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.
