As a Baltimore Chiropractor that spends a lot of my time treating patients involved in Baltimore auto accidents and provides treatment to patients with whiplash, headaches, neck pain and back pain I get asked about how patients can have their medical and chiropractic bills paid. Although this is not a clinical discussion, but rather a financial one, I think it comes up in conversation enough that it warrants a small discussion.
Personal Injury Protection (PIP)
In the State of Maryland it is mandatory that all drivers carry auto insurance. A component of the auto insurance that drivers carry is called PIP, or Personal Injury Protection. PIP is designed to pay for medical care (including x-rays, chiropractic care, and physical therapy) and up to 85% of lost wages for injured people in automobile accidents in Maryland. PIP is a no-fault benefit, meaning that it is available regardless of whether or not the driver caused the crash or was the victim of another driver’s negligence.
PIP is written in different amounts depending on the auto insurance policy. It is usually written in amounts of $2,500, $5,000 or $10,000 and can be waived in writing at the time of purchasing of auto insurance.
Maryland law dictates that medical bills and lost wages that are reasonable, customary, usual, and causally related to the automobile accident will be paid by PIP up to the policy limits.
In cases of non-faulted auto accidents, your auto insurer will not raise your auto insurance premiums even if you file a PIP claim with your own auto insurance company. That is, you can access PIP and use the benefits to pay for your treatment and lost wages without any negative financial consequences to yourself if you were the victim of an accident. If accessed during your treatment, PIP does not need to be repaid upon the conclusion of your treatment.
How do I apply for PIP ?
If you’ve been involved in an automobile accident contact your auto insurance company’s claims hotline to let them know you were injured.
Speak to your claims representative and confirm that you have PIP on your auto insurance policy.
Ask your claim’s representative to mail you an application for PIP benefits. Typically these forms are about a page long and take less than ten minutes to complete.
Ask the claims adjuster to mail you an Attending Physician’s Report and Salary Verification Form. Hand these to your treating chiropractor and your supervisor at work to be completed.
Upon receipt, complete the applications and mail the PIP application, Attending Physician’s Report and Salary Vertification Form back to your claims adjustor.
Provide your claim number, adjuster name, claim office address, and phone number to all of your health care providers. This will allow your providers to be paid for your care while you are still in treatment. This also lowers, or in some cases, eliminates any money owed to your providers for treatment rendered upon conclusion of your care.
What If I don’t have PIP?
Injured patients that do not have access to PIP do have other means to get their bills paid.
If there is no PIP coverage available on your auto insurance you can use your health insurance to pay for your medical care.
If you do not have health insurance you can speak to a qualified personal injury attorney to see what other options may be available to you. Please let us know if you are interested in speaking to an attorney.
Automobile accidents are stressful but recovery from your injury does not need to be.
If you have questions please speak to the office manager La Keesha Arrington-Vega by phone at (443) 842-5500 or by email at email@example.com. The team at Mid-Atlantic Spinal Rehab & Chiropractic would be happy to help you.
In my last blog post I discussed a lower back condition called spondylolytic spondylolisthesis. If you recall, it was a condition that resulted from an bilateral acute bony fracture and a resultant slippage of one vertebral body on another.
As a Chiropractor that uses X-rays to help me determine the structure of a patient’s lower back prior to spinal manipulation I see these pretty regularly. One of the questions that I get a lot is how I know whether to have a patient see an orthopedist/consider bracing or to undergo spinal manipulative therapy in my office and return to activities.
The first thing I consider is the mechanism of injury. If a patient comes in with an acute injury (they were weightlifting, playing sports, etc) I am more inclined to consider the injury (if present on standard x-ray) to be acute, or “hot.” In cases like these I tend to air on the cautious side and refer patients out for STIR MRIs to look for acute spondylolytic spondylolisthesis. If positive, these patients are referred for orthopedic evaluation and bracing. Bracing typically includes the fitting of a boston brace which allows for patients to spend over 23 hours a day not loading the posterior elements of the spine, and giving their bones time to heal. Research has shown that appropriately used bracing in these instances can “cure” the spondylolisthesis.
If, on the other hand, a patient presents with a spondylolisthesis and their physical examination does not seem to indicate that it is the cause of their pain I will begin treatment to include spinal manipulation of the joints above and below the effected segment. Much of the time spondylolistheses are “red herring” diagnoses- in that they are present but are not the cause of a patient’s lower back pain.
As a provider I have two concerns with these patients. The first is the pain that they are experiencing. As mentioned, most people present due to pain and want to be out of pain as quickly as possible. I will generally perform lesser invasive techniques and then progress to more aggressive techniques as tolerated. The second concern I have is the stability of the segment. If the patient has had a STIR MRI and there is evidence of an acute spondylolisthesis, I will refer the patient for orthopedic evaluation and have them discontinue provocative activity. Generally speaking, non-acute spondylolistheses are stable structures and will not continue to slip, whereas acute spondylolistheses that are active on STIR imaging are considered unstable and should be referred out to orthopedists and braced.
In summary, spondylolisthesis are one cause of lower back pain seen in my chiropractic office. X-rays are a good starting point to determine what MAY be the cause of lower back pain. In some cases it is safe to proceed with spinal manipulation of the lower back and in some cases it is not. I am trained to know when it can be handled in my office and when I should refer it out and I work with several orthopedists who are equipped to handle these conditions if they are outside of the scope of my practice.
If you, or someone you know, thinks they may have a spondylolisthesis please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!
BY: Mid-Atlantic Spinal Rehab
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