9 YO Chiro Visits
Posted By: Cyndee Weston on 2005-10-22
In Reply to: Personal question about 9 year old going to the chiropracter. ~sm~ - Wondering
As an insurance claims specialist, there are two issues here.
1) Since the mother works for the chiro, it is likely he would not bill the mother for treatment. And, if he did approve of professional courtesy by not charging the mother, then any claim to insurance would be fraudulent in the first place. This will be a policy provision in your own insurance policy.
2) The mother is probably filing fraudulent claims. You MUST speak to the Chiro on a personal and confidential basis. I would either try to contact him by phone, or send a certified letter where only the chiro can sign for the letter. Then you have proof that he received it. It won't take long for the provider to find out if the mother kept the money.
3) Filing a false claim is unlawful and can result in treble damages. You bring it up to your carrier and if it is truly a false claim, you could be entitled to part of the recoupment, if that happens. This could even potentially be a police matter of embezzlement.
4) 50% of all doctor's office will expeience some form of theft by an employee. I've seen it time and again.
No matter what, it doesn't sound right. And since the boy obviously hasn't been to the chiro in a while, it is very suspicious. Since you pay for the insurance and presumably the difference not covered by insurance, you have EVERY right to get involved. Furthermore, just as an innocent bystander, when you know someone is breaking the law, you have an obligation to report it. Don't be intimidated, find out what's going on. Best of luck.
Cyndee Weston
LINK/URL: American Medical Billing Association
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Visits to MTSTARS...sm
How many times a day, on average, do you come to this website? Just curious.
Chiropractor visits
I take myself and my two boys (14 and 8) to the chiropractor every 4 weeks. It is just to keep us "tuned up". My kids notice a difference in themselves if we miss a month. They actually like going because it makes them feel so much better. I would be concerned about it if they are going every week though. If you are paying for it, you should have the right to ask about it.
You might try a few visits and then switch to
Massage therapy. I too have muscle spasms in my neck and I have done both chiropractic and massage therapy. I have found that a good 1 hour massage does wonders!! and the effects last longer than what the chiropractor does. Sounds like a luxury but to me its preventative maintenance in this line of work. When I'm crying because it hurts so bad to hold my head up straight I can't very well type!
Limiting MTStars visits! LOL.
But one must check in from time to time throughout the day. Only trouble is, I find myself using that time to also check my e-mail, do a bit of browsing. Amazing how those the clock ticks quickly and the minutes can add up. 
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Only knew where their private records were going, I think there would be an uproar to say the least.
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I have often wondered this exact same thing. A lot of people go to the ER who have no health insurance or no primary doctor.
I had one woman bring her child in because he made a funny face after eating a sour fruit candy, I mean come on! 
sounds like my clinic visits ... sm
When sick for a visit, have done very interesting things with bodily fluids (including regurgitating on the doc). When rattled, have screwed up HPI and ROS. Have had conversations with other patients/office employees during my visits. Used to take at least 1 small child for every visit (one doc even let her play games on the computer while doing my exam, a tech let her help place EKG leads, and a radiologist let her help "read" a mammogram). Now that the small child isn't so small, have answered her calls during doc visits. They do put up with that and more. Seriously, I'd rather type about a pelvic exam than do one, especially if yeasty. Your post actually made me appreciate the doc more and be more tolerant of the way they dictate.
yes, your cranky; the patient visits are actually coded sm
due to time spent in the room. this is to document to CYA if needed. so remember, the more you talk in the room with your doc, the higher bill you will see. like office visit, regular; office visit extensive, etc.
I have Blue Cross through Webmedx. Office visits are $20. nm
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Husband's plan has no deductible, just copay and pays just straight up to 12 visits a year.
I do have a high deductible for mine, I think $5000 but the important thing to me is that I only pay $35 office visit copay. The deductible only kicks in on lab, x-ray etc.. and I have prescription coverage. The other thing you have to consider, as I also work in a physician's office doing medical billing, is that there are substantial contractual adjustments if you are with a BC plan. Say, your bill is $100 and the "allowable" from the insurance company is $75, that means that your doctor's office has to adjust off the extra $25 and you are not responsible for that; whereas, if you had no insurance, you'd have to pay the whole $100 out of your own pocket, no discount there.
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