A) WORKER’S COMPENSATION CASES – (Litigated and Non-Litigated Cases)
B) PERSONAL INJURY CASES – (Litigated and Non-Litigated, ie, CAR ACCIDENTS, SLIP and FALL with clear liability, MOTOR-CYCLE ACCIDENTS, TRUCK ACCIDENTS.)
C) MEDICARE – *(After Credentialing)
CASES NOT ACCEPTED
A) PPO INSURANCE *(In Network or Out of Network)
B) HMO INSURANCE
D) VISA/ MASTER CARD
E) MEDICAID/ or STATE INS
NOTE: *(Other than Medicare, we ONLY see work injuries and auto accident victims with pending cases, not residual pain years “after” an accident. This would fall under PPO or CASH and we do not accept patient’s under those terms unfortunately at this time. We only treat active cases that are either work injuries or auto/ truck/motorcycle/ slip and fall injuries where there is a pending legal case.)
If your case is litigated, we MUST receive an LOP or “Letter of Protection” from your attorney, or a signed lien. You must be represented if you have a case that is still pending. WE WILL NOT TREAT YOU IN THIS OFFICE WITHOUT REPRESENTATION. In other words, you must have an attorney. If you do not have an attorney and still desire to treat with us, we can appoint/ assist or help direct you to some in the area that we have worked with before and you may chose from them. But you must have an attorney to treat with us, unless it was your fault and you only desire to use your MED-PAY.
There are special circumstance where sometimes you are involved in a hit and run. Under these findings, your policy will dictate whether or not you are covered under what is called “uninsured motorist.” If you have this and have exorbitant amount of medical bills from your injuries and your med-pay is not enough, you will need to get an attorney to assist you in capturing further financial assistance from your policy under the “uninsured motorist” portion of your policy. You may have $25,000 to $100,000 there of policy limits that can be utilized but you will need to have assistance from the attorney to do this and we will not treat you in this office without representation.)
FURTHER DETAILS of TREATMENT and CARE
Unfortunately, because of the complexities of litigation now-a-days, it has made it difficult for us to take on certain cases of care. This clinic is able and willing to take cases but only under the following parameters. Please see below.
A) NON-LITIGATED Work Injury Care. – *(These are cases where you have been injured and are treating with your doctor or the company doctor and now desire to go to a different doctor and come to us for a second opinion. You have not obtained an attorney as of yet. We would accept your care and take over as your second choice. This could also be where you get injured and actually come to us first. This is acceptable too and preferred. There is only two choices given in worker’s compensation care in the State of Wisconsin. Please see statute below;
-Wisconsin Statute Section 102.42(2) directs employers to offer their employees the choice to receive treatment from a doctor who they trust to provide adequate care. This could include a Physician, Chiropractor, Psychologist, Dentist, Physician Assistant, Advanced Nurse Prescriber or Practitioner or Podiatrist. -July 24, 2020
B) LITIGATED Work Injury Care. – *(These are cases where your care is now disputed and you no longer have the insurance company paying for your work injury care. If your case has merit and we believe it is legitimate after a detailed consultation, then we will accept the case and will treat your injuries and continue on where you left off, provided that your case is still pending and you haven’t exhausted your two choice rule noted above. We have often found that the worker’s compensation insurance carriers will find some way to deny your benefits within 1-3 months either with negligent investigation or an IME that is performed suggesting that your case is either not work related, or you have pre-existing conditions, or a plethora of other ideas or excuses to deny your care. This is why they are hired by the insurance company, to have a legitimate excuse that is not theirs, to deny your care. This is not an excuse to stop your care if you are still hurting. You will have a difficult time finding a doctor who will take your case, we will, as long as you have not exhausted your second choice and your case is still pending.)
A) NON-LITIGATED Car Accident Care – *(This is where there is no legal dispute or litigation. This is where you were at fault and you just want to receive care using your MED-PAY Benefits. Usually you will have $10,000 Med-Pay Benefits. We will utilize this for your treatment costs and provide you the very best service.)
B) NON-LITIGATED Truck Accident Care – *(SAME AS ABOVE)
C) NON-LITIGATED Motor-Cycle Care – *(SAME AS ABOVE)
D) HIT and RUN CASES – *(YOU MUST HAVE LEGAL REPRESENTATION. If so, your policy will dictate whether or not you have additional means that you may receive care “beyond” your med-pay.)
E) ALL LITIGATED PERSONAL INJURY CASES – *(CAR ACCIDENTS, MOTOR-CYCLE ACCIDENTS, TRUCK ACCIDENTS, SLIP and FALLS, where there is an acting attorney on the case that we may receive a LOP or letter of protection or medical lien signed by the acting counselor or attorney. If your case is active and still open, we will be willing to accept your case and provide treatment.)
**Disclaimer – Because of the complexities of accidents and injuries, each case must be verified.