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Hi, I’m Michael Coates of Personal Injury Made Easy, and I’d like to thank the American Acupuncture Council for allowing me the honor of presenting to you on personal injury So this is part of a series on personal injury, but today’s topic, we’re gonna talk about why PI. We’re gonna talk about the pros and the cons, what providers that do really well in this kinda what, how they’re shaped, and other ones that don’t do so well, and we’ll also talk about some common myths.
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So the first thing I wanna hit to, into is about why personal injury, ’cause whether you should be in this or not, and I know that a lot of you have either experienced it in the past, and you may have had a very bad experience and a bad taste in your mouth, maybe from a law firm you dealt with or a particular patient.
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And I wanna try to have you rethink and have a new perspective. You also may be someone who has maybe dabbled in personal injury, just not done a lot. Maybe you’re a little frustrated, you feel overwhelmed or it’s out of your normal skill set. And the last would be the griddles, the grizzled veterans, those who have really have a, a solid personal injury segment, but I wanna make you better.
So let’s first talk about why PI or why to expand personal injury. So the first thing about personal injury that I think is maybe the best for the chiropractic and also the acupuncture base, and even for physical therapy, as I call them, the CAP providers, is about that you can bill your full out-of-network rates.
So when you think about a business and a practice, you also wanna think about your patient mix. Not all patients are profitable. Sometimes it takes a lot more patients to make the same amount of money as it does on a single patient, and that’s one of the beauties of personal injury, is that one PI patient, when you’re paid your 100% of your full out-of-network rates, can make up for a handful of in-network pers- or in-network patients, and also for a number of cash patients.
So that’s the first major benefit. The second one, which I find very valuable for your segment, is because it, you can bill for things that insurance would deny. So when health insurance wants to deny for laser procedures or the things that you really believe are medically necessary, are gonna help your patient, PI allows you to bill for it, and you’re gonna get paid for it, and that’s really significant.
The next area I would say is like what Warren Buffett said on investing. He always said, “Invest your money and your time and your resources by following the money.” So where is the money going in healthcare? It certainly isn’t going to normal healthcare reimbursements because healthcare reimbursements in the insurance industry have been cut in half, and a lot of medical costs have doubled.
But the one area you’re gonna find that there’s more investment in is personal injury. All you’ve gotta look is at the minimal auto policy benefits and the minimum insurance coverage in whatever state you’re in, and most of your states have had an increase or will be having an increase. So California, for example, went from 15,000 per each patient walking in the door to 30,000 behind them So that means it doubled, and a lot of states have gone way up.
So more money is being invested into personal injury to pay, of course, obviously it’s gotta pay the attorney, it’s gotta pay all of you, and it’s gotta pay the patient. But that’s a real benefit. But there’s more than just money when I say benefits or profits. So here are some other ones that I think are really fantastic for personal injury.
One is you’ve got no financial paperwork you really have to get on your patient because it’s the personal injury matter that would be satisfying your bill. So you’re really not having to chase patients. Now, sometimes you do, sometimes that occurs, but the primary aspect of PI is you’ve got an attorney who generally has a fiduciary duty to watch your financial back when they receive monies.
Even if their own client says, “Send me the doctor’s money,” wink, “I’ll pay him,” they’re not supposed to. In fact, if they do, it could be a violation of state ethics laws and other problems they’ve gotten into. So you have to hold it for you. So that’s a real benefit when you don’t have to chase patients and someone’s protecting your financial interest.
Also, it’s a great gateway to new patients. A lot of people have never heard of the magic of what you do. You know how good it is, but they’ve never experienced your medical specialty ever before. But you have the opportunity now here to wow them on how good it is, what you do, and what your profession is.
You get to educate that patient on the value, not just for them seeing you for PI, but for all the things you do. So that turns PI also into a great feeder to all of your practice segments. So that’s why I say when you’re growing a P- a PI practice, it’s not just growing personal- a personal injury segment, it’s using PI to grow all of your practice segments, and I think that’s a huge advantage.
So another really great advantage is medical, the medical lien area is a very collaborative one. So it’s not just you. There’s usually a healthcare team that is treating your patient. Now, usually because, let’s say you’re the chiropractor, you are the quarterback generally of that team. It is the only industry in this entire country where chiropractic is the number one lead medical specialty, just that one.
And for say for those in acupuncture, you’ve never even had that usually before, so it gives this whole new area to get into. But on chiropractic, being that healthcare team quarterback, you’re the one really guiding the referrals, and when you’re referring out or someone’s referring patients to you, it needs to be someone on lien, or if you’re in a letter of protection state, that will take it on LOP.
So that’s an advantage. In fact think of it this way. Every time you may have gotten a settlement notice from a law firm, and you’ve asked them to lay out all the settlement amounts, the attorney fees, costs, and all the lien holders, and the amount to their client that’s going, so you can make an evaluation of how much you should get paid, guess what you should be looking at?
the listing of all those medical lien holders. ‘Cause when you do, you now know in your community who is taking it on lien. It’s a great one to reach out to, to say, “Hey, let’s look about maybe collaborating.” But you’ve got to vet them first. Of course, you want really competent, good providers as part of your lien network, and you want to have that in the can, so when you do have to refer out to specialists, they’re there.
But what I’m getting to is that there’s a lot of peers that maybe doubt the efficacy of what you do, and they shouldn’t. It’s because just a lack of knowledge. So when you engage in the lien area, you have a chance to educate them also on how get it– good it is of what you do and how you do it, and you have someone else telling them, your patient Also their patient.
So that’s a great extra advantage. So there’s so many things that I think that are so pro– good about YPI, they outweigh the benefits. If we looked– outweigh the negatives. If we looked at the negatives, some of that’s gonna be obviously you have to wait to be paid, right? And it could be either months, it could be years.
Then again, going back to a positive, there is the fast cash options in personal injury. That would be MedPay, which most policies have, unless you’re in a no-fault state. For those states, you’ve got PIP, personal injury protection. Now, those are both auto policy benefits. They’re given for prompt care, they get prompt payment.
Now, attorneys do tricks and stuff, and we’ll talk about that later in the series. But in the end, it’s something really important to realize you can get paid on a monthly basis for you as a reha- rehabilitation professional, and that’s fantastic. You don’t have to wait. So you’ve got to learn how to identify when it exists.
You have to learn how to properly submit, and you have to learn when attorneys try to hijack it or maybe take fees out of it, how to address that so that doesn’t occur. So that’s fantastic, even though to offset the downer that I had. Now, of course, you are gonna be dealing also in an area that you get pushback.
Now, you don’t get people in insurance that are trying to sometimes degrade you or degrade what you do. It’s just the way that insurance tries to delay, deny, devalue, and defend. That’s what the attorneys do too, but they do it a lot more aggressively and forcefully. Why? They’re warriors.
They’re advocates. This is what they do for a living. Not just the attorneys, but a lot of the law firm staff. Back when I was first a defense attorney in my earlier years of course, everybody in law firms, whether on my side or the plaintiff side, all had law clerks and paralegals, so trained in the law.
They understood the law. That’s not today’s environment. All are– they are as a lien specialist is someone that follows a protocol the law firm sets, and they generally try to pay you less. But there are easy ways to work around that. You just have to learn. So that, again, is the beauty of this. And I think that personal injury’s just gotten this bad rap from prior bad taste in the mouth, like bad medicine going down, and it’s just from a lack of knowledge A lack of skill development and a lack of support for you.
Now, the great thing is all of you, you’ve got me to support you on whatever it is that you’re doing. So a little bit about me. I speak, teach, and coach around the country. I help providers in every state. All the state laws are generally unique in PI. I deal with really all medical specialties. And in the end, it’s trying to right the ship.
I think that medical providers have been used and abused, where first the attorneys are looking for themselves. They then try to make their clients happy enough so they will refer them or be happy and not slam them on Yelp. And so unfortunately, a lot of times they try to make the burden fall on you, the medical provider.
But that’s why I’m here, to help guide you along. And part of that guiding is this. When I say what is it that makes a good provider and a, maybe one who struggles more in this, and that’s learning how to be a value driver. What do I mean by a value driver? You al- are always to remain neutral as to the outcome of a PI case.
You’re there for the healthcare of your patient, and you’ve gotta stay in your lane. However, when you learn how to do personal injury right, you become a value driver to your patient, to your peers that you may be referring to or referring to you, and also to the law firms. That includes what are the things that could harm a PI case?
What are the things that when you put them in your documentation, it helps, as I call it, and we’ll talk again more later in the series, storytelling documentation, focusing on the ADLs, the DUDs, and the loss of earning. The other thing that, that’s so key when I talk about what works really great is when you can get across that value to an attorney early on in a case.
One of the biggest areas of tax that the law firms have to deal with for you, aside from poor documentation, and that is rampant in this area, I’m gonna make you better in this series. But one of the areas is of attack that the adjusters always do to the attorney, and it rolls downhill, is that you overtreat and overbill.
Now, usually you don’t hear about that till the case is already over. So a lot of times it’s a red flag. It’s not really the truth. But imagine this, if you could help the attorney support your fees and your billing before, when you’re first treating a patient, so that when they’re dealing with the adjuster, they cannot allow the adjuster to drop your bills, your fees, and lower them.
Because what does that do? That increases the value of every case. Because one of the, the tricks when I was, of course, being an insurance defense attorney is lower the value of the bills, lowers the settlement offer that we’ve gotta deal back and forth with them, and we save money, right? By you being, making yours more solid, you’re taking that kind of trick away, and it’s fantastic.
So that increases settlement value, and that’s just you holding firm to solid fees, but you gotta learn how to do that. And I do find there are providers that don’t do this area right, and they do improperly set fees too high. They have something different for personal injury versus other things. And in the end, realize you’ve got one fee schedule across, right?
We’ll talk about that more in process of the next one, but it’s really important to understand it. Okay, the, the other side of the coin is when you have proven the value, shown the value, they’ve gotten better results, obviously it makes it easier to get paid, right? From the good firms Even when you’ve got the good ones, I think you’ve got to realize that personal injury is an industry of pushback.
Insurance pushes back a little bit like, “Where’s the paperwork? You didn’t have the right code.” But in personal injury, the pushback is gonna be our client said they didn’t show these days or they didn’t get these treatments or you billed too high or your per office visit is way too high you’re way past Medicare, all these things they try to throw at you.
So in the end, what you want to realize is that those are tricks and traps and you got to learn how to spot them and then to address them. So those that learn how to do it well do really well. Those who don’t know what they’re doing get so overwhelmed and being the healer mindset that you have, you generally give in and I find it disappointing that a lot of you in your profession are so happy when you get paid half your bill.
Why is that? Are you not worth what you bill? If you are, I believe that in the cap side, chiropractors, acupuncture, and even physical therapy, that you should be getting paid 100% of your bill 80% of the time, or if you did a blended rate, because not all are winners, it’s at 80% for your medical specialty. So use that as a barometer, and there are– And it’s being done all the time.
So when the four-minute mile was broken, everybody else could do it. That’s what I’ve been doing in helping people in personal injury for medical providers. At the same time, they get more patients. So the other thing, our, maybe let’s address a few common myths. So some common myths out there in personal injury that I want to hit today are that MedPay is okay to be held by the attorney, and that’s not correct.
MedPay, as I was saying, has been for prompt payment. And what– The same thing is happening with PIP, by the way, which is less but still happening far too often than as what I see around the country. So when you get that, you have to first be able to identify it, and you want to make sure to make the proper professional pushback demands of attorneys to get paid back.
And remember I talked about an industry of professional pushback? They are being pushed back on by adjusters, defense attorneys, judges and juries even sometimes. So they’re not new to being pushed back. It’s how you push back. Do it professionally. And when you can learn about the facts that matter, have enough of the law to where you can be dangerous to know.
You’re not there to be an attorney, but once you can assert facts and law, that makes you also someone that the good attorneys want even more. And why? Because in the really good cases, they may go to trial. Less than 3% of cases actually go to a jury trial, but a lot of them position to that, and that’s where d- adjusters and defense attorneys say, “Do we settle or do we go forward to try?”
And the better that the expert is, the better that the treating physician is, the more likely we need to settle. So when you learn how to stand for your fees and your bills and can support it, when you’re treating properly, when you have the storytelling documentation when you then push back, the good firms say, “I want that doctor.”
That means they’re gonna hold up well at a deposition. They’re gonna hold up well at trial. They know what they’re doing So with that, we’re gonna wrap up for the t- today on this first session. I hope you learned a few things. You see a little bit of the overall, and the way to look at the rest of the series is this.
We’re gonna hit three segments. We’re g- And I think it’s three segments that build any medical practice, and that’s processes, systems, you know that well, but there’s unique systems in personal injury. The next is being properly paid, not just MedPay and PIP, but how to out-negotiate law firms, the trusted ones to get paid more, but also the really difficult ones, and how to protect your staff or for your staff to do it better.
And the last is growth. And like I said, it’s growing not just a personally injury segment, including how to be a better value driver, but it’s how to use PI to grow all your practice segments, and it’s gonna be fantastic for you because this really is the high-profit highway. That’s what personal injury is.
And with that said, I’d like to thank the American Acupuncture Council for their support in allowing me to present to you this wonderful series.