The Law Office of Neal H. Sobol, Personal Injury Firm

Doctor Newsletter No. 4: "Colossus", Part I

AN INTRODUCTION TO COLOSSUS & COMPUTERIZED CLAIMS EVALUATION

Our office has been asked by many doctors about "Colossus," and in particular, what they could do to maximize the potential for having their bills paid, when such a program is used in the evaluation of their patients' personal injury claim. Because we appreciate that many doctors are, for the first time, considering treating patients with a personal injury claim, and others are venturing "back" to personal injury due to changes in the workers' compensation system, we will begin with the basics.

THE DEVELOPMENT OF COLOSSUS

Colossus is a proprietary software program that evaluates insurance claims and assigns a "settlement range" based on a mathematical algorithm. The program was developed by a small technology firm in Australia, and later sold to CSC, Computer Science Corporation, the creator of the HCFA80 (the claim form universally utilized throughout the medical community).

The reason it is so important to know about "Colossus" is that, at present, virtually all insurers are now using Colossus, or some type of computer program requiring input of the same data required of Colossus to evaluate personal injury claims. Pre-2000, the use of Colossus was primarily with Allstate.

Colossus, itself, has over 10,600 value drivers, making it even more vital as a chiropractic doctor to work with attorneys skilled in handling claims of this sort. A lawyer that practices in the field of Real Estate, Wills and Trusts, Criminal Law and does "some personal injury" may not be able to read your medical records, reports and billings for colossus-required data. This may result in all, or part of your submitted billings not being paid, or at a minimum, not being paid in a timely manner.

IMPORTANCE OF WORKING WITH INFORMED PERSONAL INJURY ATTORNEYS

Colossus, and virtually all other claims evaluation software programs, require that the injury information in the lawyer's demand package and doctor's medical records be "mirror images." In practice, this means that if you, the chiropractic doctor, provide a beautiful med-legal report (with all Colossus required data), and the lawyer you are using submits your report, attached with his "demand letter", there is a high probability that your treatment will not be considered at face value, unless that attorney knows how to properly present your materials in his demand. On the other hand, if that attorney knows how to properly present his demand package, but is too lazy or afraid to call you and question you as to probable errors discovered while examining your med-legal report, the cost of your treatment may not be considered at face value.

There are things that can be done within your office, in addition to working with skilled attorneys, to see that your documentation is sufficient to withstand the scrutiny with which that documentation will be examined. A few of the basics are discussed herein, and in addition to the pointers provided, our office remains available by phone and personal consultation. Simply call Neal H. Sobol, Esq. at (818) 547-6650.