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What's New?

09-16-08 – Upcoming ProviderLAW / Self-Pay Seminar Series – This series will focus on major issues surrounding self-paying patients, patient discounts, cash payment plans, and of course, getting paid by insurance.... [more...]

09-25-08 – OIG Clarifies New Form of Discount! – "Prompt Pay" Discounts Recently, the OIG (Office of Inspector General) issued an Advisory regarding "Prompt Pay" Discounts. As its name suggests, a "Prompt Pay" discount is designed to... [more...]

09-24-08 – Free Online Resource Center For Getting You Paid! ProviderLAW Corporation and newly-formed Tipology.org have announced their intent to create a free Online Resource Center for providers and affiliates... [more...]
More New Items...

What Have Providers Said?

$4,000 Success!  We recently had a success involving an ERISA plan. The plan failed to tell us about a $750 dollar cap on care at the time of verification.... [more...]

$23,500 Success!  I just wanted to let you know that I was successful in collecting an additional $23,500.00 on three surgery cases.... [more...]
More Testimonials...
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Public Directory

This web page serves as a repository of information that we make available to the general public and periodically refer to in our seminars.
Advisories, Briefs, Studies and Other Publications
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1 09-16-08 Public
09-16-08 – Upcoming ProviderLAW / Self-Pay Seminar Series – Starting October 8th, ProviderLAW will be hosting a round of 6-hour seminars throughout the country in the major U.S. cities. The seminars, held under the title, Self-Pay Seminars, will focus on major issues surrounding self-paying patients, patient discounts, cash payment plans, and of course, getting paid by insurance.
2 09-25-08 Public
09-25-08 – OIG Clarifies New Form of Discount! – "Prompt Pay" Discounts – Recently, the OIG (Office of Inspector General) issued an Advisory regarding "Prompt Pay" Discounts. As its name suggests, a "Prompt Pay" discount is designed to help providers encourage prompt payment and thereby avoid the costs of debt collection.
3 09-24-08 Public
09-24-08 – Free Online Resource Center For Getting You Paid! – ProviderLAW Corporation and newly-formed Tipology.org have announced their intent to create a free Online Resource Center for providers and affiliates. The Resource Center, which will be located at www.tipology.org will focus on helping health care providers with reimbursement, practice growth, and compliance issues.
4 09-23-08 Public
09-23-08 – Cool New Resource on Hardship Discounts! – The Federal Government has long made it clear that providers can discount the patient-portion-due based on hardship principles. This Advisory takes a look at a powerful resource for providing such discounts.
5 09-16-08 Public
09-16-08 – PayDC.com Announces New, Law-Based Reimbursement Software – Two weeks ago, a new start-up company – PayDC.com – announced the upcoming release of the "First Cash Payment System," a promising and exciting new type of financial software system for healthcare providers.
6 05-24-07 Public
Note! If You Market Your Care Around Medical Equipment, Make Sure to Review the "Scooter Store" Case – The United States Department of Justice had alleged that "[i]nstead of the 'zippy' power scooters that were advertised, The Scooter Store sold the beneficiaries expensive power wheelchairs that they did not want, need, and/or could not use...," and that "[m]any beneficiaries had no idea what kind of equipment they were getting, until it was delivered by the Scooter Store."
7 05-18-07 Subscribers
Chiropractic Scope in New Jersey  In light of recent cases and laws, NJ DCs are encouraged to get formal legal opinions. DCs elsewhere should take note. The issues surrounding scope of practice are significant. Not understanding the scope of practice can lead to recoupment, claims of malpractice, and worse. With scope of practice being questioned in so many states it seems, not just in New Jersey, DCs everywhere are well-advised to stay tuned to the most recent developments.
8 04-24-07 Public
Light Therapy & Low-Level Laser Therapy (Cold Laser): How do I code for these services and are they interchangeable?
9 04-04-07 Public
Can CPT Code 97012 (Mechanical Traction) Be Used for the Flexion-Distraction Technique? – The overwhelming majority of commentators agree that the Cox Flexion-Distraction technique constitutes a form of Chiropractic Manipulative Therapy...
10 03-01-07 Public
Active Stretching – 97112 or 97110? – "If I'm Performing Active Stretching One-on-One in the Treatment Room with a Patient, Can I Code the Service as CPT Code 97112 Neuromuscular Re-education?"
11 01-31-07 Public
Nutritional Counseling: A Summary of the AMA's CPT Coding Guidelines and Instructions and ICD-9 Authorities – This document attempts to frame out and create a guideline for certain coding and documentation protocols that should be considered when performing nutritional counseling and like services provided by licensed doctors.
12 10-10-06 Public
Decompression Therapy News – District Attorney obtains permanent injunction and fine against doctor regarding his decompression therapy advertising. Court finds advertising "misleading" and also "unfair and deceptive." Considering purchasing a table? Already purchased a device? Make sure to closely review your advertising materials....
13 10-09-06 Public
Martin Law Firm Issues Open Letter to PA Chiropractors – The letter focuses on three reimbursement issues including: (1) "Across-the-Board" Delegation Denials / Recoupment, (2) CMT / Manual Therapy, and (3) the "12-Month" Recoupment Bill. The letter addresses the question – Is the insurance industry wrongly denying your claims and improperly recouping from you? The letter also introduces a series of reimbursement presentations which will be held in November... Open Letter. November Presentations.
14 10-04-06 Subscribers
Special Brief – CMT and Manual Therapy 2  – This second brief, a follow-up to CMT and Manual Therapy I, investigates the issue – What is meant by the phrase "different session or patient encounter" under federal law? ...
15 09-12-06 Subscribers
Special Brief – CMT and Manual Therapy 1  – This latest brief examines the issues: Is it possible that some payers are misinterpreting the phrase, "same region?" Don't therapies which target "muscle groups" treat an entirely "different site or organ system" than CMT? ...
16 06-23-06 Public
Pennsylvania DCs – ProviderLAW and DK Coding Announce Joint Initiative on Delegated Services and Carrier Denials. ProviderLAW and DK Coding announce their intent to launch a joint educational initiative regarding carriers that deny properly delegated services. Based on weeks of research, the initiative will shed tremendous light on YOUR RIGHTS when it comes to properly delegated services and carrier denials...  Announcement 1-Page Article Synopsis of 04-27-06 Research
17 05-12-06 Subscribers
New Response Letter Posted – Attorneys Who Send Limited or Conditional "Letters of Protection." It appears that increasingly providers are either not receiving letters of protection from attorneys in accident cases, or are receiving...
18 05-19-06 Subscribers
Special Series – Am I Allowed to Collect My FULL Fees in Auto Accident Cases? Must I Collect My Full Fees? Based on requests from Texas subscribers, ProviderLAW has commenced a special series on an issue which affects providers in many states....  Part i – Brief Overview and Summary  Part 1  Part 2A  Part 2B  Part 2C  Part 3  Part 4  Part 5
19 05-04-06 Subscribers
ProviderLAW Responds to Recent Article on Pre-Paid Plans. Recently, a chiropractic organization published an article encouraging the use of pre-payment plans.
20 05-04-06 Public
How to Request Provider Agreements and Copies of Plan Benefits From Health Insurance Payers. Periodically, subscribers have asked whether they are entitled to request copies of insurance documents from carriers.
21 05-03-06 Public
The Latest on the Aetna-ASHN Front – Aetna Notifies a Provider of Its Intent to "Terminate the Provider Agreement With ALL Aetna Products" Due to His Decision Not to Join ASHN with Respect to a Few Products.
22 05-01-06 Subscribers
23 03-16-06 Subscribers
What Exactly is "Medical Necessity" According to One of the Major Health Insurance Carriers? – Two Important Lessons for All Healthcare Providers in Extended Care Situations
24 03-15-06 Public
Update on Medicare Therapy Caps. In February, the President signed the Deficit Reduction Act of 2005 (DRA) into law, providing exceptions to therapy caps for certain medically necessary services. Recently, the CMS posted a "fact sheet" describing the exceptions process.
25 05-04-06 Public
dK Coding Study – Marketing Your Practice Through Various Financial Incentives: Under HIPAA, Can You Offer FREE Services, Discounted Services, or Pre-Payment Plans to Your Insurance Patients? Can You Waive Copay, Deductible, and Coinsurance Amounts? Could "Installment Agreements" Be the Best Alternative?
26 04-21-06 Public
If (or When) You Convert a Patient to "Maintenance Care," What CPT Code Can You Use to Bill For Your Service(s)? Can You Charge a Reduced Rate for the Service(s)? An Introduction to the S8990 HCPCS Code.
27 12-28-05 Public
Have You Recently Received a Request for Records From Medicare? If so, you should read this advisory. Medicare is specifically asking providers for copies of treatment plans. What are the required fields in a Medicare treatment plan?
28 12-22-05 Public
Study on Recoupment – "Recoupment" by Carriers is on the Rise. What Are the Major Limitations Which Apply to Carriers Who Wish to Recoup (i.e., Recover) Benefits Previously Paid to Healthcare Providers / Suppliers?
29 12-19-05 Public
Under Medicare Law, Can Nonparticipating Physicians/Suppliers Collect Their Full Fees? What Does State Law Say? How Can Medicare Providers Actually Calculate the Allowable Charges, Regardless of Their Participation Status?
30 10-14-05 Public
Under HIPAA, Can Clinics Use Sign-In Sheets in Their Office? Can Clinics Call Out the Names of Patients in Their Waiting Rooms?
31 09-27-05 Public
Special Advisories – What Does the Independence Blue Cross Payment "Crisis" Mean for You and Your Practice? Can Carriers Really Recoup From You? Without Notice? In Any Amount They Please? What's Next? Part I Part II
32 05-16-05 Public
An Important Update on Offering Cash Discounts to Patients – A Recent Conversation With a Healthcare Provider Regarding a Certain Discount Plan – ProviderLAW Recommendation.
33 07-15-04 Public
An Antidote to Colossus??? – Reportedly, Sequoia Visions, Inc. Has Produced Software to Help PI Providers and Attorneys to Turn Colossus Against Itself and Maximize PI Settlements. A ProviderLAW Member Reports an Impressive Success Using the Program.
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What Have Providers Said?

$2,400 Success!  We've been a subscriber of ProviderLAW for less than a month and already the subscription has helped us save $2,400! A carrier was requesting two refunds.... [more...]

$7,000 Success!  We sent a demand letter to an insurance company which had failed to tell us about an important limitation in the plan, and then later refused to pay us.... [more...]

$55,000 Success!  My office manager and I calculate that ProviderLAW saved us $55,000 in 2002. Over the last two months alone, we've collected $25,000 using ProviderLAW tools.... [more...]
More Testimonials...

Legal Notice (Rev. 05-01-07): This Legal Notice ("Agreement"), Located Online at http://www.providerlaw.com/legal_notice.php and Accessible Through Various Menu Options, Contains the Basic Terms Associated with All Resources Of, and Agreements With, ProviderLAW as Well as with Designated Resources of Ancillary Entities. You Are Responsible for Reading These Terms Carefully as a Condition of Using this Web Site, as Well as of Purchasing, Using, and Relying Upon, ProviderLAW Resources. The Terms Include Without Limit the Terms of Subscription, Business Associate Agreement (To the Extent Required by Hipaa), Licensure of Multimedia Products, Conference Participation, Web Site Use, and Privacy, as Well as General Terms Common to Agreements. The Resources of ProviderLAW and/or of Other Ancillary Entities Do Not Constitute Legal Advice, Cannot Be Relied upon as Legal Advice, and Do Not Establish a Client-attorney Relationship. Such Resources Are Provided for Educational, Awareness, and Discussion Purposes Only and as Such, Are Provided Strictly as Samples or Illustrations. While ProviderLAW and Other Ancillary Entities May Be Able to Assist You in Finding an Attorney, Unless Otherwise Stated, ProviderLAW and Other Ancillary Entities Are Not Law Firms and Do Not Offer Legal Representation to Any Third-party. If You Have Questions of a Legal Nature, You Should Contact an Attorney at Law. "ProviderLAW," "ProviderLAW Corporation," and "ProviderPRO.net" are fictitious names of the ProviderLAW Knowledgebase, Inc., a Pennsylvania corporation.... [ Click Here for Terms ]