Managing Your PI Receivables: Best Practices 101
Brian Frankenfield
In the world of chiropractic, personal injury (PI) isn't always the most desirable area of practice for some DCs. Some have heard horror stories about bills being reduced, patients skipping out on payment, or cases that take years to settle. Such scenarios are awfully extreme, even for personal injury cases, and the doctors who go through these experiences are generally the ones who don't know how to properly manage their receivables.
What are PI receivables?
For healthcare providers, personal injury receivables are any amounts owed to them for treatment and services they've provided to a personal injury patient with a pending lawsuit. With most personal injury patients, chiropractors agree to work on a lien basis, which allows patients to receive treatment without having to pay while the case is being settled. For chiropractors working with PI patients, the lien, also known as a letter of protection (LOP), ensures that the patient is legally bound to pay for any treatment or services provided by the chiropractor once the patient's case is settled. The lien provides a win-win situation for both parties—helping the patient receive immediate care, while helping the chiropractor take on new patients. Until the services provided under the lien are paid for, those outstanding payments are considered receivables.
Why PI works: The benefits
The fact is that today's most successful chiropractors have expanded their practices considerably by following this surefire system of taking on PI patients and working on a lien basis. Personal injury patients require multiple visits and extended treatment, and satisfied patients can help expand your client base through word-of-mouth referrals.
There's more good news. When you work with personal injury patients who have legal representation, you also have the opportunity to establish a referral network with the attorney. Along with properly managing your
“in order to maintain your PI attorney networkyou'll need to
be able to show that you're able,.responsive, trustworthy, and an expert in your field. ”
receivables, establishing and maintaining this PI attorney network is one of the most crucial keys to successfully growing your practice.
Since chiropractors who work on a lien basis can be few and far between in some areas, you're already an asset to personal injury attorneys if you do work on a lien basis. However, in order to maintain your PI attorney network, you'll need to be able to show that you're reliable, responsive, trustworthy, and an expert in your field. If you can maximize the case value and formulate a favorable
deposition for the attorney, he'll be more likely to send referrals your way in the future. In short, attorneys want to work with doctors who are easy to reach and can help them win cases.
A chiropractor needs to be generally astute when taking on personal injury patients, and diligent in documentation in orderto properly manage receivables from PI patient cases. To make the most of the opportunities presented by working with personal injury patients, it's vital to stick to the following best practices.
Best practice #1: Only accept PI patients with legal representation
Before you decide to accept a personal injury patient, you should always make sure that the patient has a lawyer. Not only are settlements less when the patient denies legal representation, but you'll face a much higher risk of not receiving payment for your services when the patient goes it alone.
However, situations when the patient doesn't have an attorney can actually work in your favor since you have the chance to refer the patient to a few trustworthy attorneys you've worked with in the past. If the patient decides to hire an attorney on your list, then you've essentially handpicked the lawyer, reducing the likelihood of any potential headaches that come from working with bad lawyers. By doing so, you also help nurture your working relationship with that attorney.
Best practice #2: Learn the details of the case
A majority of personal injury cases involve motor vehicle accidents and slips and falls; liability can take months to establish in both types of cases. Review a copy of the police report, and if it is a slip-and-fall case, check to see if there's video evidence. Watch out for serial "slip-and-fallers," since they often don't come away with a successful lawsuit. If the case is a motor vehicle accident, review your state's policy limits. For both types of cases, be sure to talk to the attorney and the patient before providing treatment to learn the details of the case.
“'Maintaininga relationship with a PI attorney is all about give and take, and the more you go out of your way to help the attorney, the more likely he or she will go to bat for you when it comes time to settle. ”
This is also when you'll wantto find out who your point of contact is at the attorney's office. Sometimes the attorney will want to be contacted directly, and other times the point of contact will be an office manager or paralegal. The point of contact will be your source of information on the progress of the case, and you'll wantto have a strong rapport with this person so that it's easier for you to obtain information when you call for updates on the case.
Best practice #3: Sign the promissory note and lien
Once you've agreed to work with a PI patient, the next best practice in effectively managing your PI receivables is to have the patient and his or her attorney sign the promissory note and the lien before you provide services. While the promissory note makes the patient legally responsible for payment, regardless of the outcome of the case, the lien is the agreement that allows payments to be made after the case is settled. Without the promissory note and lien, the attorney can pay you an amount that he feels to be fair, often an amount much lower than the cost of your services. In a worst-case scenario, the patient can simply skip out on payment if there is no documentation that shows the patient's legal obligation to pay.
In most scenarios, attorneys with strong track records of cases won will sign the lien. These attorneys understand the nature of personal injury cases and know how to get maximum recovery for their clients. Any refusal or hesitation to sign the lien is a red flag, and you should avoid working with those attorneys and their patients. Such refusal signals the attorney's lack of confidence in the opportunity for recovery in the case.
Best practice #4: Contact the claims adjuster
Once you accept the PI patient, you should work to establish an honest relationship with the claims adjusters. Remember, these are the people responsible for paying the settlement, and you should do whatever it takes to develop a strong rapport with them. Of course, claims adjusters are in the business of saving money, and it's in their best interest to pay out the smallest settlement possible. However, they will be more willing to work with you when you are honest and amicable, and can even cut you a check in your name when it comes time to settle. By doing so, you take the attorney out of the payment equation and further ensure that you are paid in full for services provided.
Best practice #5: Stay in touch with the attorney
While providing treatment to the patient, be sure to keep the attorney abreast of the patient's progress (or
lack thereof), and notify the attorney of any new findings. Maintaining a relationship with a PI attorney is all about give and take, and the more you go out of your way to help the attorney, the more likely he or she will go to bat for you when it comes time to settle.
Once treatment is complete, be sure to send the final bill to the attorney and confirm receipt. One of the downfalls of personal injury cases is that they can take several months to settle, so you'll want to contact the attorney monthly or quarterly to check on the status of the case.
Best practice #6: Update your cases on a regular basis
Even if there is no progress on the status of the case over the course of a few months, you need to keep the case updated on your end on a regular basis. In many cases, a settlement is reached and the patient is paid directly without the chiropractor's knowledge. In other cases, a chiropractor will wait months for payment without updating the case, only to find out that the patient switched attorneys. It's not uncommon for a patient to fire the attorney, or for the case to be reassigned to a new attorney after the previous attorney moves to a new firm.
By staying in touch with the attorney's office and keeping your cases updated on a regular basis, you'll be able to keep up with such changes and know exactly who is handlingyourcase. If a different attorney is handling the case, make sure you contact the patient and find out the name of the new lawyer. From there, contact the new attorney's office and check that they have your final bill and lien on file.
When you reach out to the attorney's office for updates, you don't need to know the nitty-gritty details of the case. Instead, you only need to know whether or not the case is stil I pending and if you missed out on any payments. When you call, simply ask whether or not the attorney is still representing your patent; if so, then also ask if the case is pending or has been settled. If the case is pending, then there are no red flags to be concerned about.
On the other hand, if the case has been settled, the attorney may still be waiting for a payment from the defense, or the attorney simply hasn't cut you a check yet. A friendly phone call once a month is a good way to remind the attorney that you're paying attention to the case. Whenever you call, always make sure that the attorney still has your lien on file. In today's high-tech world of data breaches and computer crashes, lost data is commonplace, so it never hurts to make sure that the attorney still has your lien and contact information.
Best practice #7: Have your receivables managed by an expert
Between treating patients and marketing your practice, it's not easy to find the time to keep your cases updated and chase lawyers and patients for unpaid bills. At the same time, some chiropractors don't like to wait
“A friendly phone call once a month is a good way to remind the attorney that you're paying attention to the case. Whenever you call, always make sure that the attorney still has your lien on file. ”
for a case to settle to be paid, which is why many have found success in having their receivables managed by a medical lien finance company. These companies are the experts in managing liens, and they know the ins and outs of the personal injury practice. Medical lien finance companies work with insurance companies and attorneys on a daily basis, and have the expertise to help you effectively manage and collect top dollar on all of your receivables. Remember, not all medical lien finance companies are the same, and you'll want to go with one that is well backed and offers additional services, such as free attorney networking.
In conclusion: PI and the future of your chiropractic practice
The key to growing any chiropractic practice by working with personal injury patients requires chiropractors to know how to manage their PI receivables effectively. To do so, a chiropractor needs to be diligent with documentation, and should establish and nurture a trusted network of personal injury attorneys. While the case is pending, the chiropractor should build a strong rapport with the attorney's office and the claims adjuster, and update the case on a regular basis. By following these best practices, a chiropractor can make the most of the lucrative opportunities presented by working with personal injury patients and grow his or her practice substantially.
i Brian Frankenfield moved from Syracuse, New
'éSar York to Cornelius, North Carolina to become the « Sales Director for Chiro Capital in 2013. He is a graduate of New England College M’here he studied Sport and Recreation Management. During his stay in New York, Brian also coached Lacrosse at Morrisville State College. Please direct questions to bfrankenfield@ chirocapital. com.
