Chiropractic fraud – Can perception become a reality?

Perception: A large number of consumers and investigators believe that fraud in the chiropractic industry is ubiquitous, and unfortunately, all chiropractors may be portrayed as abnormal actors using a thickline pen.

Why are the above impressions so common today?

This cognition is the result of a historical background. The basic premise of chiropractic therapy is chiropractic – subluxation, which is neither an objectively identifiable nor a confirmed condition.

Subluxation may be associated with the general perception of chiropractic therapy. However, based on more than two decades of experience in investigating chiropractic fraud and assisting chiropractors in complying with regulations, I suspect that some of the following activities of chiropractors may constitute the practical basis for this cognition:

– Do you want what I have? : Using practical activities advocated by practicing building consultants, they have huge bank accounts, expensive cars, expensive clothes, luxurious holidays… and the key to successful practice. A large number of chiropractors are recruited directly from the Chiropractic Academy.

– Wealth Audit: The practice income is usually increased through practice activities under the guidance of a practice building consultant, without determining whether the activity complies with applicable laws and regulations, including but not limited to: marketing activities for recruiting new patients; lawyers and medicine a doctor-recommended generation; conversion/retention of patients; treatment options for all; management of new or repackaged health care services; provider services provided by unlicensed employees; use of computer-generated annotation systems; Strengthen reimbursement; and collect mechanisms to maximize income.

– Explore your practice: Create multidisciplinary and/or professional practice, combine with existing chiropractic therapies, avoid limited spinal massage therapy coverage, and get more health care funding – including federal health care plans payable cost of.

– Our location is convenient: operating multiple clinics, scripts and agreements are the norm – guiding clinic doctors and staff to do what, how to do it, charge…

– We provide good service: all patients can provide the same service at similar intervals regardless of individual needs. The service involves chiropractors using new "state of the art" treatment equipment or unauthorised staff to manage the actual hands-on treatment of most patient care.

– The reason for our treatment is not the symptoms: to adjust the spine report to treat the cause of the disease and abnormalities, so that the body's innate intelligence can be cured, instead of masking the symptoms with drugs or surgery.

– Welfare design: The services provided are not based on established, individual patient needs, but based on philosophical beliefs – everyone needs chiropractic treatment, no actual health care complaints [if insurance is needed, can be found], chiropractic therapy Adjustments can achieve optimal health, as well as for all patients [upper cervical vertebrae, full spine] and the way to help with final adjustment.

-Wallet Biopsy: Determine the available insurance or the willingness to commit to pay for potential patients, even if they are asymptomatic – if they find an existing source of income, inform potential patients that they have medical conditions that require chiropractic treatment.

– You believe: Say and do almost anything that can earn income from people who express their "believe" chiropractic therapy – claiming to treat acne, allergies, anxiety, bedwetting, cancer, colic, depression…

– You may be injured without knowing: Provide a check under the guise of public service to determine the health condition that needs treatment. Such examinations typically performed on asymptomatic individuals include the use of non-clinical or scientifically-accepted testing devices to generate reports that allegedly display medical conditions and the therapeutic needs outlined in the scripted presentation.

– Winners, winners, free chicken dinners: free or donated services promised in active marketing campaigns – mailing, telemarketing, screenings, dinner talks, etc. – designed to allow as many people as possible to receive patient conversions at the clinic, regardless of actual medical needs how is it.

– Let us reach an agreement: to provide services to patients who are covered by insurance, rather than cash patients who receive similar services. Agreement with insured patients, acceptance of insurance payments and waiver of deductibles, co-payments and non-insurance services. Patients with cash are dealt differently for the fees they will pay.

– Witness the court: use the court system to file a lawsuit, challenge the payer's reimbursement decisions and practices to reduce resistance to suspicious activity – making it normal and acceptable.

– You are picking us up: Professionals can be victims when they are considered to be improper practice – even if reasonable thinkers know that such activities are inconsistent with the laws and regulations of health care.

Reality: The spine medicine profession has largely gone beyond the limits supported by its founders and is today regarded as a true health care discipline that provides patients with valuable health care services.

Reality: Not all chiropractors are involved in fraud. Not all lawyers are sh.. Not all insurance companies refuse to pay legal claims. Not all investigators want to get a spine therapist!

Reality: There is a problem with spine correction in every geographic area of ​​the United States, and abnormal chiropractors are unscrupulously promoting their plans.

Reality: Regardless of the provider's discipline, investigating the crime scene of a provider's fraud is the provider's clinical and billing record. Moreover, if you know what you are looking for when evaluating your chiropractic record, you can identify fraud. Investigators regard the following as "red flags":

– Commitment to provide free/discount services to induce patients to the clinic


– Extensive examination, testing and treatment of subjective complaints of injured or asymptomatic patients


– Convince the patient to have a condition and require treatment using a test device that is not clinically or scientifically identifiable


– Scripts and protocols – Similar services for similar programs, even better


– Services that provide conditions not found at the time of the complaint


– Services based on available insurance or legal reasons – not actually needed


– Provider services provided by non-providers to patients


– Patients directly treat or treat themselves


– Charge too much for the service


– The goal is to charge a certain amount per visit


– the settlement code reported based on the best reimbursement results, not based on actual conditions or things done


– "Quick Code" automatically covers insurance coverage for all services, whether needed or actually provided


– Conditions reported only when the report needs to be paid [Subluxations – Medicare]


– Clinical records show the same in all patients, ready to support payment – no health care,


– Clinical instructions prepared only at the request of the payer – more extensive for the responsible carrier

Reality: A large number of chiropractors see what others see and try to fight for change and responsibility, often fighting on the island, escaping the attacking bullets of their peers and payers.

Reality: Many other honest and ethical chiropractors succumb to the temptation of fraudulent activity because they see that the abnormal spine doctor's wealth insurance has no adverse effects [eg, consumer refusal, claims denied, government audits and fraud investigations].

Reality: If effective measures are to be taken, chiropractic educators, chiropractors, consumers, legislators, insurance companies, regulators and law enforcers must address the problem of chiropractic fraud – especially those that are already well known and visible.

Reality: Observing this ruthless recipe can lead to an unimaginable disaster for chiropractors:

– Chiropractors get more health care costs


– Whether it is a substantive or quantitative step, it does not solve the well-known fraud problem


– Failure to take steps to prevent bad actors from damaging the reimbursement of health care professionals who follow laws and regulations while providing quality care to patients, a disaster that could lead to unimaginable levels of fraud.

According to James Edwards, president of the American Chiropractic Association, ["News report: Obama's victory may lead to a full range of chiropractic therapy," dynamic chiropractic therapy, 1/15/09], President Obama's election, and the Democratic Party controls both houses of Congress Most of them are promoting “national health care”, and the spine correction profession has the best opportunity to achieve long-term goal of full practice across the country [full implementation] -reimbursement access].

In addition, Dr. Edwards reports that if all-round practice becomes a reality, the spine correction profession should thank the ACA leaders for their courage to file a lawsuit against the National Health Insurance Corporation, the insurance company that manages the federal health care plan, and the countless ACA Legal Action Funds. Contributors make litigation possible.

Can the government’s greater control over individual choice and freedom be combined with universal health care to deliver lasting positive results? The last time the Democratic Party had this leverage, we got the Health Insurance Circulation and Responsibility Act.

Can a chiropractor be provided with a full physician status, as well as full reimbursement for the services they perform, can it solve the problem of chiropractic fraud?

Does the treatment of chiropractors with other doctors lead to a significant reduction in nonsense involving some chiropractors? Treating chiropractors as other doctors will hamper those chiropractors…

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