How they are legally allowed to collude
Hi everyone, Dr. Brian Capra here from Genesis Chiropractic Software. Today I’m gonna talk to you about how insurance companies are actually legally allowed to collude against we chiropractors to actually keep our money, gain interest on that money and use that money to actually use it to audit more chiropractors, taking more money back from us.
Last video I talked to you about how insurance companies actually make more than 50% of their profit on interest. Interest on your money. So they should’ve paid you right after you adjust that patient. There’s nothing technically preventing them from actually paying you at the time of service. They do not and then it, in most states, they have usually about 30 days to process a claim. Not necessarily pay you, but process the claim, right? They have actually been able to rig the laws in their favor to do this. They are actually protected by the law.
I am going to share with you some secrets I have learned over the past 15 years while running a chiropractic billing software and chiropractic billing service company. I hope you enjoy this little nugget.
So why is it that on Wall Street, way more complex transactions happen every single day, but yet it’s the law that everybody involved in those transaction must be paid before the end of the day. Why is it that the law on Wall Street, but not for us or we?
So, there’s a very simple uh answer to that which I can’t bel- I couldn’t believe it when I found this out. It turns out that insurance companies are legally allowed to collude against physicians. So, it’s not really just us, it’s everybody. Every physician. The, actually the entire healthcare uh, profession or industry. Insurance companies are allowed to collude.
We’ve heard a lot about collusion these days, right? Um, you know in politics. This is actually real collusion. This actually happens and it’s, by law it’s on the books. It’s, it’s no secret out there. As a matter of fact, if doctors were to all get together, if every chiropractor in the country were to get together and say, “From now on, adjustment is for whatever code, is $60.00 and we will never take less.” That’s actually illegal. That’s called a monopoly, right?
You may remember Microsoft went through a massive what’s called antitrust case back in the day when they were seen as having a monopoly on the personal computing world, right? Um, it’s, it’s a real thing in a uh, capitalist economy that a company by law cannot monopolize an industry. They can’t be the only provider of a good or service and once they do that, they have so much power that they have full power over dictating the price of that good or service. So that’s, that’s against the law. It’s called antitrust law, it’s very well documented, you can Google it and you’ll find a billion different antitrust cases. It’s very important for it to be there in our economy.
Um, so what insurance companies have done is the opposite of, of what is a monopoly. A monopoly again is provide, is being the only provider of a good or a service, product whatever, what have you. Inscur- insurance companies are the opposite of that. There’s a word for it, it’s called an oligopoly. Google it – oligopoly. Um, and what you’ll notice is that, that’s when there’s only one buyer of a good or a service. Right now, over 70% of lives in this country are covered by three insurance plans and you’ll probably know if you’ve done any reading on this, every time a little insurance company pops up, they get gobbled up by one of the big dogs out there. And in doing so, since there’s only one buyer out there of chiropractic adjustments if you would, one payor, um they dictate the, the the price of an adjustment and obviously you’ve seen what happens when that, when that’s the case, your payment or reimbursement continues to go down over time. God only knows what would happen if we had a single payor system um, and left it all up to the government.
‘Cause here’s what actually happened. So, we wanna know why we don’t get paid right after our adjustment when technically that could happen, um, and probably save everybody a whole lotta money. And why the insurance companies want to be able to wait 30 days to process a claim and then have a denial process and hopefully you never remember to, to get that claim, to follow up on denials… Hopefully they make the co- the process so complicated, you never even submit the claim to begin with. That’s actually happening.
We’re gonna get more into the tactics that they actually use to make the, to drag out the timeline for a claim to be processed in my next video, we’ll go into very specific tactics. In this video what I want you to understand is that it’s actually legal for insurance companies to collude. Why do they wanna collude? They wanna control the market, gain the profit and continue to use that money to reinvest in their own company and in lobbies. Once they have the lobbies, once they have the collusion and the power, they lobby to gain the law and actually legally in 1945 gained one of eh the only industry or one of the only industries um exempt from antitrust law.
So insurance companies are one of the few and only industries in the country that are exempt from collusion. The antitrust laws that everybody else in every other company has to abide by including chiropractors and physicians, all physicians across the country cannot do what insurance companies do to us. It’s a pretty amazing fact. So, what do they do? They can collude, they consolida- they collude by consolidation and gain power. Once they gain the power, they can ga- they can write the law basically. They can write the laws and they guidelines on how claims are processed in this country.
So this whole thing starts to become a little bit more clear, that how they make their money is on profit and how they gain so much power is by colluding against us, the healthcare industry, to gain the power to make the rules for claim processing. And if you think cash kinda protects you from this, there’s actually something more to that even. Cash or going cash actually doesn’t protect you, um, and that’ll be a later video. I’ll go into how going cash and just when you thought you were out, they pull you back in. And it’s not even the insurance companies at that point, it’s a lotta state boards and thing uh, things like that where you could wind up in more trouble, uh, or have uh worse ramifications than accepting insurance.
So I’m gonna go into all that, but I’m just want to make sure you understood tonight that um, insurance companies are legally allowed by law, this government in our, our country, our government has given them them the power to collude against us legally.
Um, r- uh next video I’m gonna go over the actual tactics. Now they’ve got the pow- you know, we know how they make their money, they, we know how they got their power and rigged this whole system if you would, and now we’re gonna go into some more specific details of now they got the power, what are the tactics they use to actually keep your money even longer to gain that interest and then obviously once they have that money not only investing in lobbies, but they’re investing in audits. There’s a 14:1 dollar uh, return on investment. Every dollar they invest in an audit, they get $14.00 back.
So um, we’ll go into a lot more detail in future videos, but right now I just wanted to quickly um, get this video out to you. Uh, hopefully not too late tonight. So, thank you so much guys, we’ll see you on the next uh video.