Arizona Chiropractic Society eNewsletter

Breaking News      

May 23, 2011Newsletter Subtitle

Month Year
What's New Right Now!

 

BREAKING NEWS 05/23/11: ADOI files Reply to Plaintiff's Response to Motion to Dismiss. Click here to read full motion. The next step is oral arguments and then a ruling by the Superior Court. ACS is in action solving the profession's problems!

 

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.




Quick Links

Read entire full color PDF with breaking news about the ADOI lawsuit, BCBS, ASH, the Board, insurance equality and much more by clicking on this link.

Website with Full Info about ACS Attorney David Abney

ACS Four Point Plan to Deal With ASH








The Arizona Chiropractic Society is here to serve you!

ARIZONA
CHIROPRACTIC
SOCIETY
 
ACS Logo


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
Alan M. Immerman, D.C., ACS President and Executive Director

BREAKING NEWS AND UPDATES

 

Join the Arizona Chiropractic Society on Facebook by Clicking Here

 

BREAKING NEWS 05/23/11: ADOI files Reply to Plaintiff's Response to Motion to Dismiss. Click here to read full motion. The next step is oral arguments and then a ruling by the Superior Court. ACS is in action solving the profession's problems!

 

BREAKING NEWS 05/22/11: ACS issues Media Release calling for informed consent legislation prior to receiving angioplasty, coronary bypass surgery and spinal epidural injections so that patients will know that much safer and less expensive alternatives such as medical therapy for heart problems and chiropractic care for neck and back pain are equally effective. Click here to read the Media Release and call for legislation in 2012.

 

BREAKING NEWS 05/17/11: ACS posts newsletter from MedicoLegal Services which provides reference and abstract for the best literature review journal article on the biomechanics and injury mechanisms of whiplash. Click here to read the newsletter. This is information you must know for your personal injury cases.

 

BREAKING NEWS 05/12/11: ACS discovers the ASH "Smoking Gun" document which allows 30 days of care for an acute condition, 60 days for a chronic condition, and up to four months of supportive care if necessary. Actual ASH practices contradict this document which you can read by clicking here.

 

BREAKING NEWS 05/11/11: ACS releases ACS May 2011 eNewsletter with in-depth analysis of the ADOI lawsuit, SB 1593 and the Governor's veto, and full instructions for what you need to be doing to solve the problems with ASH. Click here to read the full eight page PDF document in full color.

 

BREAKING NEWS 05/09/11: ACS files Plaintiff's Response to Motion to Dismiss for Failure to Make a Claim. Click here to read the motion. ACS Attorney David Abney, click here to read his biography and list of prominent cases, has argued that ADOI must enforce the law the Legislature charged it to enforce. Click here to read the counts of the lawsuit in plain English. Click here to join ACS or donate unless you want a full time cash practice with no health insurance. 300 ACS members have awakened and we are waiting for the rest of you.

 

BREAKING NEWS 04/28/11:ADOI has responded to the ACS lawsuit with a Motion to Dismiss for Failure to Make a Claim. The defendants have argued that we do not have the right to file a lawsuit to ask a judge to order a state agency to do its job. They believe ADOI simply has the right to ignore our law and not enforce it if they so choose. They are trying to redefine the very meaning of a "Writ of Mandamus" and the rights of citizens to petition the courts to force the government to do the tasks required of it by law.

 

BREAKING NEWS 04/12/11: California Department of Managed Health Care (DMHC) initiates a "non-routine" investigation into American Specialty Health (ASH) regarding possible violations of the state Medical Loss Ratio (MLR) law. Click here to read the letter from DMHC. This law requires ASH to spend at least 85% of revenues on patient care. According to ASH financial statements posted online (click here to read), the ASH MLR is approximately 50% which appears to be a clear violation of the MLR. It is for this reason that a "non-routine" investigation was launched immediately. The outcome of the investigation will posted on the DMHC Final Examination Report Page as soon as it is completed. Check back regularly for the report. It will be reported by ACS.

 

BREAKING NEWS 04/06/11: Arizona Republic publishes front page article about ACS lawsuit against ADOI. Click here and here to read the article.

 

BREAKING NEWS 04/06/11: ACS releases April 2011 eNewsletter with explanation of each count in ADOI lawsuit. Also, doctors must file complaints with the AG and ADOI over insurance company misconduct. Learn how the Arizona Chiropractic Board may help if insurers deny needed care. Read these reports by clicking here for the April 2011 ACS eNewsletter.

 

BREAKING NEWS 03/14/11: Two Chiropractors and a patient, backed by ACS, filed a lawsuit today against the ADOI alleging failure to enforce the chiropractic insurance equality law, ARS 20-461(A)17 and ARS 20-461(B). This law requires insurers to let patients use their health insurance to see either an MD, DO or DC and pay the same copays and deductibles with the same overall limitations such as preauthorization on treatment. Currently, copays, deductibles and other limitations for chiropractic care discriminate against chiropractic care with barriers so huge that insurers, led by BCBS, force patients to choose MDs or DOs. ADOI has refused to enforce this law which only they have the authority to enforce. Therefore, this lawsuit asks the courts to order ADOI to enforce the law. Click here and here and here to read the official filed lawsuit documents. Click here to follow the case on the webpage of the Maricopa County Superior Court. Click Case History and enter CV2011-093099. The legal minds behind the lawsuit are attorneys David Abney and Frederick R. Berry, Jr., considered foremost in their field in Arizona. Click here and here to read their biographies and list of prominent cases. Click here to read Mr. Berry's letter to the Attorney General.

 

BREAKING NEWS 03/11/11: ACS unveils all new website login privileges for members providing instant access online to all member benefit documents, services and products by clicking here. Members can login now by clicking here and then clicking Forgot Password. Enter your email address and your password will be sent to you. Non-members can gain instant access by joining online using our live secure server. Click here to join. Or you can Donate to support the ADOI lawsuit by clicking here.

 

Most Read: Click here to read the ACS Four Point Plan for ASH, 3 of 4 parts of which are in action now. Learn the all-important information about how to file complaints which YOU MUST FILE NOW against ASH with the Attorney General (click here for AG complaint instructions) and with the Arizona Department of Insurance (click here for ADOI complaint instructions). Click here to read the newsletter on the entire subject.

 

Most Read: Arizona State Senators hand deliver hard hitting letter to BCBS lobbyist with pointed questions about ASH at the request of ACS. Read the letter by clicking here. Read the response from BCBS by clicking here.

 

Most Read: ACS releases September 2010 eNewsletter Auditor General's criticism of the Chiropractic Board's "fishing expeditions," balance billing in PI cases, and much more. Read by clicking here.

 

Most Read: ACS offers members group medical, life, dental and vision programs. The group health insurance is guaranteed-issue which means no medical questions asked! PPO and HMO options for employees and families. Many copay/deductible options. High quality Arizona insurer. Call ACS at 602-368-9496 for more information. ACS members can click here and here and here to get full information.

 

Most Read: ACS offers rebuttal material to reports written by defense low speed impact experts from Biodynamics Research Corporation (BRC) and local experts such as Joseph Peles, PhD and Robert Anderson. Click here for more information.

 

Most Read: Watch live testimony from the Legislature on 02/16/09 as Dr. Immerman argues that committee should include chiropractic in health insurance. Click here to see video from Legislative archives. Dr. Immerman begins at the 50:30 minute mark -- advance the cursor.

 

Most Read: Find an Arizona Chiropractor near you by using the ACS Find-A-Doc Search Engine. Just click here. All ACS members are automatically included in this search engine when they join but can opt out by going to their account.

 

Click here to join or donate online with our live secure server. For a detailed description of each of the 58 valuable documents, products and services now available to new members, click here.

 

    
 


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.

,

      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.

Arizona Chiropractic Society - MEMBERSHIP AND MEMBER BENEFITS
 

 MEMBERSHIP AND MEMBER BENEFITS

 

SPECIAL TREASURES MEMBER BENEFITS

 

Attention ACS Members: You can now log in to the ACS webpage and then all of the documents below will become "live" and will open when you double-click on them. Just go to the Login Button on the top left of every page. Enter your email address and click "Forgot Password." Your password will be emailed to you. Use it to log in and then return to this page and you will have instant access to all of the documents. New members gain access immediately upon joining.

 

GROUP MEDICAL INSURANCE, LIFE, DENTAL AND VISION PROGRAMS FOR MEMBERS

 

ACS offers its members a wide range of benefits and services including a group medical, life, dental and vision programs.

 

1 -- Group Medical, Life, Dental and Vision Programs -- Membership Form.pdf:  Group health insurance for ACS members with guaranteed issue coverage begins after a 90 day waiting period with no medical underwriting. PPO and HMO plans are available statewide.

 

2 -- Group Medical Insurance Info.pdf

 

3 -- General Benefits and Group Medical Insurance Pamphlet.pdf

 

INSURANCE CLAIMS AND DENIALS SOLUTIONS

 

4 -- Fees allegedly above Usual and Customary.pdf:  How to protest when an insurance company claims your fees were too high.

 

4.1 - Chiropractic Lifecare of America Page.pdf: The solution for your cash practice.

 

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.

 

5.1 - Grievance Letters and Law Explained.pdf

 

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.

 

6.1 - Health Care Appeal Request Form for Expedited Medical Reviews.pdf

 

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.

 

10.1 - Small Claims and Civil Suits Instructions Simplified.pdf

 

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.

 

11.1 - Timely Payment of Claims, Adjudication and Adjustments.pdf: ADOI Info Brochure. 

 

11.2 - Post Payment Audit Demands information.pdf

 

ERISA AND SELF-INSURED HEALTH PLAN TOOLS TO GET CLAIMS PAID

 

12 -- ERISA Claims Procedure DOL Rule 29 CFR 2560.5030indf:  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.

 

14.1 -- ERISA Patient Authorization Form.pdf: Your patients must sign this form so that you can file appeals and request a copy of the Summary Plan Description on their behalf.

 

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.

 

MD-DC PRACTICE AND REFERRALS

 

 

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.

 

RECORD KEEPING AND DOCUMENTATION COMPLIANCE GUIDANCE

 

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: Full course notes given by former Chiropractic Board chairman. Click here to open this 56 page document with complete instructions on record keeping.

 

23 -- Medicare Noridian Chiropractic Coverage and Documentation 2010.pdf

 

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.

 

24.1 -- Forms:

1.      Assignment of Benefits and Payment Agreement Form

2.      Informed Consent

3.      Nordhoff Patient Intake Form 2000A

4.      Nordhoff Patient Intake Form 2000A Updates

5.      Nordhoff Patient Intake Form 2000B

6.      Update to Nordhoff Forms

7.      Pain Drawing 2011

8.      Medicare Records 2011

9.      Pain Intensity and Disability Graph for Documenting Recovery

10.  Progress SOAP Note

11.  Outcome Assessment Tools for Neuromusculoskeletal Conditions including Numeric Rating Scale, Visual Analogue Scale, Oswestry, Roland Morris, Neck and Extremity Disability, Fear Avoidance, Patient Health Questionnaire and more.  

 

     Lawrence S. Nordhoff, Jr., D.C., is the preeminent author of chiropractic office forms today. Forms #3-9 above were created by him. ACS urges you to buy his entire book of forms for only $150. His webpage is http://www.chiropracticofficeforms.com/chiropracticofficeforms.html. Part of the purchase price will be donated to the ACS legal fund. 

 

MISCELLANEOUS

 

25 -- Medical Records Protocol 2010.pdf:  Arizona Chiropractic Board requires you have this on file in your office at all times. ACS updates the Protocol whenever the law changes and sends the updated version every year to members.

 

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.

 

PERSONAL INJURY TOOLS

 

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.

 

36 -- Forms:

1.     

Attorney Lien Form

2.      Automobile Accident Report Form

3.      Injury Causation Checklist

 

 

 

ARIZONA CHIROPRACTIC SOCIETY (ACS)

ALAN M. IMMERMAN D.C., PRESIDENT AND EXECUTIVE DIRECTOR

3515 East Carol Avenue

Phoenix, Arizona 85028

VOICE: 602.368.9496 FAX: 866.567.6762

EMAIL: ACS@AZChiropractors.org

 

 

Inserted from <http://www.azchiropractors.org/pages/MEMBERSHIP-AND-MEMBER-BENEFITS.php>

   
 
    

SUPPORT ACS CORPORATE MEMBERS

 

Click here to learn how to become a Corporate Member -- Platinum, Gold and Silver Levels Available

 

ACS posts listing of Corporate Members and Sponsors here and Online Classifieds here. Our Corporate Members offer great services and products and they support the Arizona chiropractic profession. You should FIRST do business with them.

 

Pincus & Associates, PC and Pincus & Lespron, PC: excellence in personal injury law. Click here for the firm's website.

 

Standard X-Ray: x-ray services and supplies. Website: Call Lisa Dionisio at 602-275-3344 or go online to www.standardxrayaz.com.

 

Dr.. Tallman NMD Prolotherapy: naturopathic medicine. Contact the office at 480.922.1101 or visit www.drtallman.com for more information.

 

Scottsdale Medical Imaging (SMIL): medical imaging with MD and DC reports. Ten locations. For order forms, Call/email Shannon Barrow at 480.425.4136 or SBarrow@eSMIL.com.

 

Cancer Treatment Centers of America: full service conventional cancer hospital with the bonus of naturopathic and chiropractic care, healthy organic nutrition, much more. For more information, your patients can call 800-234-9113 or go to cancercenter.com.

 

Team Motion X-Ray: mobile digital motion x-ray to objectively document ligament instability. Visit Teammotionxray.com and call 602-694-5014 for a demonstration.

 

Custom X-Ray Equipment Sales & Service: The Arizona Chiropractic X-Ray Solution Since 1968. Call Custom X-Ray at 602-439-3100 or 800-230-9726. www.customxray.com

 

Wholesale Credit Card Processing for ACS Members: ACS has teamed up with Eliot Management Group to offer members special WHOLESALE RATES on their credit card processing! ACS itself has converted all processing to Eliot due to the incredible savings. Contact Jerry Waling at 602-685-1400 today!

 

ChiroFutures Malpractice Program: Securing the future, managing your risk. Comprehensive coverage and competitive rates. Best value in the market. Contact: www.chirofutures.org or 800.219.9090. Key administrator is Dr. Matt McCoy, a name long associated in chiropractic with integrity and intelligence.

 

Protandim Is A Great New Herbal Product For Patient Health And Your Bottom Line. Breakthrough patented blend of herbs to combat aging and many diseases is supported by seven peer-reviewed studies. Doctors around the country are experiencing new explosive income from this source in their practices. Call (800) 808-9442 to learn how to distribute and begin to help patients now. Endorsed by Dr. Immerman due to the scientific evidence.

 

Click here to learn how to become an ACS Corporate Member -- Platinum, Gold and Silver Levels Available

 

To see the sizes and costs of Corporate ads in the ACS newsletter and online, click here. The deadline for placing an ad is the 28th of the month preceding publication. Call ACS at (602) 368-9496 or send an email to ACS@AZChiropractors.org to place an ad.

MOST READ FROM THE ACS WEBSITE
  
Click here to read the ACS Four Point Plan for ASH, 3 of 4 parts of which are in action now. Learn the all-important information about how to file complaints which YOU MUST FILE NOW against ASH with the Attorney General (click here for AG complaint instructions) and with the Arizona Department of Insurance (click here for ADOI complaint instructions). Click here to read the newsletter on the entire subject.

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.