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CORPORATE EVIDENCE-BASED PRACTICE and MARKETING FIND AN ARIZONA MEMBERSHIP and INSURANCE LAWS, ARIZONA STATE BOARD of CHIROPRACTIC EXAMINERS IMPORTANT REPORTS, ARTICLES, BOOKS and LINKS
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MEMBERSHIP AND MEMBER BENEFITSSPECIAL TREASURES MEMBER BENEFITS
New members receive a package of documents including all of the following. Each has been carefully selected to solve problems and provide solutions facing Arizona chiropractors. Join today and get this package immediately.
HEALTH INSURANCE FOR MEMBERS
1 -- CIGNA -- ACS Membership Form.pdf: Group health insurance for ACS members with guaranteed issue coverage after a 90 day waiting period, no medical underwriting. PPO and HMO plans, statewide. 2 -- CIGNA Health Insurance Info.pdf 3 -- CIGNA Pamphlet.PDF CLAIMS AND DENIALS
4 -- Fees allegedly above Usual and Customary.pdf: How to protest when an insurance company claims your fees were too high. 5 -- Grievance Letters -- The Best Way to Get Insurers to Pay.pdf: How to use the Arizona grievance law, a powerful tool to bring pressure on an insurer that misbehaves. 6 -- Health Care Appeal Request Form.pdf: There is a legal process when a claim is denied as not medically necessary. This is a sample request form. #7 contains complete instructions. 7 -- Health Care Appeals Process.pdf: A three level process. The third level involves review by an independent party chosen by the Arizona Department of Insurance and paid for by the insurance company. 8 -- How to file a complaint with ADOI against an insurer.pdf: When insurance companies violate laws, complaints must be filed. 9 -- Medical necessity appeal letter.pdf: An excellent general appeal letter. 10 -- Small Claims and Justice Court Instructions.PDF: Sometimes the only solution when an insurance company does not pay is a lawsuit. Here are instructions for suing an insurance company. 11 -- Timely Payment of Claims, Adjudication, Adjustments.pdf: Claims must be paid within a certain time frame, and demands for repayment can only be made within certain guidelines. This document contains the legal details. ERISA TOOLS
12 -- ERISA Claims Procedure DOL Rule 29 CFR 2560.503-1.pdf: Key section of the law which you need to know to get results with your appeals. 13 -- ERISA Letter to File an Appeal.pdf: Use this letter today to get results when claims are denied. 14 -- ERISA Letter to Request for a Copy of the Summary Plan Description, Claim Appeal Procedure, EOB.pdf: The first step in an ERISA appeal is to get a copy of the plan document. This is the letter to send. 15 -- ERISA Self-Insured Plans ADOI Letter.pdf: This is the position of the Arizona Department of Insurance regarding ERISA self-insured plans. 16 -- Understanding ERISA.pdf: Complicated subject, simple explanation. 17 -- Understanding ERISA Detailed.pdf: Complicated subject, detailed but understandable explanation. MD-DC PRACTICE
18 -- The path to medical referrals.pdf: Key information about how to get referrals from MDs and DOs. 19 -- MD-DC Alignment in Practice.pdf: An entire book by a DC who once was a drug representative and knows exactly how to get into and talk comfortably with MDs and DOs. This is a blueprint with detailed plans. RECORD KEEPING AND DOCUMENTATION20 -- Recordkeeping as Mandated by the Arizona Chiropractic Board.pdf: Detailed instruction complied and updated by ACS over many years. 21 -- Record Keeping and Documentation Course.pdf: Outline of course given by lead auditor retained by the Arizona Chiropractic Board. 22 -- Record Keeping 2005.pdf: Full course notes given by former Board chair. Must request separately since file too large to include with email package. 23 -- Medicare Chiropractic Coverage and Documentation Nov. 2006.pdf: This is the full document from Medicare and must be requested separately since it is too large. 24 -- CMS Rules for reporting timed codes.pdf: These are the rules for reporting timed codes which you must follow to be in compliance with the requirements of the Arizona Chiropractic Board for all documentation. MISCELLANEOUS
25 -- Medical Records Protocol 2008.pdf: Arizona Chiropractic Board requires you have this on file in your office at all times. 26 -- How to search the National Library of Medicine and retrieve articles from a medical library.pdf: These are the types of journal articles the Arizona Chiropractic Board requires you to have to back up your claims. 27 -- DC Power of Attorney directing payments to doctor.pdf: Use when an insurance company refuses to honor assignments of benefits. 28 -- DC Power of Attorney Instructions.pdf: Instructions for #27. 29 -- State Board Investigations and Disciplinary Actions.pdf: Every doctor with a state license needs to read this background document about boards and discipline. Forewarned is forearmed. PI TOOLS
30 – Ethics Opinion 98-06 which requires PI lawyers to pay your bill if they know it exists (constructive knowledge) even if there is no written agreement. 31 – Balance Billing in PI Cases: Why balance billing to a third party insurer is almost always allowed in PI cases including citations to legal authorities. 32 – PI Attorney’s Explanation of Healthcare Provider Liens: Detailed explanation of the law. 33 – Sample form for Notice and Claim of Medical Lien: Fill in the blanks with your office information. 34 – Sample form for Release of Medical Lien: Fill in the blanks with your office information. 35 – Arizona Department of Insurance Circular Letter 2000-02 mandating fair investigations of low speed impact automobile accidents. Use to combat insurance company fraud.
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