BOARD
 
25 -- Medical Records Protocol 2008.pdf:  Arizona Chiropractic Board requires you have this on file in your office at all times.
26 -- How to search the National Library of Medicine and retrieve articles from a medical library.pdf:  These are the types of journal articles the Arizona Chiropractic Board requires you to have to back up your claims.
27 -- DC Power of Attorney directing payments to doctor.pdf:  Use when an insurance company refuses to honor assignments of benefits.
28 -- DC Power of Attorney Instructions.pdf:  Instructions for #27.
29 -- State Board Investigations and Disciplinary Actions.pdf:  Every doctor with a state license needs to read this background document about boards and discipline. Forewarned is forearmed.
 
PI TOOLS: LIENS, BALANCE BILLING, ETHICS . . .
 
30 -Ethics Opinion 98-06 which requires PI lawyers to pay your bill if they know it exists (constructive knowledge) even if there is no written agreement.
31 - Balance Billing in PI Cases:  Why balance billing to a third party insurer is almost always allowed in PI cases including citations to legal authorities.
32 - PI Attorney's Explanation of Healthcare Provider Liens: Detailed explanation of the law.
33 - Sample form for Notice and Claim of Medical Lien:  Fill in the blanks with your office information.
34 - Sample form for Release of Medical Lien:  Fill in the blanks with your office information.
35 - Arizona Department of Insurance Circular Letter 2000-02 mandating fair investigations of low speed impact automobile accidents. Use to combat insurance company fraud.