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10/20/2017 1:01:18 AM
9/22/2017 12:11:25 AM
Posted: 10/7/2005 1:12:26 PM EDT
I am thinking about filing an insurance fraud claim against a chiropractor. I am looking for any input on this before I do this and start a shit storm.

First of all I had a great Chiropractor that I went to for over 20 years. I know Chiropractors have been a controversial subject on these boards. But this doctor was great! I would screw my back up every year or two and after 3 or 4 adjustments I would be good as new. Unfortunately he passed away last year.

Fast forward to this year. I screwed my back up, pinching the sciatic nerve (that’s a bitch!) I go to a new Cracker that was referred to me by a few people. And this guy put on a good show. Free exam, group meeting dog and pony show, big screen video presentation yada, yada. So I give them the benefit of a doubt and start treatment. They figure treatments out for me and ask that I pay a $100 a month for my copay. About ten treatments into this I ask them for an itemized bill. I am given very strange response with this request. Like we don’t do that here, we don’t know how to do that etc? Well I finally get a bill and I’m blown away with what there charging me. The $45 for the adjustment seems on par. But they want me to sit in a wobble chair every time I come and to do traction on my neck. The wobble chair is a chair with a loose seat that you do circles on to limber up your lower back. Traction consists of a piece of rope and 2 pieces of pvc pipe that’s mounted on the wall. You place your neck into it and apply pressure on your neck. The traction apparatus has to cost $2.00 to make and I can’t imagine a wobble chair being $200 tops. They are charging me $25 for traction and $45 for wobble therapy… OUCH!! That’s $115 to walk in the door. They also want to Re-Examine you all the time to the tune of $66 per Re-exam. Screw them I’m out of there!

I feel these charges are way excessive and basically fraud. I need some opinions here. Is this Fraud? Should I turn him in? Has anyone been in this situation before?

Link Posted: 10/7/2005 1:50:55 PM EDT
[Last Edit: 10/7/2005 1:51:53 PM EDT by DScott]
Check with the chiropractic licensing board. They will investigate complaints involving incidents of these guys practicing beyond/outside the scope of their license, and if they are following all the laws/regulations. They can help you decide how to proceed.

IL Board



It's my opinion that high fees are not by themselves fraud or malpractice, but charging for services NOT delivered is. Doesn't sound like that happened here, though they sure as hell are padding the visits (and the bill) with a bunch of stuff that's probably not all that necessary for your care. Of course, I see little benefit in anything chiros do, but YMMV.

If you went along with it, you could be seen as being partly responsible. Did you think wobbly chairs are *free*??

Any decent doc will tell you what he's going to do, and why. A good doc will tell you how much it's going to cost. A good patient will ask beforehand.


IMO, I would complain to the doc directly, ask for a reduction in the bill for the unnecessary and/or unwanted services. Do it in writing, and threaten a complaint if he doesn't work out a fair solution for you. Be reasonable. Get it over with and move on to someone you like better.

A complaint to a licensing board is easy to file, and a major pain in the ass to respond to for the doc. It's better for everyone if you can resolve the issue without doing that. OTOH, occasionally, docs counter-sue for frivolous complaints, and win.
Link Posted: 10/7/2005 1:52:44 PM EDT
A chiropracter aint a doctor.
Link Posted: 10/7/2005 1:54:45 PM EDT
How did his bills compare to your previous doctors'?

Link Posted: 10/7/2005 2:14:11 PM EDT
I've got a real fraud case for you...

My ex wife was on the birth control pill.
Every month, she would go to the Womans health center, to get a new package of pills.
As they catored to low life pieces of shit, payment was required at the time of service.
And since birth control pills weren't covered by my insurance, it wasn't a big deal.

4 years passed, and it was the same way every month.

My ex was always going to the doctor for something, so I had a stack of
"explaination of benefits" forms several inches thick. I never looked at them.
Well, one day I did.
And it happened to be a claim from the woman's health center.
For something like 35 dollars worth of outpatient medication.
And my insurance company was paying $20 back to them.
(or whatever it was)

I called the womans health center and asked for an itemized billing statement of our account
from the time of creation. They strongly objected. I made up a story about tax problems,
and that we had claimed medical expenses, and the auditor needed the information. I said that
they can either mail them to me, or I'd send the IRS auditor to them. Made no difference to me.

When I got the itemization in the mail, it took me a while to decipher it and figure it all out.

They were getting checks from my insurance company, crediting my account, then billing my
account under a generic "miscellaneous code". Pretty slick. Someone was pocketing a bunch
of money from me, and probably hundreds of other patients.

SO, what to do. I could call my insurance company and report the fraud.
The insurance company would try to get their money back.

OR, I could demand the money from the clinic.

It wasn't my money, since insurance doesn't cover the pill.
But it wasn't the clinics' either, because they got it fruadulently.

Link Posted: 10/7/2005 2:22:54 PM EDT
Whoops, my mistake: I thought this thread was about doctors....
Link Posted: 10/7/2005 2:33:11 PM EDT

Originally Posted By The_Reaper:
I've got a real fraud case for you...

My ex wife was on the birth control pill.
Every month, she would go to the Womans health center, to get a new package of pills.
As they catored to low life pieces of shit, payment was required at the time of service.
And since birth control pills weren't covered by my insurance, it wasn't a big deal.

4 years passed, and it was the same way every month.

My ex was always going to the doctor for something, so I had a stack of
"explaination of benefits" forms several inches thick. I never looked at them.
Well, one day I did.
And it happened to be a claim from the woman's health center.
For something like 35 dollars worth of outpatient medication.
And my insurance company was paying $20 back to them.
(or whatever it was)

I called the womans health center and asked for an itemized billing statement of our account
from the time of creation. They strongly objected. I made up a story about tax problems,
and that we had claimed medical expenses, and the auditor needed the information. I said that
they can either mail them to me, or I'd send the IRS auditor to them. Made no difference to me.

When I got the itemization in the mail, it took me a while to decipher it and figure it all out.

They were getting checks from my insurance company, crediting my account, then billing my
account under a generic "miscellaneous code". Pretty slick. Someone was pocketing a bunch
of money from me, and probably hundreds of other patients.

SO, what to do. I could call my insurance company and report the fraud.
The insurance company would try to get their money back.

OR, I could demand the money from the clinic.

It wasn't my money, since insurance doesn't cover the pill.
But it wasn't the clinics' either, because they got it fruadulently.




Call the DA and the dept. of insurance for your state. That's criminal.
Link Posted: 10/7/2005 2:52:00 PM EDT

Originally Posted By ARDOC:
A chiropracter aint a doctor.





+1000



<­BR>
GO BLUE![/b]
Link Posted: 10/7/2005 3:05:19 PM EDT
[Last Edit: 10/7/2005 3:08:54 PM EDT by jms92]
"Get it over with and move on to someone you like better. " I did. I just fairly want to settle my bill....

"Did you think wobbly chairs are *free*??" No But $45.00 to wobble in a chair for like 4 minutes seems excessive to me. I can buy a $15 yoga ball and do the same thing.

$45 for a back adjustment is probably the going rate, and I don't have a problem with that. I have a problem with the bogus wobble Therapy. All the paperwork I recieved from the doctor never addresses this. I was told that I would have six adjustments then start traction, while I was billed for traction from visit two. Not sure what visit I started traction but it was not visit two.

I sent a certified letter today requesting an itemized bill, that I wanted the billing errors corrected,so my account could be paid and closed. I stated there services where no longer needed.

I did not make any threats nor did I state that I feel they hurt me more than they helped me... I will see what there response is before I start with threats......

Edit to add... They are charging me more per visits than they told me and I have that documented by them....
Link Posted: 10/7/2005 3:27:48 PM EDT

Originally Posted By jms92:
"Get it over with and move on to someone you like better. " I did. I just fairly want to settle my bill....

"Did you think wobbly chairs are *free*??" No But $45.00 to wobble in a chair for like 4 minutes seems excessive to me. I can buy a $15 yoga ball and do the same thing.

$45 for a back adjustment is probably the going rate, and I don't have a problem with that. I have a problem with the bogus wobble Therapy. All the paperwork I recieved from the doctor never addresses this. I was told that I would have six adjustments then start traction, while I was billed for traction from visit two. Not sure what visit I started traction but it was not visit two.

I sent a certified letter today requesting an itemized bill, that I wanted the billing errors corrected,so my account could be paid and closed. I stated there services where no longer needed.

I did not make any threats nor did I state that I feel they hurt me more than they helped me... I will see what there response is before I start with threats......

Edit to add... They are charging me more per visits than they told me and I have that documented by them....



Sounds good to me. If they don't work with you on squaring up their bill, move to the next step.

Oh, and just to clarify: I didn't meant to say you should "get over it", but meant "finish this and move on to someone better". The "wobbly chair" comment is a joke about their goofy practices.

No insult intended, and I hope none was taken.

Good luck on this!
Link Posted: 10/7/2005 3:37:39 PM EDT
DScott Hey your replies where not offensive.... "with the get over it".... I understand where you where coming from.... I quit going to them folks there ideas and mine differ allot... I moved on... I know some people hold on to anger and keep the ax on the grinding wheel at all times. I see no value in this. I want to settle my bill and be done with these quacks... I have had great luck with Chiroprators in the past and am sad to see the way they practice here... If they are ripping off people and Insurance companys I have no problem with blowing the whisle on them. Ya do the crime ya do the time....

Thanks for the reply's.....
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