Chiropractor Under Investigation

I was recently contacted by Progressive Insurance Company regarding a personal injury claim and patient I was treating. They are investigating and indicated that they wanted to verify and take pictures and the like. So today I let them come and do their thing. I really don’t know all the laws or what I should have done. I don’t feel I have anything to hide… but who knows, maybe I shouldn’t be so arrogant. But I did think about the rest of the profession regarding this. I read something about this kind of thing… but it didn’t stick; so I didn’t remember what to do. But I thought, had I seen a video or something that stuck… maybe even of a physician that screwed up… then I would remember and not be the guy that screwed up. But maybe I did mess up and give them something that might cost me. After all, it isn’t that easy to keep up with all the statutes and abide by all the rules. I like to think I do but I probably don’t.

Anyway, I decided to video tape this meeting. I was surprised they agreed. Of course, now I don’t know if it is legal to put this tape on the net without their permission! But they knew they were being video recorded in my place of business. But I didn’t have anything signed by them or anything like that. But then again the news does it all the time… right? And I’m not using it for commercial gain, does that mean anything?

So, I’m putting it here so that physicians can see it… even if I did screw up. I hope that doctors might in some way benefit and maybe get some instruction regarding what to do when the insurance company wants to investigate. This costs us time (and money). I know that the insurance companies are getting more aggressive at keeping the money they should give to physicians regardless of the excellent services provided. Understand, I am all against fraud and even sent a health care reform plan that addresses fraud to our wonderful President of the United States of America (did wonderful sound sarcastic?)

So watch the video and put your comments in the section under the video. Please give your critiques and don’t be a sissy! We need real input to get this broken system fixed.

michael haley DC, Chiropractor in Pompano Beach

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  1. Dear Dr. Haley,

    Thank you so much for providing this tape to the ICCOM. Also, for being cool-headed enough when they just “popped in” on you to refuse (and very politely, I might add) to give them the patient’s personal information.

    I will have both my assistants and the doctor watch this as a learning tool. Insurance companies are a treacherous lot. Your suspicion of them was valid, and there are a lot of us out here who pretty much trust anybody.

    Thanks again!
    Susan Flores
    Office Manager

  2. Wow, From what I can see, there are so many times that you have to guard against violating HIPAA. It would be so much easier to comply if they gave written notice and you had a chance to check for validity. Without the written notice it makes it very hard to comply with their requests.
    I think that was a great video for those of us who have never seen an audit. Thanks for your contribution.

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