in a Complicated Scenario - Bad Chiropractor - See below

Posted: Thu Apr 17, 2008 04:00 am Post Subject: insurance

I just wanted to let you know that your 'story' is SOOOO sad. I'm sorry I can't give much adice, pertaining to this issue, but, I ALSO wanted to say your issue hasn't fallen' on deaf ears'. I'm sure Lori can answer this pretty clear for you. She has REALLY helped alot of people here. Also...wanted to say welcome to 'our' forum.

Posted: Thu Apr 17, 2008 05:27 am Post Subject:

Here's the dilemma, the Chiro's final bill is nearly $14k, but since I have alienated myself with my INS company by telling them that this bill is NOT worth it because of the inflated costs, I am concernced that the Chiro is going to come after us for the $14k.

Posted: Thu Apr 17, 2008 06:01 am Post Subject:

Hi..

I know that I can get him in serious trouble on a number of levels with the state.

Also, this Chiro is telling us that the INS hasn't paid them yet and we closed out the visits to the Chiro in late Dec 07.

Posted: Thu Apr 17, 2008 10:16 am Post Subject:

Good morning scammedbychiropractor, and welcome to the community...sorry it's taken me longer than usually, had a lot on my plate lately...thank you for the very kind words.....let's see if we can figure this out together...

My wife and I were were involved in a hit and run accident by an uninsured motorist. I chased him down and caught him and the police arrested him

he manipulated her mentally. He had her going 2 to 3 times per week over the course of 3 1/2 months. I was getting suspicious of the things he was saying and doing to convince her to go so often. When my wife tried to get the information as to the amount they were billing to the INS company, they gave her the run-around (now mind you, my wife had them set up direct billing w/the INS company, but the Chiro office never submitted the bills until the very end).

but since I have alienated myself with my INS company

What would you do in this case? I just don't know what to say to the INS company and the Chiro wants me to intercede on his behalf so that I can get the INS to pay him.

Posted: Thu Apr 17, 2008 02:13 pm Post Subject:

I am sorry that you and your wife were involved in an accident, much the worse that it was with an uninsured driver. Not fun at all.

Please don't take this personally but I must play devil's advocate here.

It sounds like your whole problem boils down to lack of communication.

1. Your wife was treated by a doctor for 3 1/2 months before either of you demanded answers to questions like "how much does this cost?" and "Are 3 treatments per week really medically necessary?" (I kind of get this, most people don't care when they expect insurance to be picking up the tab)

2. Since you didn't ask up front, how are you so sure that these bills are "padded"? I don't do chiropractic, but even a decent massage therapist in my area (Ohio) charges around $100 per hour. So is it really so outrageous for a chiro to charge $240.00 per visit? That depends on a lot of factors that you didn't mention.

3. You called your insurance company because you didn't want them to be taken advantage of, now you feel that you've alienated yourself from your insurer. I don't get it. First, when someone looks out for my best interests it usually endears said person to me, certainly doesn't make me mad at that person. Secondly, you don't state any reason for feeling this way, nor do you tell us what your company told you when you called to rat out the chiro. Also, why did you try to call the CEO of the company instead of the claims department? Were you unable to contact the claims adjuster assigned to your case or his/her supervisor?

4. Where did you get the idea that simply because it's an uninsured motorist claim that you "have to" sue your insurance company? The whole point of UM coverage is to avoid lawsuits. Sometimes UM claims do lead to an insured suing his company but by no means should you "have to".

I think we also need to know the severity of the accident. You say you chased the other driver down, I assume that to mean your vehicle was still driveable, or did you run him down on foot? What was the extent of your wife's injury, and was she referred the chiro by her primary physician?

One more thing. I get the distinct feeling that you are holding something back about your true reasons for calling the insurance company to try to "protect" them from the big, bad, bill padding chiropractor.

I mean, you wouldn't be the first man to have compassion for his insurance company but honestly I rarely run across that attitude, most prefer to see the big, bad, deep pocketed insurance company get hosed.

I apologize if this comes across as harsh, not my intention, it's just that we can help you better if you present the whole story and it sounds like the root of the story is a vendetta against the chiro. You accuse him of mental manipulation, you threaten that you have a case to get him in trouble with the state, you called the insurance company to, from what I'm getting here, try to keep them from paying him.

If you let us know what the insurance company had to say about your "tip" and what they told you when you asked about the chiro's claim that he hasn't been paid then maybe we can go from there.

Posted: Fri Apr 18, 2008 12:33 am Post Subject:

fishman,
Those are great questions. Hopefully, we'll hear from scammedbychiropractor. There are alot of angles to this dillemma. It will be interesting to know more.
Thanks

Posted: Sat Apr 19, 2008 02:27 am Post Subject: RE: CHIROPRACTOR ISSUES -Potential fraud / erroneous charges

HI All,

This is ScammedByChiropractor,

First let me say thanks so much for all of your responses. I am so very sorry for the late response. These last few days have been hectic and I wasn't able to review the responses. First let me say "THANK YOU" to all. I'll start from the last response and move upward. I apologize in advance for SUCH the LONG reply... I am not the best writer and am so HOT on this issue that it is a challenge for me to be more concise.

LUCKYMAN:
Thanks for thoughts and I do feel this is a huge dilemma.

FISHMAN:

I totally understand where you're coming from and I truly appreciate you and everyone playing the devil's advocate. First let me say that I do feel the chiropractor should be paid for his services (just not that much, he and his sister clearly tried cover things up and are still trying to cover up... also, there are charges listed on the bill that NEVER took place, they are in code). I do like the person as a person. I am in no way looking to avoid payment. I do agree w/you that this was a total lack of communication on many levels. I'll get back to that, first I will address each of what you've stated.

In Response to your concern on #1:

1) From the very first visit, my wife did address the payment issue... she asked about payment and stated that she had a PIP plan w/the INS company. The Chiro's sister (manages the finances) told my wife that they would prefer to direct bill them. My wife stated at that point that it's not a problem if we pay it because she was getting some checks in the mail from the INS re: a Doctor's visit, MRI, etc. The Chiro's sister insisted that it would be easier for a direct bill. My wife at that time did not see an issue w/that. So the Chiro's sister called the INS on the spot and supposedly worked it out for a direct bill.

RE: the 3 1/2 months before the answer... We thought all along the Chiro was billing the INS company (please note: that at that time, my wife just started a new job 1 week prior to the hit-and-run accident and I was working over 80 hours a week / 7 days a week. We were both simply super busy people). (Also, my wife had severe headaches and had some dizzy spells. We saw a neurologist and had several tests to done to try to figure out what her ailments were) About a two months into the visits, I started to ask questions to my wife as to why she had to go for so many visits. I had met w/the Chiro and mentioned these concerns. He had my wife convinced that ONLY he was making the difference in her treatment. He would get her to admit to it. I started to get a suspicious feeling and had told my wife to ask questions as to why 3 treatments a week were necessary. It was just an awkward time in our lives, my wife just started a new job and I was really stressed and overworked in mine. We should've been more savvy about this much sooner.

In Response to your concern on #2:

2) After about 3 months, our suspicions were growing based on various odd comments that they were making to my wife (and me). They were confused about the amount of damage to our car (it was very, very minor, less than $400 to fix as it was a "low impact" collision to use the INS co's term. The sister of the Chiro originally thought it was around $4k in damage. From that day on the Chiro started telling my wife what that the INS company was going to try to say negative things about the treatment and why he was treating her 2-3 times per week. My wife told me of all of this and I told her straight out to ask "WHAT ARE THEY CHARGING OUR INS company". When she went in the sister of the Chiro said "don't worry honey, the INS company will take care of the bill". My wife is a very tender and meek person and at this time she wasn't fully aware of all of the mind games, etc. I went in and pushed to find out what they were charging to which they said they didn't have the bill prepared. I said, well, you're billing the INS company, what have you been billing them? To which she said, we haven't billed them yet. I was FLOORED!!! I immediately pushed and pushed. Finally she said your bill is around $12k. I hit the roof. I truly did not expect it to be that high... after all, she was only going for about 20-25 minutes per each visit (which also included talking to the various sisters of the chiro).

We had a meeting w/the chiro and I demanded to see the bill then they set up a meeting. The Chiro said that they get beat up all of the time by INS companies and that even if the bill was $2k they would still get beat up. I told him that I simply asked him if these were reasonable and customary charges to which he said... yes. He went on to say that the INS will reduce the bill down. He said that they always deal w/them and that this is what they do. He didn't have an explanation as to why they weren't billing the INS company. So after this meeting, I fully expected them to bill the INS company. I contacted both the PIP claims person and the Unin Motorist claims person. I told them that they would be receiving a bill shortly and that it looked suspect to me. I didn't say "fradulent, or anything like this" I just said that it was VERY high for such short stint visits although it was a lot, based on the Chiro's suggestion. My wife was a busy at her new job, it wasn't her intention to go 2-3 times per week, but since he did convince her that it would take that high amount to fix her (she knows better now and learned a valuable lesson).

In Response to your concern on #3:

3) Yes, I called them re: this... We're new to this type of situation and never had a claim other than the typical winshield here and there and some minor things over the past 13+ years. I also alerted to the fact very early on when I got the estimates for the body damage. I called a few places and got estimates ranging from $400 to $2,000+... Just my bumber took the beating and some minor scuffing elsewhere. So I put together a list of the bodyshops for them re: that issue (not knowing what lay ahead re: the Chiro).

My first call to the INS was the PIP person and she was glad to hear that I was concerned about this bill (mind you, the Chiro's sister was supposed to have been billing them, had they been billing them at the rates that they were early on, the INS or myself would have been alerted to this).

My second call to the INS was to the Uninsured Motorist claims rep... she gave me an awkward response. She told me that she can't help and she doesn't understand why I am telling her this. She went on say that because the impact was so low that they're probably not going to pay the Chiro bill, that's just too high.

My third call to the INS was to a random INS claims office of the same INS company. I had told her of the above and she was really happy to hear this come from a customer because most people don't care what the bill is.

My fourth call to the INS was to the CEO of the company. He wasn't in, so I spoke w/an exec VP and through that contact they too were happy to hear this but they said that they cannot tell me anything. I just wanted to alert them to the fact of potential padding and that I wanted them to take note re: this particular Chiro. They noted my concern and that was it.

The reason I now know that I alienated myself from the insurer is because I asked an attorney about this situation and they straight out told me that when you're involved in an accident w/an uninsured, your INS company takes the other side as if they were the person and you're in a position to where you're going to have to sue them. He went on to say that I did some major damage. The attorney saw $$$ on this and now he said I won't get much at all. I told him we don't care about $$$ we just want to put this behind us. We are not seeking a payout, we wish we were never in the accident at all.

In Response to #4:

4) See #3... the attorney told me of this and it was confirmed by two other attorneys as well.

As you now know the accident was very minor... I don't know why I gave chase... I guess it's just fight or flight. This whole thing is just a nightmare. From the beginning even the police didn't want to help. The 911 operator told me that they were too busy to help with a hit and run accident. I was hit by an SUV w/a grill bar. This happened on the interstate. I chased him for 5 minutes and corned him, but he tried to ram me, but my little car was just ever so nimble. Finally after refusing to take no for an answer from the non-responding first responders, a cop came to pull him over. He had warrants for his arrest and this was his 4th offense for driving under a suspended license. Also, FYI... the INS asked me for the favor in showing up in court (he also didn't have Insurance) so that they can ensure he'll get the permanent SR-22 mark on his record (what ever that means).

Also, my wife only went to this Chiro because he is open very early in the morning (this Chiro lines people up to do 15-25 people at a time for their adjustment).

I guess I was protecting the INS company and/or anybody who is a MEEK person (my wife was, she's now stronger minded) so that they can ask direct questions and not be afraid to confront potential conflict head on so it doesnt resort to this.

I don't think you were being harsh... I truly appreciate the honesty. I try to live my life with the utmost integrity and hold others to that as well.

WOW... I am spent!!! Again I am sorry for the long-winded nature of this response but felt it was necessary to fully explain.

Lori and the others... I will log back on later tonight (after I tuck my wife in). Also, I have an update to give you...

Again, thank you ALL again for all of your patience and I feel truly blessed to have found this forum (I am new to forums). I can't tell you how grateful I am. :-)

-Anonymous

Posted: Sat Apr 19, 2008 06:04 am Post Subject: Reply to Lori :-)

Hi All,

I am back and waayyy tired. I am sorry if I don't have my wits about me at this hour.

Lori (and all others),

Thank you so much for taking the time to respond regarding my complicated situation.

RE: Chasing the hit-and-run driver. I just felt I had to do it. My instincts took over. After all, not only was it my wife and I but I didn't mention to you all earlier that my little dog was also slightly injured. Here's how it happened, we were in stop and go traffic on an interstate during a intermittant rainy day. Well, we hit a stop pattern and the person behind me failed to do so. At the last second prior to impact we knew we going to get hit. My wife and I looked at eachother, we couldn't even get a word out, it just happened that fast. I let loose and limber at the last second and she held on tight for dear life. Needless to say, I did not sustain any after effects of the accident (although I did not get check out), but my wife did and our dog hit the glove box. We got her checked out by the vet, she's doing fine, she just yelped for a second. Needless to say, we now have a dog safety seat and place her all buckled up in the seat.

RE: The problem w/this and other chiro's. Well, I am very resourceful. After finding out about the bill and hitting the roof, something told me it just wasn't right. Although I couldn't put my finger on it, nor could I accuse him since I don't know how to read chiro code (mind you, I am a very very busy professional. I should've done better by being more mindful to the potential for fraud since I saw the manipulation that was taking hold of my wife).

Once I found out what the bill had come to, I anonymously called Horace Elliott (SUPER NICE GUY) - Vice President of the NBCE (National Board of Chiro Examiners). I told him of the situation. He empathized and agreed with me and was dismayed by the impropriety. I did this as a fact finding mission (based on my the convo I had w/the atty, I had to make nicey nice w/the chiro because if we pissed him off, we could be holding the bag for the fraudulent bill, because as I stated before, if the INS got wind of the dispute between us and Chiro, they would wash their hands of the situation because we are in a situation of having to face off w/our own insurance. As the atty said, whey would they want to pay a bill that their own insured says is fraudulent). Believe me, I sooooo badly wanted to CALL THE POLICE and get it on public record for what this Chiro was doing.

In addition to contacting the VP at NBCE, I also contacted the licensing board in my state, the attorney general, the dept of insurance and googled various insurance fraud investigators. I even made some anonymous calls throughout the country to ask some questions.

I put all of this info away and on the back burner as after all now that we uncovered his high prices we wanted to simply close out the case, but we had to do it in a very careful and NICE way so not to piss off the Chiro even further. The atty said to see him a few more times so to ease it up a little and make it appear that we're working w/him to get the case closed so that they can close out my wife's file (trust me at this point, my wife knew she was taken advantage of and just felt mentally raped... me too for that matter). The Chiro said he had to do a few more exams to close out the file to include a final moving X-ray as instructed by the INS company (come to find out none of this matters to the INS company) but I was told by the atty not to make waves w/the INS and just let things die down and simply let the Chiro close it out and submit the piece of the file to the INS.

To give the appearance that we were friendly w/them (after all the Chiro said that they're dealing w/the INS company and that the bill would ultimately be whittled down and that nothing would be visiting our mailbox as far as any sort of bill), my wife even paid out of pocket for one visit (we wanted to test him to see if he would charge $245 for the simple 15-20 minute as he has done in the case w/the accident... WELL he didn't, he charged $60 for the office (which is typically normal in this case... I also called 15 different Chiros in the area and they all charge anywhere from $25 to $60 per visit).

Moreover the last time we visited the Chiro or had any contact w/them was over 3 months ago. When we left off, they were supposed to have at least billed the final bill to them. We already uncovered that they weren't billing when they were supposed to. They didn't submit the bill until just a few weeks ago. They had the nerve to tell my wife that they needed to paper the file because of the amount the INS would question the bill. Well it took them over 3 months to do this.

Lori... I hope that this is all making sense, I know this may appear a little disjointed. I am running on fumes at the moment. But just to make sure that I am answering your question. All of the bills were submitted to the INS all along from my wife through her other care, other Doctor's, medicines, Vet Bill, etc. and they were promptly paid (via PIP).

Here's what came to a head this week. On Monday I pulled up the charges the Chiro charged to my wife's credit card ($180) for a different type of treatment because they said they needed that because the INS company wouldn't cover it (making it sound like they were communicating w/them). Well, I was going to submit the $180 to be repaid via PIP since I paid the credit card bill on my own. My wife misplaced the receipts and I wanted submit them right away. No biggie, I simply contacted the Chiro and asked them to just provide a separated copy of the charges for $180. When I did this, apparently I opened a can of worms.

The Chiro's sister started in by saying that my wife signed a lien and that they need their bill to be paid. I was floored, I said well, that's between you and the INS company as discussed from day one. I said I don't know why you waited so long to submit the bill. Well it started to get heated and I just had enough. I told her that one of the assistants at the Chiro office was providing treatments for which he was not licensed to do so (I found this out by talking w/the state chiro licensing board). She proceeded to say "who", "who"... apparently she was either shocked that I made those (TRUE) allegations, so I said don't play games w/me. I then proceeded to tell that she herself has performed on my wife for which she was not qualified for (I looked her up on the state site also, ooops, she's not listed, SHE'S BUSTED). She freaked out and called in the Chiro to talk to me (I had the impression he was recording my phone call). He started by saying that they don't get involved in w/the INS at all and that's between me and them. BS... I was making reference to our earlier convo when we caught on to why he wasn't billing the INS company.. he basically gave me the runaround. He said in no uncertain terms that he now wants me to intercede to get the INS to pay the bill. He said that he will work w/me on the bill and to trust him. I said "what does that mean?"... he was talking in generalities. I figured it would be best to ax this convo and I did.

Well, I did in fact call the INS (yesterday - 4/17). I spoke w/the PIP girl, she really likes me and understands my HUMAN MOTIVATION in this matter.

She was SUPER nice to me, I know she understands the position I am in. She also said that they're simply not going to pay the chiro bill and also said that she's never seen one that high EVER for such a short time and she's been doing this for a LONG time.

I asked her when she received the bill from the Chiro (now mind you I was expecting the Chiro to send in the bill over 4 months ago). Come to find out... the Chiro just submitted the bill 3 weeks ago. WHAT THE HELL... in addition, to show how disorganized they are. The Chiro called asking for the status of when they would get paid to which the PIP girl said they never submitted ANY bill. So, they realized this stupid mistake and finally submitted the bill to the INS. How could they expect the INS to pay a bill like this after so long? I had the INS send me the notes from the Chiro. I'll update you on this another time. My eyes are drooping.

Sorry for the rambling. Again thank you so very much for taking the time to read and respond.

Oh, I forgot to tell you the state. Would you mind emailing me privately or can I email you? I don't want to reveal the state in this venue.

Thank you again for everything :-)

p.s. I've got to tell you before going to bed... you (all of you) have made me feel much better about this situation. My wife and I have gone through a lot mental anguish about this. Just one more thing before going to bed. The state licensing board really wants us to make a formal complaint so that they can start the investigation.

-Anonymous

Posted: Sun Apr 20, 2008 07:02 pm Post Subject: accident

We all have our 'normal' instincts, when it comes to our families...if our family gets hurt, we want the BEST care. If someone HURTS our family, we want to find out who is was OR if we KNOW who it is, we want revenge of some type. Amoung dealing with Doctor bills, etc and worrying for our families safety, it can ALL get overwhelming!! Speaking from experience, of course.

Posted: Thu May 01, 2008 08:48 pm Post Subject:

scammedby, I've read and re-read your second two posts and I just don't see this as an insurance issue.

I truly hope that you find peace and learn from this experience.

I still feel very strongly that there is an undercurrent you are leaving out of this because of your repeated allusions to manipulation of your wife by the chiropractor, but I respect your right to leave that out of a public forum.

I will say that the attorney who saw big $$$ didn't have your best interests at heart. To suggest that filing a UM claim puts you at odds with your company and in a position where you "have to sue them" is just wrong. Remember insurance is not supossed to be about getting "big money" it's about indemnity. Only lawyers and scam artists see getting in an accident as a an opportunity to profit.

I also understand your being a busy professional as I am one myself. Occasionally failing to give attention to family life while we are caught up in our careers causes us to learn a painful and sometimes expensive lesson. I've been there, really I have, and it made me angry at people I shouldn't really have been angry with.

So again, best wishes to you and your wife, may you never again be traumatized in such a manner and may you achive whatever will make you feel better about the whole issue with the chiropractor.