A chiropractor recently sent a file to this office regarding a patient involved in an automobile accident.  The insurance company had a peer review performed for the care rendered in which the peer reviewer submitted the following opinions:  The patient had reached maximum medical improvement (MMI) one month after the trauma of the accident.  The reviewer reached this conclusion because the subjective complaint of continued low back pain at that point was the same as it was on the first visit.

My argument to the judge and the defense attorney is that it would be unusual if the patient did not

experience low back pain one month post-accident.  Aside from the ridiculousness of the insurance company’s position, what is most important is that the provider in question was not aware that he had four years from the date of the accident, or from the last payment by the insurance company (whichever date is later) to initiate a lawsuit to get his money back.  Not knowing this fact, the chiropractor had essentially written off the monies as a loss.

In this regard, it should be noted that my office does this type of work on a contingent basis.  This means that if there is no recovery for the provider, there is no fee except the initial court filing fee.  (In Philadelphia Municipal Court, where these cases are most often filed, the filing fee ranges between $56 and $132.)  If you are having trouble getting paid by an insurance company, contact my office for a consultation.