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Colorado Worker's Comp - Pinnacol

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Any Colorado L.Ac.'s out there being screwed by Pinnacol?

They approved hundreds of re-evaluations for my patients last year (CPT# Z801),

and then six weeks ago sent me a bill for $2600.00 worth of them saying they

" paid them in error " because it's THEIR policy to only pay 1 out of 4. I sent

them a copy of the state regs showing what their requirements are for paying me,

plus notes for every one showing I fulfilled them, and they said it made no

difference - they " considered " them though (yeah, right.) Now they are taking

the money out of their payments every time I send in a claim. I'm trying to

figure out if a lawsuit is in order, but I'm gonna try to go through the state's

injured workers division first to seek a stop. Anyone else had this issue?

 

-Ben Hawes, L.Ac. (Cortez)

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