PI Paralegal has a question regarding Chiro fees

Hello,

I hear so often when negotiating a PI settlement that the Chiro fees are over the general fees in that area. When I ask what information/data/charts/stats they are referring to a thud of silence falls.

Is there such a chart etc.? CPT code definitions are easy to locate - but how are those CPT fee values set?

Any information you could share would be greatly appreciated.

Thanks,

Kim

Answer to PI Paralegal has a question regarding Chiro fees


Hello Kim,

Please note, we don’t answer via email.

You are very perceptive. Those are “averages” that the insurance company calculates. They hire “independent” companies who survey fees all around the area and come up with those fees. They argument is that they will not allow more than what is reasonable… and anything above average is not reasonable.

However, if you control the “average” then would not that be the best case scenario? Why is it that the adjusters cannot give you a straight answer? They are provided with those numbers, but they are nor provided with any support.

There is no answer yet, only until trial lawyers continue to challenge the veracity of those numbers.


Good Luck,
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