Category Archives: Newsletter

Did you know that ICD-10 became effective on October 1st, 2015?

Below is a link to a Medscape article on the rollout of ICD-10, CMS’s new billing code quagmire. It became effective on October 1st, and many (most?) docs aren’t ready.

Problem is, it’s not just for Medicare billing; private payers are also adopting it. Critics think insurers will take advantage of it to deny or delay payments to docs. See the last four paragraphs of the story.

The Centers for Medicare and Medicaid Services (CMS) has rolled out its new billing code system. For services delivered starting October 1 (the start of the federal government’s 2016 fiscal year), providers are required to use the new ICD-10 coding system. If you thought ICD-9 was a morass of minutiae, ICD-10’s 70,000 codes is considerably larger and its coding scheme is very different.

It’s vitally important that you get on top of this if you want to keep your business healthy.

Granted, you may not have a big book of Medicare business. But there is a larger issue to worry about: insurance companies. Health insurers almost always follow CMS’s lead in billing and payment issues, and it’s almost certain private payers will be requiring bills to be coded using ICD-10. I know this is hard to believe, but critics think insurers will take advantage of provider problems in adapting to ICD-10 to delay or deny payments to docs.

This also affects you and me in the personal injury world. Auto insurers use a computer program called Colossus (or others programs like it) when analyzing how they value a claim. Colossus relies heavily on ICD-9 and CPT codes to judge injury severity and how much they’ll pay for those injuries. Insurers will almost certainly reprogram Colossus using ICD-10, if they haven’t already. Improper provider coding or delaying the switch to ICD-10 could give insurers an excuse to delay payments at best – or at worst, to deny claims we make in our demand letters.

Bottom line: Help us help you.

The sooner you complete the switch to ICD-10, the sooner we can incorporate it into our demands and keep a strong hand in settlement negotiations – and get you paid.

Below are a couple sources to check for more info.

If you’d like more information on this issue, give me a call at (303) 758-4777.

What Senate Bill 15-265 Means for Chiropractors

 We Won a Big Victory for Chiropractors!

There’s good news coming the first week in August that could mean more money for you and more flexibility in how you care for your personal injury patients. On May 29, 2015, Gov. John Hickenlooper signed into law Senate bill 15-265, titled Concerning Conditions that Must Be Met Before a Hospital Care Lien is Created. We worked hard to make this bill happen, and it is a big victory for personal injury attorneys and chiropractors alike.

Before this law, when a client who was hurt in a car crash was treated at the emergency department, the hospital could choose to take 100 percent of its billed charges from the case settlement instead of having to accept the rate they contracted for with a health insurer. That tilted the tables in their favor, the hospitals knew it, and they regularly took advantage of it. Not anymore.

What does this mean to chiropractors?

When your patient has health insurance, the hospital will no longer be allowed to unfairly gobble up a huge chunk of the settlement and force you to take a deep reduction in your lien. Now, they must file their bill with the insurer first and accept the rates they’ve contracted. With the hospital no longer taking unfair advantage of your patient, your lien can be paid at a higher value because there’s more money available. You will have the freedom and resources to direct care for your patient’s whole health, as a chiropractor who understands trauma care knows best how to do.

This is one of the most important things Colorado lawmakers have done for injured patients in many years. I can give you more detail on how this helps you, if you’d like – just give me a call at (303) 758-4777.

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Making Work Comp Laws Work For You | Newsletter March 2015

The Colorado legislature has done something good for workers in the state. Legislators last
year passed a bill which Gov. John Hickenlooper signed into law, making changes to
workers’ compensation law.

If you’re injured on the job, Colorado work comp law requires that an employer, or the
employer’s work comp insurance company, provide you with a doctor for treatment. Before
this change in the law, employers only had to give you a list of two physicians or two
corporate medical providers, or one physician and one corporate medical provider, to
choose from. The new law changes that number to four physicians or corporate medical
providers.

This is important, because the doctors on the list an employer or insurer gives you are
almost never independent ­ they’re almost always a hired­gun paid to give medical reports
in the employer’s favor, which can cost you money. By doubling the number of physicians
on the list, your odds of getting a more impartial doctor are much better. Plus if you request
it, the doctor you choose has to give you a list of ownership interests and employment
relationships ­ such as a contract to do work comp exams for the employer or insurer ­
within five days of your request.

The new law takes effect on April 1, only a couple of weeks from now. So if you’ve been
hurt at work it’s important that you get in touch with the Law Offices of Dianne Sawaya
right away. We know the new law inside and out, and can help make sure you get the care
you need from an unbiased doctor. Give us a call today at (303) 758­4777 or contact us through our website, www.dlslawfirm.com.

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Getting the Medical Care You Need | Newsletter November 2014

When you’ve been injured in a car accident, you enter a whole different world when it comes to medical care. You may have been treated in an emergency room, and you’ve probably seen your family doctor. But the world of personal injury care also includes specialists in pain management, surgery, chiropractic, physical therapy and more.

That can be daunting to navigate by yourself when you’re hurt. The law in Colorado does not require the at­fault insurance company to pay for your medical care until the end of the case. That’s why it’s so important to contact us now. The Law Offices of Dianne Sawaya has an extensive network of specialists to call on to get you the treatment you need. Our providers work with us on the finance side, too. We can arrange for the bills to be paid after your case is settled so you can get the treatment you need ­ even if you don’t have health insurance.

You’ve probably already seen how our doctors and specialists are there for you as your case has progressed. If a family member or friend could use our help, have them give us a call for a free meeting to talk about their case.

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Snow Means Accidents. Make Sure You’re Covered | Newsletter February 2014

It’s starting to snow – again – as I write this. Watching on the news what happened in Atlanta after their freak snowstorm got me thinking about all the accidents that happened and the fair number of people who were injured by uninsured drivers. I wonder how many of those injured people have uninsured/underinsured motorist and medical payments coverages on their own policies to pay for their injuries, pain and suffering.

Some estimates say as many as one­-third of drivers on Colorado roads don’t have any auto insurance ­ or they have only the minimum amount, which usually isn’t enough. If you’re hurt in an accident on an icy street by one of these uninsured drivers, having med­-pay and UM/UIM coverage on your own auto policy gives you the security of knowing your insurance will pay for your injuries.

Insurance companies in Colorado are required by law to offer med-­pay and uninsured/underinsured coverage as part of any auto insurance policy. If the insurance company tries to “save you a little money” on your premium by signing a waiver form, I advise you not to sign. You may save a little but wind up losing a lot in the end. UI/UIM coverage is crucial and med­pay is a great deal. You shouldn’t be without them.

I can give you real-­life examples of how these two coverages have helped many of our clients avoid financial disaster. Give me a call at (303) 758­4777.

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Keeping Insurance Companies Honest About Whiplash | Newsletter October 2013

One of the most common injuries in a car accident is a so-called “whiplash” injury. Because these injuries can be slow in developing, insurance companies often try to take advantage of your whiplash injury to deny you payment. That’s why you need the Law Offices of Dianne Sawaya.

I call whiplash “so-called” because whiplash is not a medical term. In an accident that causes whiplash – typically when you are rear-ended – you suffer what is called cervical hyperextension (when your head is thrown back) and cervical hyperflexion (when it is thrown forward). If your head is turned to one side instead of facing straight forward when you are crashed into, your neck injuries can be much worse.

Generally it takes from a day to several days for the extent of a neck injury to become apparent. For that reason, many people who have been rear-ended don’t address their injury right away. That can be a mistake – and that’s where the insurance companies pounce.

Because you may not realize the extent of your injuries and delay seeing a doctor, the insurance company will try to claim that there is no connection between your symptoms and your neck injury. Also, the speed of the impact or the damage to your car isn’t a good guide to the severity of your injury. Low-speed crashes can do as much damage as one at high speed. But we regularly hear insurers say, “Look, there’s almost no damage to the car. Your client can’t possibly have been hurt that much.”

Insurance companies will try anything to get out of paying you what you deserve. If you’ve been hurt in a rear­end collision and think you have a neck injury, give me a call today. We’ll get to the bottom of it, help protect you from the games insurance companies play and get you the money you deserve.

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How You Can Help Your Own Case | Newsletter November 2012

You’ve been hurt in an accident, and now we’re working with you to build your case. There is a lot you can do to help us help you.

One very important step you can take is to continue getting care until your doctors say you’re better. If you have long periods between medical treatment, insurance adjusters and defense attorneys may try to use that against you.

Do the things that your medical providers tell you. Not only will this give your attorney proof of the extent of your injuries, but it will show that you’re taking responsibility for your recovery.

Take photos of your bruises, cuts and scrapes over time as you work on getting better. Often, photos help prove that you suffered serious injuries.

Keep track of what you spend on your care and recovery. All those expenses add up and you’re entitled to reimbursement for all your expenses. And last, keep a list of how the accident has affected your ability to live your usual life ­ whether it’s preparing meals, eating, sleeping and bathing, or driving, working and doing the fun things you used to do like hiking.

We have other tips on how you can help your own case. Give me a call at (303) 758­4777 and let’s talk.

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How We Put a Value on your Case | Newsletter September 2012

It’s a common question we hear at the Law Offices of Dianne Sawaya: How much is my case worth?

There’s no standard answer and each case is different. There are a lot of factors that go into arriving at a number. But I can tell you a little about how we develop an amount to demand from the insurance company.

First we do a full investigation of the accident, get police records, interview witnesses as necessary and, depending on the situation, hire experts like accident reconstructionists..

Next we look for all insurance policies that may cover the accident, beginning with the atfault party’s coverage, the at-fault party’s employer if he was on company time, your own insurance policy’s uninsured or underinsured motorist coverage, and sources like a resident relative’s insurance policy.

Then we review your medical records and analyze the medical treatment you’ve received, as well as the costs of treatment you may need in the future. In some cases we hire experts like life care planners to review your future needs. We factor in physical impairment and loss of function you may have suffered. We look at what income you have lost by being off work following the accident. And we look at many other factors such as loss of enjoyment from activities you used to do.

At that point we calculate a settlement value we think is fair and reasonable for you. We discuss that value with you and then prepare what’s called a demand letter for the insurance company with that settlement value.

Getting you treated and better, calculating the value of your losses and finding the money to pay for those losses is complex and takes a lot of time. But to be sure you get all the money you’re entitled to, it’s worth the extra time.

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Think the Insurance Company is There to Help You? Think Again. | Newsletter March 2011

When you’re hurt from injuries you suffered in a car accident, you want to get better – and fast. You want your claim handled fairly and you want a reasonable settlement. Unfortunately in many cases that’s not easy, and there’s a big reason: Insurance companies are not your friend.

Their warm and fuzzy (and even sometimes funny) TV commercials may give you the impression that they care about your situation and that they’re there to help you. But remember – insurance companies are corporations that care only about profits, executive bonuses and stockholder dividends. Having to pay out claims really gets in the way of those goals.

You see it in several ways. An insurance company representative may ask you to sign something or ask for a recorded statement so they can use it against you later. They may offer you a quick check for a paltry amount, hoping to get you to sign away your legitimate claim. And if those tactics don’t work, the insurance company may try to drown you in paperwork and endless delays, hoping you’ll get tired and agree to a small settlement just to make them go away. In extreme cases they may even force you to file a lawsuit to make them pay what they rightfully owe you.

As I say in the TV commercials we’re running right now, I’ve never seen a personal injury case where you don’t need an attorney. The reason is simple. Insurance companies are not your friend.

If you, a loved one or a friend has been hurt in a car accident, we can help. Give me a call and let’s talk about your case. You can call me at (303) 758-4777, email me at DLS@dlslawfirm.com, or visit us on the web at The Law Offices of Dianne Sawaya. We fight insurance companies every day – and win. And we don’t get paid unless you get paid.

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Work Comp- Winter Can Mean a Bump Up in Workplace Injuries | Newsletter January 2011

The snow and cold have invaded Colorado and winter has set in, particularly in the mountains. Winter can be a dangerous time for Colorado’s workers, and the Denver worker’s compensation lawyers in the Law Offices of Dianne Sawaya want to remind you to take extra care and be safe in your workplace.

The next few months can be a time when workplace accidents happen. If you work outside, snow and ice can make a worksite a dangerous place. Slipping and hurting yourself are a real possibility. Many people don’t realize it, but if you slip and injure yourself while you’re at work – even in the parking lot – your injuries likely are covered by worker’s compensation.

Or maybe you’re someone who travels the city streets and county roads for work – delivery drivers, nurses visiting patients in their homes or even just running a work-related errand for the boss, for example. If you’re involved in a crash and are hurt, work comp likely covers you, in addition to automobile insurance coverage.

Even when workers take every available precaution, though, accidents can happen. Work comp cases can be complex, especially in cases where you’re injured while driving on the job. A skilled Colorado worker’s compensation attorney is a must. If you or a loved one or friend are hurt at work, give me a call at (303) 758- 4777 or contact me at DLS@dlslawfirm.com. We’ll sit down and talk about your circumstances and your options.

The visit is free. And remember – if we take your case, we don’t get paid until you get paid.

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