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What's Special for ACS Members
Friends of the ACS: This is a national organization of allies that realize the national implications and signiicance of the ACS litigation to stop ASH from imposing its standard of practice onto the entire chiropractic profession. Here's the webpage:
http://friendsoftheacs.org/
MedicoLegal Services: Home of the best, most practical, tried and proven resources for winning PI cases with special emphasis on low speed impact cases. Here's the webpage: http://arizonachiropracticso.intuitwebsites.com/index.html
ACS Store: This is the place to go for sample reports to rebut IME reports from MDs and DCs, and reports from defense biomechanical engineers and accident reconstructionists. You will also find literature reviews on the key current topics in PI cases about forces involved in accidents, the threshold of injury, and much more. Here's the webpage:http://www.shop.azchiropractors.org/
Member Benefits and Practice Solutions: Includes extensive information on how to handle claims denials for both insured and self-insured plans (the rules are completely different), a complete blueprint for developing referrals from MDs, eveything you could ever want to know about recordkeeping and documentation and staying in compliance in Arizona, the key personal injury practice tools needed by every DC, and much more. Click here to go to the Member Benefits and Practice Solutions Page.
Full Time Help Line: (602) 368-9496. ACS members call and email all the time to get assistance on a wide range of issues from Dr. Immerman, a veteran DC with 31 years of experience.
To gain full access to all pages and documents, all you have to do is join by clicking on Become a Member Online. You will be directed to a secure online server. You can also Donate in any amount to support the cause. Even $10-$25 per month makes a difference. |
| The Arizona Chiropractic Society is here to serve you! |
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ARIZONA
CHIROPRACTIC
SOCIETY
3515 E. Carol Avenue
Phoenix, AZ 85028
VOICE 602.368.9496
FAX 866.567.6762
ACS@AZChiropractors.org
 | | Alan M. Immerman, D.C., ACS President and Executive Director |
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URGENT: NEED INDIVIDUAL BCBS POLICYHOLDERS WITH UNFAIRLY DENIED CLAIMS NOW
These are individuals who did not get their insurance from an employer but bought it personally on their own
It is a simple but urgent request. By now, you have had many BCBS/ASH patients where necessary care has been denied. Approximately 10% of those patients have policies that they bought personally and did not receive from an employer. It is imperative that you have those patients contact Dr. Immerman personally to discuss the possibility of suing BCBS for bad faith. This will cost them nothing since attorneys take these cases on a contingency fee basis. It is urgent that you do this immediately.
Bad faith lawsuits demand damages for the treatment that was not covered and also punitive damages. Wikipedia defines punitive damages as "damages intended to reform or deter the defendant and others from engaging in conduct similar to that which formed the basis of the lawsuit. Although the purpose of punitive damages is not to compensate the plaintiff, the plaintiff will in fact receive all or some portion of the punitive damage award." The damages for the denied treatment may be a few thousand dollars, but the punitive damages may be hundreds of thousands or millions of dollars.
Insurance policies from the workplace are governed by ERISA which does not permit bad faith lawsuits. If there is an unfair denial, you can only sue for the amount of the treatments that were denied. You cannot sue for punitive damages. Therefore, we need individual policyholders, not those who have coverage from their employers.
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Thus the importance of identifying which of your patients have individual BCBS policies, have had care unfairly denied by ASH, and immediately getting them in touch with Dr. Immerman. Have them call directly at (602) 368-9496. We only need 5-10 and then we may be able to certify a class of all Arizona individual BCBS policyholders. This may be the most powerful attack of all against unfair claims practices by ASH and BCBS. Therefore, please take action immediately. |
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CALL 888-396-PAID TO REGISTER
Get Paid Chiro Systems is coming to Phoenix on May 21st, 8am-1pm, and Tucson on May 19th, 8am-1pm. This seminar is imperative for doctors and staff to attend because Dr. Ricchio will be going over getting paid 100% from ASH, BCBS, Aetna, UHC and all other insurance companies. He will also be going over cashflow and high income strategies. Click here for full information. Registration is limited!
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SPECIAL SEMINAR
NEWS FROM ACS CORPORATE MEMBER PROTANDIM, THE MOST POWERFUL ANTIOXIDANT SUPPLEMENT EVER FOUND AND A GREAT BUSINESS OPPORTUNITY
PROTANDIM MEETING EVENT MAY 11, 2011
There will be a meeting in Phoenix on Wednesday, May 11th at 7:30 PM at Dr. Anthony Infantino's office where Dr. Jeff Rebarcak will be available to answer all your questions personally. The address is Platinum Wellness, 4727 East Union Hills Drive #100, Phoenix, AZ 85032. Phone: (602) 866-8100.
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CALIFORNIA DEPARTMENT OF MANAGED CARE RELEASES ASH INVESTIGATION LETTER REGARDING MEDICAL LOSS RATIO (MLR) LAW
INVESTIGATION TRIGGERED BY ACS COMPLAINTS
The California Department of Managed Health Care has just released a formal letter documenting that it has initiated a "non-routine" investigation into American Specialty Health (ASH) regarding possible violations of the state Medical Loss Ratio (MLR) law. To read the letter, go to www.AZChiropractors.org and scroll down to the section on Breaking News.
ASH is a subsidiary of ASHN which is a licensee of the California Department of Managed Care and so subject to the state MLR. This law requires plans including ASH to spend at least 85% (in special circumstances 75%) of revenues on patient care, and no more than 15% (special cases 25%) on overhead and profit.
According to ASH financial statements which are posted on the ACS webpage next to the California letter, the ASH MLR is approximately 50% which appears to be a clear violation of the California MLR. It is for this reason that a "non-routine" investigation was launched immediately upon receipt of complaints from ACS.
The outcome of the investigation will be reported by ACS as soon as it becomes available. It appears inevitable that ASH will be found in serious violation and ordered to pay fines and refunds.
To inform you about the MLR, ACS has written an article entitled: The Medical Loss Ratio (MLR) Law and How ASH is Doomed. This report is posted on the ACS webpage at http://www.azchiropractors.org/pages/HEALTH-INSURANCE-LAWS,-ISSUES-AND-LITIGATION.php, #3.
When ASH is forced to spend no more than 15% to 25% on overhead and profit instead of the current 50%, much more money will be available to pay to doctors for their services rather than to the many "babysitters" hired to oversee the treatment of every chiropractic patient. This is as it should be.
It is wrong that 50% of premium dollars is being spent on overhead and profit and not patient care, and this is why laws were passed to ban such outrageous percentages. Much more of this money must and will be spent on patient care thanks to the complaints filed by ACS and the upcoming enforcement action by the California Department of Managed Care. ASH will be unrecognizable when it can only spend 15% rather than 50% on overhead and profit. Prepare for major change, brought to you by ACS. If you are not a member, please join or donate to continue to make this work possible. |
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DO YOU WANT HEALTH INSURANCE TO COVER CHIROPRACTIC AGAIN?
Litigation is expensive but without it there is no hope of restoring insurance equality. We know that right now your cash flow is decreased because of current tactics by insurance companies. The only hope of reversing the status quo is to gain enforcement of our excellent insurance equality law. The only way to accomplish this goal is to get a judge to order ADOI to enforce the law. This takes a lawsuit which means lawyers and money.
Be smart and invest in this lawsuit to restore health insurance coverage for chiropractic. There are multiple ways to help. You can either join as a member or donate in any amount by clicking on the Become a Member Online or Donate Today Online! You will be directed to our online secure server for your transaction. Act today and safeguard your future. This lawsuit is literally your only hope. Even $25 to $50 per month donations are meaningful and there is no doctor in Arizona that cannot afford this amount. Everyone needs to participate in this effort in order for us to have a chance at winning. It's now or never. This is truly D-Day for chiropractic in Arizona. |
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