This regulation is directly from the Oklahoma State Department of Insurance
and is specific for manage care/indemnity plans
If utilized properly, you will ensure your collections without having to beg and plead
from the desk of:
Mark Studin DC, FASBE(C), DAAPM, DAAMLP
The carriers have 45 days to pay or deny your claim. Anything beyond that will result in a default of the payment of your claim and mandate a 10% penalty to be paid, by regulation. A telephone call will fall on deft ears, therefore create a paper trail with a demand for payment.
The Law:
45 calendar days after receipt of a |
10% per year interest |
|
Title 36, § 1219; Title 63, §
2514 and Title 74, § 1328
(2001)
Language for your complaint:
Dear Claims Examiner:
The services rendered were billed within the Oklahoma Insurance guidelines. It has now been beyond 45 working days allowed by Oklahoma Prompt Pay Law, Title 36, § 1219; Title 63, §2514 and Title 74, § 1328 (2001)
Since you have violated this regulation we can submit this entire claim for summary judgment or arbitration through our legal counsel.
We would like to resolve this issue without using legal counsel. If we do go to court, It will cost you both the amount of the claim and attorney fees with 10% interest annually as mandated by regulation Title 36, § 1219; Title 63, §2514 and Title 74, § 1328 (2001)
We request payment within 3 weeks of the date of this letter for the resubmitted bill(s) as prescribed by law. By doing so we will waive the interest due us as described in the regulations previously cited. If we do not receive payment, we will be forced to litigate this matter and also file a complaint with the Oklahoma Department of Insurance.
Oklahoma Insurance Department |
405-521-2828 |
Street Address |
|
Can only send email on website: http://www.ok.gov/triton/contact.php?ac=181&id=157 |
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WHAT IS THE SIGNIFICANCE
As I shared, there are laws and regulations that insurers know all too well, but are banking on that we don't know them and laughing all the way to the bank because we don't invoke the laws and regulations in place to reimburse us as legally required. I have been using these regulations and guiding offices for decades on how to understand and implement these laws allowing doctors nationally to increase their collections by as much as 50% on a consistent basis.
With utilizing the power of the law, insurance carriers are now paying doctors interest for delaying payments as prescribed in most states, which is the deterrent for delaying timely payment of our claims. In addition, we will be supplying language for you to use so that you can collect your fees timely.
It is these regulations that the US Chiropractic Directory will be researching and providing for doctors in your state. We are providing this as a free service; why?
WHY
The answer is research. As of 2011 there is no research that proves the basis of what we do; the true effects of the adjustment/manipulation. When we care for patients in our chiropractic offices, people get better, whether it is musculoskeletal, asthma, digestive issues, reproductive issues, pediatric issues, etc... and there is minimal to no research to certify in the scientific community as what we do as valid. In fact, there is no research that validates subluxation; the basis for chiropractic since 1895.
That doesn't mean chiropractic doesn't work or that we have to make anyone other than our patients happy...but...my goal is to realize 95% of the population under chiropractic care in my lifetime and after 30 years in chiropractic the clear path towards the realization of that goal is "peer reviewed" research. We need more, it is costly and the government is not funding chiropractic anytime soon at a level significant enough to make a difference.
Therefore, I am willing to provide doctors of chiropractic the power to collect more money, the knowledge to be more profitable and the action steps to realize that goal. The rules are the same for chiropractic, medicine, dentistry, etc... for insurance reimbursement and I have been successfully guiding multi-disciplines towards increased profitability for decades.
My ulterior motive (yes I have an ulterior motive) is that when chiropractors become more profitable and I ask for donations to support chiropractic research, there will be enough money to make a difference.
HOW TO GET THE INFORMATION
Although the Directory does offer paid memberships for any doctor who wants a preferred listing, there will be a free level of participation for any chiropractor to join and get the same insurance information. In addition, the free members will have access to the curriculum vitae builder, which is the only place anywhere to build your CV in an admissible, professional format. There are no strings attached, no requirements to spend any money and is not free for a limited amount of time. Basically, there are no games...it is free for those who choose that avenue and easy to enroll.
To get started:
2. Click on "Sign Up Today" on the homepage in the left column
3. Print the fax back form
4. Complete the form and fax it back
Once enrolled, to find the information:
1. Enter your username and password
2. Click on "Doctors" on the top toolbar
3. Scroll to "Doctors Consulting Site"
4. Click on State Collection Regulations..." on the left toolbar
5. Click on "Oklahoma"
I look forward to getting your collections up.
Respectfully,
Mark Studin DC, FASBE(C), DAAPM, DAAMLP
Academy of Chiropractic
US Chiropractic Directory
631-786-4253
www.TeachChiros.com
www.TeachDoctors.com
www.USChiroDirectory.com