Secrest Family Chiropractic P.C.

Prior to the auto accident, I paid $65 per visit to Secrest Chiropractic (SC). SC does not supply exit statements. Since I had a zero balance, I did not care.

When I informed SC in January, 2012, that I had an auto related injury, they opened a file and put a lien on me for future payments, even though I have a history of paying at every visit and gave them 4 referrals. SC refused to let me pay for the treatments as I went, saying "we bill insurance differently."

SC did not supply me with exit statements, monthly statements, or records during this time. I kept calling SC to find out if they were getting paid, and what else needed to be done. Lee, the office mgr, kept assuring me it was fine; their billing company would sent out the billings; I should not worry.

I was unaware until, 10/31/12, that I still had a lien AND a balance due of $655. Because I received no emails, letters, or statements, I had no idea of the financial status of my account.

Upcoding refers to the practice of assigning a code that commands more money than the correct code would pay. SC assigned 2 CPT codes for the same date of service and same body region. My insurance company gave SC every opportunity to revise their bills and recode. Instead, SC kept doing the same thing the same way and did not get paid. Which, based on prior treatments, SC should not have gotten the additional payment for manual manipulation as it is part of his usual and customary treatment.

SC overcharged (upcoded) invoices to my insurance company for each of the 12 visits (1/30-5/18 in 2012) by $45, billing duplicate manipulations. Exclusive of the first evaluation on 1/30, each treatment I received by SC was the same techniques and length of time as my prior to the auto accident visit I paid $65. It was also the virtually the same as those received by the people I referred to his practice ( my mother-in-law, daughter, and husband.)SC double billed manipulations, using different codes (upcoding) and showed overbilled the insurance for same services I received at a different rate. The AZ Chiropractic Board site and the each insurance claim SC submitted to the insurance company stated that "manual treatment code 97140 cannot be billed to for the same area on the same day as chiropractic manipulation..." My insurance company repeated denied this as double billing of manipulations to the same body area.

I paid $65/ visit, prior to the auto accident. SC billed insurance $60 for the manipulation and and additional $45manual manipulation for each visit, attempting to redefine what they were doing and collect more money. I have informed them of this and been on top of this to get the claims paid with my insurance, who will NOT pay for the double manipulation charges. Some insurance companies will, mine will not.

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SC believes I should pay the difference because I have a third-party insurance. Additionally, they are charging me for the lien, which I did not agree to.

(State recorders records SC recored over 60 insurance-related liens in the past 23 months, with a good number still unresolved.

Just because I have third-party insurance does not mean I should have to reimburse them for their upcoding and overcharging. Because of the lien, they are in control.

When SC sent bills to my insurancer, that CPT manual determined how much SC get paid. Different codes allow them to bill for higher or lower amounts of money. As long as the provider uses the right code, then the provider will be paid whatever he or she has earned by performing the services and procedures performed.