One quick way to self-audit yourself is to randomly pull five old patient files and try to code or bill the services based upon the docu-mentation found in your patient file. Even money says you won't be able to do it!

4. Liability Insurance Carriers Are Taking Pre-Litigation Depositions of Your Patients and/or You

If this is occurring, you can bet that the liability insurance industry has you targeted as a fraudulent provider. The "type" of fraud it deem to exist may take many different shapes.

Likely your referral relationships with other providers or attorneys, or your marketing practices, are considered to violate your state's anti-kickback laws. Perhaps the manner in which you are billing for another provider's services is being ques-tioned, or the insurance industry is investigating whether you are billings for services not rendered (e.g., billing multiple units of physical therapy without appropriate timed documentation, up-coding, unbundling of services or just plain billing for serv-ices that are not provided).

I once represented a doctor who was employed to treat the driver of a UPS truck who was injured in an accident. Another UPS employee was riding with the driver but was not injured. The doctor treating the injured driver "dummied up" a $2,000+ bill purporting to reflect services provided to the passenger over the same span of time as he provided services to the injured driver, and submitted it for payment. A quick check with the passenger revealed the fraud in that transaction.

If you are encountering this type of oversight by the insurance industry, a thorough self-audit of your practice's marketing programs and business relationships, as well as a little self-evaluation, is definitely in order.

5. You Are the Target of Multiple Complaints Filed With Your Chiropractic Licensing Board

Obviously patients lie in order to avoid paying their bills and for other dastardly reasons. However, when a doctor finds them-selves responding to multiple complaints filed with the state licensing board, something is obviously amiss in the doctor's practice.

Often the complaints involve allegations that the doctor has failed to respond to a patient's request for their medical documentation or bill; or the manner in which the doctor has advertised the services they provide; or the degree of supervision provided by the doctor to the doctor's clinic personnel.

All of these potential problem areas can lead to serious sanctions by a doctor's state licensing agency. However, all of these prob-lem areas can be avoided if the doctor simply takes the time and makes the effort to learn and comply with the laws of their state.

Know Your State's Rules and Laws

Because of the current difficult economic times, many doctors seem to be trying to expand the marketing of their services beyond the tra-ditional chiropractic areas, such as co-managing diabetes, audiology, operating diet clinics and diagnostic testing. Each of these are potential serious problem areas for doctors of chiropractic in that they all potentially infringe on the domain of the medical profession and are therefore outside the scope of practice of chiropractic.

A thorough reading and understanding of your state chiropractic act and state board rules of practice should enable you to better understand what your legal obligations are and what areas of practice you should not venture into.

It is hoped that this "check-list" will help you do an little internal investigation of your practice habits and take the appropriate corrective action to eliminate any problems that are identified before they pop up and create legal problems for you and your practice.

---

Larry Laurent represents doctors of chiropractic. He is a member of the National Association of Chiropractic Attorneys and conducts seminars on chiropractic law issues. He is the founder of the Chiropractic Law Group, a consulting firm specializing in providing counseling services on chiropractic laws and regulations, business protocols, and practice organization and marketing strategies. He can be reached at or (512) 996-8844.