Arizona Chiropractic Society eNewsletter

Breaking News      

July 17, 2012Newsletter Subtitle

Month Year
What's New Right Now!

 

BREAKING NEWS 07/17/12: Chiropractic or Oxycontin for pain? BCBS says Oxycontin, we say chiropractic, let the public decide after our next major Media Conference.

 

BREAKING NEWS 06/28/12: US Supreme Court upholds national healthcare reform. Read about the many powerful positive benefits for the chiropractic profession. 

 

BREAKING NEWS 06/13/12: ADOI Director Urias resigns effective 06/13/12, possible replacements unknown at this time. Policies may or may not change with new Director.

 

BREAKING NEWS 06/06/12: ACS provides report from 06/06/12 hearing before Arizona Court of Appeals in ADOI insurance equality lawsuit. ACS now awaiting ruling from Court.

 

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 04/18/12: ACS  releases nine necessary documents and practice tools that you need today. Check out all 60 vital documents on Member Benefits Page.

 

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. ACS now awaiting ruling from Court of Appeals.

 

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 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 or honoring LaBombard demands in PI cases. 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.




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.

 

Scroll Down for Member Benefits and Practice Resources or Click Here

  

SUPPORT OUR ACS SPONSORS AND CORPORATE MEMBERS!

 

PINCUS & ASSOCIATES, PC AND PINCUS & LESPRON, PC - ARE YOU TIRED OF REDUCING YOUR BILL? With offices in Tempe and Tucson, there is no longer any reason for you to routinely reduce your bill on accident cases. Call Richard Cruz, Esq. at 480.777.2599 or Michelle Lespron, Esq. at 520.888.2599 to learn how it is to work with attorneys who understand how to beat the insurance companies at their own game. You deserve to be paid for all of the work you do!!! Click here for the firm's webpage with full information.

 

X-RAY EQUIPMENT * NEW * REFURBISHED: WE CATER TO CHIROPRACTORS!! STANDARD X-RAY -- OWNED BY A DC FAMILY! High Frequency X-ray Systems, Digital X-ray Systems * Digital Cassettes, 300 MA Systems * Automatic Processors, Chiropractic Tables * New * Refurbished, Statewide Sales and Service. Call Lisa Dionisio at 602-275-3344 or go online to www.standardxrayaz.com.

 

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 [email protected] for more information.

 

DAVID TALLMAN, DC, NMD: Practice exclusive to prolotherapy for over 10 years. 480-922-1101 or arizonaprolotherapy.com for more info. 

 

CANCER TREATMENT CENTERS OF AMERICA: offers whole-person, integrated cancer care by combining state of the art technology and conventional treatment with nutrition, naturopathic medicine, mind-body support, massage, acupuncture, spiritual support, pain management, rehabilitation services and chiropractic care. For more information, your patients can call 800-234-9113 or go to cancercenter.com.

 

TEAM MOTION X-RAY: Doctor what truly OBJECTIVE reproducible finding do you have to support your WHIPLASH diagnosis. Digital Motion X-ray is available to your patient at your office. Traumatic ligament instability is real, and could be proven. Visit Teammotionxray.com and call 602-694-5014 for a demonstration. Arizona's mobile Digital Motion X-ray Center.

 

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.

 

PATIENT BUILDERS, INC. - NEW PATIENT MARKETING FOR CHIROPRACTORS: The Solution to the New Patient Dilemma! No more spinal screenings! No more spending money on marketing with "possible" results! No more spending maximum dollars with minimal results! We deliver new patients to your door when you want them! Call 480-756-9377 or email [email protected] to get started.

 

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 email[email protected]

 

CENTRAL PHOENIX PAIN MANAGEMENT: Manipulation Under Anesthesia, Epidural Injections, Facet Injections, Trigger Point Injections. Contact Don at 602 279-0044, [email protected].

www.azsurgicalcenters.com

 

GOT DOCUMENTATION? New Patient Forms for ALL patients plus E/M Exam Form and PI Forms - Great Documentation in Less Time - $129. Want to know about computerized SOAP notes? Contact Gregg Friedman, D.C. at [email protected] or 480-947-8381 for more information.

 

DIGITAL MOTION X-RAY (DMX): You've never seen subluxation like you can see it with DMX! Contact Dr. Winberry for a demonstration of the next big thing in diagnostics. Expand your horizons and get the best for your patients. Accepting referrals immediately in Tucson. Call 520-298-5111 or cell 520-241-1995. Email [email protected]. Web: www.winberrychiropractic.com

 

LOWY'S TAX PLANNING AND ACCOUNTING, PLLC: Accounting can be backbreaking, let the pro's do it! Tax Planning For Chiropractors, Business & Individual Tax Preparation, Bookkeeping & Accounting Services, Payroll Taxes. Call today for a FREE consultation 602-943-5861.      




 

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 $3,000 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. 

 

MISCELLANEOUS

 

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 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 �

FAX: 866.567.6762

EMAIL: [email protected]

 

 

 

































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































 








































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































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

[email protected]

 

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

CHIROPRACTIC OR OXYCONTIN? BCBS SAYS ADDICTIVE NARCOTIC OXYCONTIN FOR PAIN, WE SAY CHIROPRACTIC, LET THE PUBLIC DECIDE 

 

           Insurance company restrictions on chiropractic care of back and neck pain patients are fueling the prescription painkiller epidemic of addiction, overdose and death in Arizona. When patients cannot get pain relief from chiropractors without drugs, they have no choice but to go to their MDs and get prescriptions for drugs like Oxycontin and Loracet. These drugs are highly addictive and now the greatest drug problem in the U.S. with deaths from overdoses now exceeding those from heroin and cocaine combined. Many of these deaths could be avoided if patients had more liberal access to effective chiropractic care, now denied by BCBS, CIGNA, Aetna and the others.

 

            The refusal of the Arizona Department of Insurance (ADOI) to enforce the chiropractic insurance equality law has now taken on deadly consequences. Approximately 5% of patients exposed to opiate painkillers become addicted and many die. Many of these patients would never be exposed to these drugs were ADOI to do its job and enforce the anti-discrimination law and require insurers to give patients the choice of chiropractic care. ADOI and the insurance companies have now jeopardized public health, welfare and safety with their illegal policies. They literally have blood on their hands.

 

            ACS intends to bring this issue to the attention of the public with a massive press conference and media release created by the Rose+Moser+Allyn PR Firm, Arizona's most powerful and creative. Prepare for live fireworks. This will be unlike anything you have ever seen. We intend to place the blame where it belongs for the current epidemic of addiction, overdose and death from prescription painkillers. Much of this epidemic could be stopped in its tracks if chiropractors were first contact providers for back and neck pain patients. ADOI and the insurers like BCBS, CIGNA and Aetna have made this almost impossible.

 

            ACS now has a treasure trove of resources on this subject all together in one new online page: Dangers of Opiate Pain Medications and NSAIDs. Start out with the ACS Position Paper "Solving The Prescription Painkiller Addiction And Death Epidemic With Chiropractic." Then read the 13 news reports and articles about the epidemic summarized below. Follow with the full text journal studies also summarized below which prove chiropractic is equally or more effective than prescription painkillers in reducing back and neck pain, and then the studies which prove it is cost effective. 

 

          Email, print and distribute this material widely and immediately. There has never been a better or more important time to tell the chiropractic story. It has never been more urgent for the chiropractic profession to step in and save lives by sparing people exposure to addictive prescription painkillers. Now is the time to act, and act aggressively we shall.

 

          This PR program will, of course, cost money and lots of it. The more we spend, the more of an impact we will have. Remember how last December everyone was talking about how the insurance companies were cheating chiropractors after our December 13th press conference at the Capitol? We will do this again but bigger and better with your financial support. Please mail checks in amounts as close as possible to $500 to ACS at 3515 E. Carol Ave., Phoenix, AZ  85028. Please do it now. Is there any time at all to waste? You know the answer is a resounding "NO!"

CURRENT NEWS REPORTS AND ARTICLES ON PRESCRIPTION PAINKILLERS

 

Links to full-text articles from USA Today, CNN, CBS News, New York Times, etc. at http://www.azchiropractors.org/pages/dangers-of-nsaids-and-opiate-pain-medications.php 

  • In 16 states and counting, drugs now kill more people than auto accidents do.
  • Prescription painkillers have now surpassed heroin and cocaine as the leading cause of fatal overdoses.
  • Prescription painkillers now proven to be a gateway drug leading to heroin addiction.
  • Abuse of prescription painkillers increased four-fold from 1998 to 2008 according to a government report.
  • The rate of chronic prescription painkiller abuse increased by 76% from 2002 to 2010
  • The FDA convened an expert panel to decide if MDs need a few hours of special training before it is safe for them to prescribe addictive, long-acting narcotic painkillers such as Oxycontin that are fueling a horrendous epidemic of overdose and death. The panel voted overwhelming in favor. The FDA overruled the panel and vetoed the expert recommendation.
  • Some parts of the country have seen sales of prescription painkillers increase by as much as sixteen-fold. Increases of five to ten-fold are not uncommon.
  • Reformulating Oxycontin didn't solve the addiction problem, it just caused addicts to change drugs.
  • Workers treated with high doses of prescription opioid painkillers stayed out of work three times longer than with similar injures treated with lower doses.

CURRENT MEDICAL JOURNAL STUDIES ON CLINICAL AND COST EFFECTIVENESS OF CHIROPRACTIC COMPARED TO PRESCRIPTION PAINKILLERS DEMONSTRATING SUPERIORITY

 

Links to full-text journal studies at http://www.azchiropractors.org/pages/dangers-of-nsaids-and-opiate-pain-medications.php

 

           The North American Spine Society, in a study which reviewed the findings of 699 studies and published its results in the premier medical journal Spine in 2010, concluded that "5 to 10 sessions of spinal manipulation administered over 2 to 4 weeks achieves equivalent or superior improvement in pain and function when compared with other commonly used interventions such as medication."

 

          A 2012 study published in the prestigious Annals of Internal Medicine concluded that spinal manipulation was actually more effective in reducing pain than medication for neck pain both in the short and long term.

 

          A recent study of the Tennessee Blue Cross Blue Shield plan found that when chiropractors were first contact providers for neck and back pain, overall costs of care were 40% lower than when medical doctors were first contact providers. When adjusted for severity of condition, the costs were still 20% lower when patients were first seen by chiropractors. A previous study from UCLA of a health plan with hundreds of thousands of members found the same cost savings with chiropractic versus medical care of back pain. This study was published in the Archives of Internal Medicine in 2004.


US SUPREME COURT UPHOLDS NATIONAL HEALTHCARE REFORM -- READ ABOUT POWERFUL POSITIVE BENEFITS FOR CHIROPRACTIC PROFESSION 

 

           The U.S. Supreme Court, in a surprise move to many, completely upheld President Obama's national healthcare reform law today in a split decision. Chiropractors are wondering what impact this new law will have on their practices and the following is a brief analysis.

 

            Incredibly, this new federal law contains a full-blown chiropractic insurance equality section, Section 2706, Non-Discrimination in Health Care. Here is the complete language:

 

(a) Providers- A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider's license or certification under applicable State law. This section shall not require that a group health plan or health insurance issuer contract with any health care provider willing to abide by the terms and conditions for participation established by the plan or issuer. Nothing in this section shall be construed as preventing a group health plan, a health insurance issuer, or the Secretary from establishing varying reimbursement rates based on quality or performance measures.


(b) Individuals- The provisions of section 1558 of the Patient Protection and Affordable Care Act (relating to non-discrimination) shall apply with respect to a group health plan or health insurance issuer offering group or individual health insurance coverage.

 

           This section of the law will now go into effect in 2014. If will affect fully self-insured plans like Motorola that have been immune from our state insurance equality law and so have never previously covered chiropractic. 

 

            Other sections of the law require (1) Inclusion of Licensed Complementary and Alternative Medicine Practitioners in Medical Homes; (2) Integrative Health Care and Integrative Practitioners in Prevention Strategies; (3) Dietary Supplements in Individualized Wellness Plans; (4) Licensed Complementary and Alternative Providers and Integrative Practitioners in Workforce Planning; and (5) Experts in Integrative Health and State Licensed Integrative Health Practitioners in Comparative Effectiveness Research. For more details, go to http://theintegratorblog.com/site/index.php?option=com_content&task=view&id=658&Itemid=189.

 

           The other major impact of this law on your practice is that 30-40 million Americans now uninsured will, over time, become insured with private health insurance that will cover your care. This will also be a boon to your practice.

 

            We are well aware of the fact that many of you are philosophically opposed to the President and/or to the overall concept of National Healthcare Reform. We are not here to debate these issues in this column. The purpose here is simply to explain how the new law will affect chiropractic alone. It is clear the impact will be very positive. For the first time ever, we will have federal insurance equality. Welcome to a brand new world. This is truly a day to celebrate from a chiropractic point-of-view! 

REPORT FROM THE JUNE 6TH, 2012 COURT OF APPEALS HEARING IN THE ADOI LAWSUIT

Alan M. Immerman, D.C. 

 

           I preface this report with the observation that after testifying in 68 trials, I have learned it is impossible to predict the outcome from listening to the testimony. Therefore, even after listening to the oral arguments today, there is no way I can predict the outcome. Nevertheless, here are my impressions.

 

           The three judge panel pressed both attorneys equally hard with difficult and penetrating questions. One key issue is the fact that ADOI filed a motion to dismiss and not a motion for summary judgment. This means ADOI acknowledged as true all of the allegations we made against BCBSAZ and ASH regarding illegal copay structure, illegal preauthorizations, limitations on number of visits, etc. This fact obviously troubled the judges.

 

           On the other hand, the judges were not particularly friendly to the general idea of ordering a state agency director to act. As one said, if a prosecutor decides not to prosecute a particular case, should a court then intervene and order the prosecutor to act and override his discretion? The judges thought not.

 

            Our attorney responded and stated that we are not trying to tell the ADOI Director how to act. We just cannot accept a complete lack of action. Because ADOI did not defend its lack of action with a motion for summary judgment, the Court of Appeals may send the case back to Superior Court to force ADOI to more clearly explain its actions, thus keeping the lawsuit alive.

 

            My guess is that the Court will not accept ADOI's motion to dismiss and will send the case back to Superior Court for further action. The work we will have to do there, however, will be difficult. No one said this lawsuit would be easy but we will keep fighting it. A decision from the Court is expected in 1-3 months and we will inform you immediately when it is rendered.

 

            In the meantime, we have two other litigation approaches moving forward. One is the bad faith insurance lawsuits directly against BCBSAZ for failure to cover all medically necessary care. The second is the requirement by all health insurers for patients to pay any copayments. Our law states insurers may require coinsurance and deductibles but it is silent on copayments. We copied our law from the Wisconsin law and a Wisconsin law firm currently has litigation in progress over this exact issue. This law firm will work with Attorney Steve Ryan to file the same lawsuit in Arizona and hopefully eliminate all copays for chiropractic in Arizona.

 

           We are also planning a legislative solution to our problem. Ultimately, whether we win or lose the ADOI lawsuit, we will still have to count on ADOI to enforce the law. Clearly, ADOI does not want to enforce our law. Therefore, we intend to ask the Legislature to remove the prohibition for citizens to enforce the law, thus allowing you and your patients to take legal action when there are violations.

 

            To win a legislative campaign, we need volunteers to work with legislators on a local level. There are 30 legislative districts statewide and so we need only 30 doctors to volunteer to work with 1 senator and 2 representatives each. This is not hard or time-intensive work. Email or call me if you are willing to do this work and I will tell you exactly what you need to do. We need to do this work starting immediately since we are in the middle of election season. This is mandatory work if you want insurance equality. I look forward to hearing from you.

 

            In this world of uncertainty one thing is absolutely certain: ACS will never give up until we achieve complete insurance equality, one way or the other. That has been our key mission since our founding in 1991 and remains so to this day. We will win, the only question is when.

ACS RELEASES NEW DOCUMENTS AND PRACTICE TOOLS THAT YOU NEED TODAY

  

COMBAT LaBOMBARD CHALLENGES TODAY!

 

          ACS has released 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. 

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. 

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.