The ICS has been advised that a major automobile liability insurance company has contracted with a large health insurance network in an effort to discount third party payment to participating chiropractic providers. We also understand that some workers’ compensation carriers have started to use similar practices.
The scenario is as follows: A patient is injured by a party who carries auto liability insurance, and the liability carrier has agreed to pay for chiropractic treatment. The doctor submits claims to the auto liability carrier for the usual charges for service. The doctor also happens to be a network provider for a health insurance network. The auto liability insurer has made an agreement with the health insurance network to "lease” its network and gain access to the discounts agreed to by providers who are members of the network. Based on this agreement, the auto liability insurer pays for services at the agreed discounted rate, rather than the doctor’s regular charges that were billed in the case. This scenario may also occur in workers’ compensation cases with companies who provide workers’ compensation insurance.
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