What's New Right Now!
BREAKING NEWS 05/17/12: Chairperson Dianne Haydon, DC resigns from Arizona Chiropractic Board and replaced by former AAC President Richard Guarino, DC, highlighting incestuous relationship between Board and AAC.
BREAKING NEWS 05/09/12: Oral arguments set in Court of Appeals in ADOI insurance equality lawsuit. Date is 06/06/12, 9:30AM, Arizona Court of Appeals, 1501 W. Washington, Dept. D, Courtroom 1, Phoenix. Each side has 20 minutes.
BREAKING NEWS 04/28/12: Dr. Geoff Ricchio's Get Paid Chiro Systems seminar returns on May 19th with innovative programs and aggressive insurance collection methods so that you can get paid now. Past attendees rave about their results. Click here for full information including how to register.
BREAKING NEWS 04/18/12: ACS releases nine necessary documents and practice tools that you need today.
BREAKING NEWS 03/17/12: Dangerous PI bills dead for legislative session. No more threat that you will not be able to file liens and have to accept health insurance as payment in full in PI cases. No evidence of collateral source of payment will be introduced in court thus reducing jury awards and amount of settlement available to pay your bills. Another great ACS victory!
BREAKING NEWS 02/24/12: Plaintiffs' file Reply Brief with Court of Appeals in ADOI lawsuit. Click here to read entire brief and see why victory is inevitable. This lawsuit is the only path to insurance equality in Arizona. Join ACS now and support this lawsuit or risk losing your practice.
BREAKING NEWS 02/07/12: Senator Gray kills SB 1250 Health Insurance; Interstate Purchase, dangerous bill for chiropractic profession.
BREAKING NEWS 12/22/11: ACS releases 2 minute killer video that tells whole story about BCBS, ADOI and ASH. Distribute widely!
BREAKING NEWS 10/26/11: ADOI Director Urias' term expires Jan., 2012, relief may be in sight. With a new director comes new policies.
BREAKING NEWS 09/10/11: ACS hires powerful Rose Law Group as lobbying firm to protect profession at state legislature.
BREAKING NEWS 08/02/11: ACS members are NOT paying back insurance refund demands. Learn why by calling ACS.
The ACS Home Page: Constantly updated with breaking news, click here: www.AZChiropractors.org.
MedicoLegal Services: Find the best resources for winning PI cases with special emphasis on low speed impact cases at http://MedicoLegalServices.com/index.html
ACS Store: Sample reports to rebut IME reports from MDs and DCs, and reports from defense biomechanical engineers and accident reconstructionists, plus literature reviews on forces involved in accidents, the threshold of injury, and much more. Click on http://www.ACS-Store.org/
Member Benefits and Practice Solutions: How to handle claims denials, a blueprint for developing referrals from MDs, all about record keeping and documentation, key PI practice tools, and much more. Click here to go to the Member Benefits and Practice Solutions Page.
LIVE Help Line: (602) 368-9496. Call now for LIVE HELP from Dr. Alan Immerman, a veteran DC with 32 years of experience.
To gain full access to all pages and documents, 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.
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.
ACS is your Refund Demand Defense Center
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SUPPORT OUR ACS SPONSORS AND CORPORATE MEMBERS!
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YOUR LISTING HERE AND IN THE NEWSLETTER: Reach our Internet readership and approximately 2000 licensed chiropractors practicing in Arizona who receive the ACS newsletter monthly by U.S. mail! Contact ACS at 602-368-9496 or ACS@AZChiropractors.org for more information.
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CUSTOM X-RAY EQUIPMENT SALES & SERVICE: The Arizona Chiropractic X-Ray Solution Since 1968. Affordable analog or cutting edge X-ray digital systems, all types, most manufacturers. Processors, film, supplies, complete service. Call Custom X-Ray at 602-439-3100 or 800-230-XRAY(9729) www.customxray.com
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.
THE NIELSEN LAW FIRM PLLC -- AGGRESSIVE LEGAL ADVOCACY: Yuri Nielsen, Esq., 310 S. 4th St., Ste. 1401, Phoenix, AZ 85004. Call (602) 257-7535. Webpage: www.personal-injury-attorney-arizona.com.
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RichCOR TABLES, MODALITIES AND SUPPLIES: Richard Corcilius is tried and proven having served the profession in Arizona for over 25 years. He is THE source for tables, modalities and supplies. Call 480-334-7430 or firstname.lastname@example.org.
ACS MEMBER BENEFITS AND PRACTICE SOLUTIONS
GROUP MEDICAL INSURANCE, LIFE, DENTAL AND VISION PROGRAMS FOR MEMBERS
ACS offers the only health plan you will find that covers all your pre-existing conditions after a one year waiting period. Deductibles $2,500 or $5,000. Insurer is CIGNA of Arizona. Rates are competitive. PPO or HMO. Best plan available for independent businesses in Arizona for many years. Life, dental and vision also available.
INSURANCE CLAIMS AND DENIALS SOLUTIONS
The many documents under this heading provide you with ammunition to defend your fee structure as usual and customary, how to file medical necessity appeals using all Arizona laws, how to file complaints with the Arizona Department of Insurance, how to file Small Claims Court Lawsuits, how to handle post payment audit review and refund demands, and a great solution for your cash practice called Chiropractic Lifecare of America (CLA).
ERISA AND SELF-INSURED HEALTH PLAN TOOLS TO GET CLAIMS PAID
ERISA governs all health insurance plans that your patients get from their employers so it is really important that you understand all of your rights under this law. We have put it all together in seven key documents including the most important provisions of the law and sample ERISA appeal letters. Everything you need for ERISA is right here.
MD-DC PRACTICE AND REFERRALS
A chiropractor who formerly was a drug rep has put together a brilliant blueprint for how to meld your practice life with MDs. We provide the reference to her webpage and book. This is simply the best material on the subject out there today.
RECORD KEEPING AND DOCUMENTATION COMPLIANCE GUIDANCE
Teaching compliance with record keeping and documentation in Arizona has always been a paramount goal for ACS, and so we have assembled a packet of information that is the most comprehensive available. Read the fruits of ACS' investigation along with an outline of the course on record keeping given by the lead Board auditor, full course notes of a lecture on the subject by a former Board chair, Medicare Noridian requirements, CMS rules for reporting timed codes, and eleven key office forms to use to streamline your operations and documentation.
The Chiropractic Board requires you have a Medical Record Protocol on file and ACS supplies it here. We also teach you how to search the National Library of Medicine and retrieve articles from a medical library. In this section is a limited power of attorney form directing payments to the doctor when insurers other than BCBS deny assignments of benefits. Also, don't miss reading the great article about state boards and disciplinary actions.
PERSONAL INJURY TOOLS
Personal injury tools include the Arizona Bar Ethics Opinion that requires attorneys to pay your bill if they know it exists. We also have a position paper you can use to defend yourself when attorneys want you to pay 1/3rd of the collection costs, and when they want you to accept what the health insurance company has paid as payment in full, i.e., no balance billing. This section also includes all forms needed file County Health Care Liens, a Circular Letter from the Department of Insurance mandating fair investigations of low speed impact automobile accidents which can be used to combat insurance company fraud, and three invaluable forms for your PI practice.
LIEN FORMS FOR HEALTH INSURERS THAT REFUSE TO HONOR ASSIGNMENTS AND FOR AUTO INSURERS UM/UIM AND ALL CLAIMS
ACS Attorney David Abney has developed new lien forms that will force insurance companies to send checks directly to you even when the deny assignments of benefits. BCBS has initially refused to honor these new liens and so we expect to have to litigate to force them to do so. We intend to litigate to gain enforcement of our new liens, and have initiated a fundraising campaign for the lawsuit. No other health insurer has yet reacted to the new liens.
The liens will also work in PI cases and in fact give the provider more rights than County Health Care Liens. We still recommend filing County Health Care Liens, but these liens cannot be filed in UM, UIM or medpay cases and so the new ACS lien is the only lien that can be filed in such cases. It is highly recommended that the ACS lien be filed in these cases. These liens are a very special new member benefit for ACS members.
HOW TO QUALIFY AS A COURTROOM EXPERT IN CLINICAL BIOMECHANICS
ACS has developed a Position Paper documenting how your chiropractic education has provided you the foundation to be a courtroom expert in clinical biomechanics today. It is available to all members.
ARIZONA CHIROPRACTIC SOCIETY (ACS)
ALAN M. IMMERMAN D.C., PRESIDENT AND EXECUTIVE DIRECTOR
3515 East Carol Avenue
Phoenix, Arizona 85028
VOICE: 602.368.9496 ·
|The Arizona Chiropractic Society is here to serve you!|
3515 E. Carol Avenue
Phoenix, AZ 85028
|Alan M. Immerman, D.C., ACS President and Executive Director ||
CHAIRPERSON DIANNE HAYDON RESIGNS FROM ARIZONA CHIROPRACTIC BOARD, REPLACED BY FORMER AAC PRESIDENT RICHARD GUARINO, HIGHLIGHTS INCESTUOUS RELATIONSHIP BETWEEN BOARD AND AAC
ACS has just learned that Arizona Chiropractic Board Chairperson Dianne Haydon, D.C. has resigned from the Board. The Governor filled her seat with former AAC President Richard Guarino, thus highlighting the incestuous relationship between the AAC and the Board. Over the many years that ACS has worked to reign in the abuses of the Board, the AAC has never once criticized the Board for even one single action it has taken. Board members are always selected from the ranks of AAC leaders and then, once they finish service there, they return to AAC leadership in a game of musical chairs. Only ACS is independent of the Board and free to do whatever is necessary to protect Arizona chiropractic from abuse by the Board.
We have had our disagreements with Dr. Guarino in the past, but the fact is that Dr. Haydon's resignation and replacement with Dr. Guarino is a great day for the entire profession. Dr. Haydon was always very sympathetic to the insurance industry having had a long history of performing insurance claims reviews and defense IMEs. Dr. Guarino is a typical treating chiropractic far more sympathetic to the average chiropractor in practice. He will be far more fair to doctors than was Dr. Haydon. Therefore, this truly is a great victory for the profession. We wish Dr. Haydon a long and happy life at her home in Mohave County no longer doing the insurance industry's bidding on the Chiropractic Board. ACS will continue to monitor the Board as always, but with Dr. Haydon gone there will be much less trouble coming from the Board.
ORAL ARGUMENTS SET FOR 06/06/12 IN COURT OF APPEALS IN ADOI INSURANCE EQUALITY LAWSUIT
Oral arguments have been scheduled in the Arizona Court of Appeals in the ADOI insurance equality lawsuit. Date is 06/06/12, 9:30AM, Arizona Court of Appeals, 1501 W. Washington, Dept. D, Courtroom 1, Phoenix. Map link: http://azcourts.gov/coa1/ClerkofCourt/BuildingLocationDirectionsGeneralInformation.aspx. Each side has 20 minutes. The public may attend. Our attorney has said you may get an indication of which way the court will rule from the questions and answers during this hearing.
ACS will be there in force. Go to www.AZChiropractors.org and click below Breaking News under Most Read to review all lawsuit filings and documents. All insurance coverage for chiropractic in Arizona is on the line with this lawsuit, fully funded by ACS members. D-Day is coming.
DR. GEOFF RICCHIO GET PAID SEMINARS RETURNS MAY 19TH (NOTE DATE CHANGE)
While you are waiting for insurance equality to return, learn innovative new programs for your office and aggressive insurance collection techniques from Dr. Geoff Ricchio at his Get Paid Chiro Systems Seminar on May 19th. Past attendees rave about the results they have achieved. Click here for full information about the program plus instructions for how to register.
You will learn:
- How to collect 100% charges on insurance claims
- Collect $100,000 profit on massage cash programs
- Get 60 or more new patients each month
- 10-20 new PI and med-pay patients
- Setup high profit nutritional programs
- Stop patients from dropping out of care
- Create a $100,000 chiropractic wellness program
- Pay yourself $20,000 or more each month
- And Much More!!
for complete seminar and registration information.
ACS RELEASES NINE NEW NECESSARY DOCUMENTS AND PRACTICE TOOLS THAT YOU NEED TODAY
ACS has developed and now released nine new practice tools and documents to help you with the problems we are hearing about the most from our members. Here is the list with the documents posted live online at http://www.azchiropractors.org/pages/MEMBERSHIP-AND-MEMBER-BENEFITS.php.
8.1 -- Workers Comp - Procedure to Deal with Workers Comp Medical Necessity Denials.pdf: Here are full instructions for how to file an appeal and go to the Administrative Hearing level when a workers' comp carrier denies further care based on medical necessity, usually following an adverse IME.
10.1 - Small Claims and Civil Suits Instructions Simplified.pdf: One counter argument from insurance company lawyers is that any dispute over medical necessity is governed by the federal law ERISA and so belongs in Federal Court, not State Court, and so the lawyer may file a motion to remove the case to Federal Court. Here is your counter letter: Why ERISA Does Not Apply to this Medical Necessity Dispute. You will need to cite the ERISA Savings Clause which states that state insurance laws apply to ERISA plans and include it with you letter.
12 -- ERISA Claims Procedure DOL Rule 29 CFR 2560.503-1.pdf: Key full section of the law which you need to know to get results with your appeals. Here is the key clause with the language to use in every appeal: ERISA Key Clause -- ERISA Claims Procedure 29 CFR 2560.503-1.
25 -- Great Sources of Information for Billing, Coding and Documentation.pdf: With these resources, you likely won't need to take a course because the books and webinars are so thorough and accurate. Plus, we have found materials priced quite fairly.
29a -- What To Do When You Receive First Notice of a Complaint from the Arizona Chiropractic Board: Don't panic! Read this blueprint, follow the steps and it will likely turn out much better than you think.
29.1 -- Medicare Advance Beneficiary Notice of Noncoverage ABN: Medicare's most comprehensive statement on the subject.
30.1 -- PI -- Letter to Get Attorney to Release Settlement Monies He Has in Hand.pdf: This is the letter to use when you have billed medpay or a PI case has settled and the attorney has the money in hand but refuses to disburse the funds and pay your bills.
31.1 -- LaBombard Case: Sample letter to send to an attorney who cites this case as a basis for demanding that you pay 1/3rd of your medical bill for legal fees. The Illinois Supreme Court just ruled in favor of providers and against attorneys in a case which you should print and send in as support of your LaBombard letter. Click here for a copy: No common fund fee recovery for health care liens -- IL Bar Association.
FIREFIGHTERS TO RAIN INSURANCE BAD FAITH PUNITIVE DAMAGE LAWSUITS ONTO BLUE CROSS BLUE SHIELD OVER ASH
Firefighters from across the Valley are lining up to file insurance bad faith punitive damage lawsuits against BCBSAZ for having their chiropractic care cut off prematurely when additional care was clearly medically necessary. The most active single group is the Phoenix Firefighters. The bad faith attorney recommended by ACS and chosen by the firefighters to handle the cases is 30 year veteran plaintiffs' insurance lawyer Steve Ryan. The list of huge cases he has won against insurance companies with very large awards can be found on his webpage along with his complete biography at http://www.stephencryanpc.com.
All city, county and state employees insured by BCBSAZ can sue for punitive damages if they have been cheated by BCBSAZ, just like individual policyholders. Their rights have been preserved to file insurance bad faith punitive damage lawsuits. The firefighters did not know of these rights until informed by Dr. Immerman who then connected them to Mr. Ryan. Now the ball is rolling.
If you have any governmental employees who have had medically necessary care denied by ASH, refer them to Attorney Steve Ryan immediately for a free consultation. His phone number is 480-661-3977.
DANGEROUS PI BILLS DEAD FOR LEGISLATIVE SESSION
The two dangerous PI bills introduced this year, HB 2546 and HB 2547, have failed to make it through the legislative process in time to meet key deadlines and so are dead for this year. This means you are no longer threatened with being forced to accept health insurance payments as payment in full in PI cases. You will still be able to file County Health Care Liens against third party payers to collect your full bill. Also, defendants will still be prohibited from telling juries that the plaintiff's medical bills have been partially or fully paid by health insurance or medpay which would have reduced jury awards and thus the amount of money available to pay your final bill. ACS, together with a powerful coalition, convinced sufficient numbers of legislators that these bills should not become law and we prevailed in the end. This is great news for the chiropractic profession. Earlier in the session, ACS killed the only other bill that could have hurt the profession, SB 1250, which would have permitted out of state insurers to sell their policies in Arizona, which in turn would have allowed Arizona health insurers to drop their chiropractic coverage. We are batting 100% for 2012 at the Legislature. Now all that remains is for us to win our lawsuit against ADOI and 2012 will be a banner year for chiropractic. We fully expect to win this lawsuit and restore full health insurance coverage for chiropractic.
A word to the wise: Join ACS now or risk losing your practice. We have never been under such fierce assault and your only hope is a strong and well funded association. Do it today, not tomorrow If you are already a member, commit to recruiting a new member immediately and also raise your dues contribution by $25 per month. Let's rack up more victories in 2012. We are on a roll.
WELCOME RichCOR TABLES, MODALITIES AND SUPPLIES AS ACS CORPORATE MEMBER!
We would like to take this opportunity to introduce you to our newest ACS Corporate Member, Richard Corcilius of RichCor. Rich has been in business in Arizona for over 25 years selling and servicing chiropractic tables (new and used), modalities and supplies. He is a fixture in our profession, well known by scores of Arizona chiropractors as someone with great business integrity and character, not to mention selection and pricing. He really should have "DC" after his name after this many years of fine service to our profession. As an ACS Corporate Member, he is contributing substantial sums of money each month to help fund your lawyers and lobbyist. His products are as good or better than any on the market and so be sure to do business with him whenever possible. His phone number is 480-334-7430 and his email is email@example.com. Welcome aboard, Rich, and thank you for your support of our profession!
MUST READ: PLAINTIFFS' REPLY BRIEF IN ADOI LAWSUIT IN COURT OF APPEALS
The Plaintiffs have filed their Reply Brief in the Arizona Court of Appeals in the ADOI lawsuit. Click here to read the entire brief and you will see why victory is inevitable. This lawsuit is the only viable path to insurance equality in Arizona. The legislative effort attempted by others died without receiving even a single committee hearing due to pressure from the insurance industry. Help has been denied from the offices of the Governor and Attorney General. All hopes ride on this lawsuit. Fortunately, ACS has retained the finest appellate lawyer in Arizona, David Abney, to litigate this matter.
THE ACS ADOI LAWSUIT -- IT'S DO OR DIE TIME
An Editorial by Alan M. Immerman, D.C., ACS President
Our only hope is litigation to restore insurance equality in Arizona. The Arizona Department of Insurance has refused to enforce our insurance equality law which is why we have sued them. The Governor's Office and the Attorney General's Office have both turned a blind eye towards blatant lawbreaking by insurance companies. Legislation to solve the problem was killed by the insurance industry without receiving even one committee hearing. The only place insurance company money is not in control in Arizona is the Arizona Court of Appeals and Arizona Supreme Court. Therefore, that's where ACS has gone for justice.
Litigation is expensive. We have the facts on our side but will only win if we can continue to pay attorneys' fees. Unfortunately, with ASH in control of the purse strings, almost no dollars are flowing to doctors which makes it difficult for some to pay association dues. This creates the ultimate Catch-22: Will doctors be able to pay dues long enough to finish and win the lawsuit?
The future is in your hands, doctor. Clearly, litigation is the only way. We are firmly in the middle of the war in the Court of Appeals. A final decision will come this year. You have two choices: Fund this lawsuit with ACS dues or live forever under the ASH regimen imposed on you this year. Fortunately, there are still hundreds of doctors paying dues to ACS and so we can still pay all legal fees and costs, but it is getting tighter as ASH tightens the noose around doctors' necks. Therefore, we call again for any doctors not already members to join immediately and support this most important of all possible causes. It's literally now or never. Also, current members are strongly urged to up their dues by $25 per month if at all possible. Notify ACS immediately if you can. This is the ultimate war for survival of chiropractic in Arizona as we have known it. We can and must win this lawsuit, but only will if we can keep funding it. That is in your hands to decide.
HUGE PLAINTIFF'S AWARD IN CLASSIC LOW SPEED IMPACT CASE IN TUCSON 02/29/12
On 02/29/12, a Tucson jury awarded a plaintiff $70,000 in medical bills, pain and suffering in a classic low speed impact case in which State Farm brought in their top Arizona PhD biomechanical engineer. This engineer testified strenuously and at length that the forces were too minor to cause anything more than a minor injury with symptoms subsiding in a few days. Dr. Immerman rebutted each of his arguments with peer-reviewed journal studies and completely defeated every one, leading the jury to discard the engineer's conclusions. The case was Shamrock v. State Farm, CV 20091753, Pima County Superior Court. Whenever you hear uninformed attorneys say these cases cannot be won, tell them to look up this case and then call Dr. Immerman for a free consultation. This is far from the first time the defense has lost in a low speed impact cases. Plaintiff victories are now becoming routine.
ACS UNVEILS COMPLETELY REDONE WEBPAGE
You have a delightful surprise in store the next time you visit the ACS website at www.AZChiropractors.org. Prepare for a whole new look and ease of navigation. The website will just open up for your use like never before. Click on the link now and take a look. Members should be sure to look at the Member Benefits and Practice Resources Page and take advantage of all the resources found there. They are now extremely easy to access. We would appreciate any feedback you might have on our new look!
HOW TO GET BCBSAZ TO COVER CHIROPRACTIC CARE
Based on nearly unknown BCBS contract clauses, BCBS will not cover chiropractic care for correction of subluxations or relief of pain. BCBS will only cover chiropractic if it is expected to, and then does, produce functional gains that can be objectively measured. Almost no chiropractor is documenting patient function objectively and then looking for gains on a regular basis. This provides BCBS a basis to deny claims when files are audited.
Therefore, ACS has created a package of functional assessment tools for members to use to evaluate and document function thoroughly. There is a functional capacity questionnaire along with all of the actual 12 assessment tools recommended for use by BCBS. Completing the package are four full-text modern journal articles about functional capacity evaluations. All documents are available on the Member Benefits and Practice Resources Page. Scroll down to #24.2.
You will also find the legal response of BCBS to a lawsuit filed by a doctor over a claims denial. In this response, BCBS explains its contract language and exactly what is covered and what is not, i.e., there is only coverage for care expected to improve function. The presence of this limited chiropractic coverage language in all BCBS contracts is the basis for one of the counts in the ADOI lawsuit. This limitation only applies to DCs, not to MDs and DOs, and so is a violation of the insurance equality law, ARS 20-461. MDs, for example, can treat patients for pain and get paid by BCBS even if their function continues to decline based on objective measurements. This is illegal discrimination that will end when we win our lawsuit.
MOST READ FROM THE ACS WEBSITE
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.