Signs of Chiropractic Insurance Fraud
Patients may also be able to identify potential chiropractic insurance fraud by voicing their concerns about unscrupulous providers or practices that aim to exploit patients' pain. While patients might have limited insight into chiropractic complaints regarding fraud, they can speak up about several red flags:
High up-front costs: Chiropractic visits should not involve exorbitant up-front costs to be seen by the practice. Especially when your chiropractor’s office accepts insurance, requests for payments beyond your regular co-payment should raise alarm bells, indicating that something may be amiss. This is a common concern among those filing chiropractic complaints.
Fearmongering: Many patients seek chiropractic care due to severe or chronic pain, which can cloud their judgment. A chiropractor making unrealistic promises or attempting to manipulate your choices by preying on that pain should be reported for improper care, as this may be indicative of healthcare fraud.
Requests for daily visits: Chiropractors, like all medical practitioners, cannot perform miracles and can only provide certain benefits to patients. Excessive requests for visits and adjustments may signal that your chiropractor is primarily focused on overbilling your insurance for reimbursements. According to one OIG study, after 12 chiropractic treatments in one year, the likelihood that the services offered were not medically necessary increases, potentially leading to cases of insurance fraud.
Your pain is not being addressed: If your condition is not improving or is worsening due to chiropractic visits, it’s crucial to speak to a healthcare fraud attorney. There may be other patients experiencing similar situations. Speaking up can help prevent a deceitful practice from profiting off the pain they may be inflicting.
Bills for treatment that was never administered or necessary: Chiropractors are constrained by what they can charge, especially for patients receiving 'maintenance therapy.' Billing for nonstandard practices or continued care in some situations may exemplify insurance fraud.
Common types of abuse include:
- Billing for unnecessary services
- Overcharging for services or supplies
- Misusing billing codes (upcoding) to increase reimbursement
Remember this scene from Matilda?
Imagine moving across the country to a new city. As you grab the last of the moving boxes off the truck, you aggravate your lower back. You are in desperate need of a chiropractor so you can feel better and finish the move. Like anyone would in 2026, you scroll through Google and Facebook and see some ads for local chiropractors that are close to you but you are having trouble deciding what office would be best. Some of the ads have great offers but seem a little used car salesmen-like. The last thing you want to do after the big move is to get scammed by a chiropractor.
5 Chiropractic Scam Strategies Exposed:
1. Big Bucks Upfront
Beware of any office that asks for large sums of money prior to initiating care. Classic chiropractic scam 101. In the event you plan to use insurance, then this is straight-up insurance fraud. An office cannot legally ask for large amounts of money prior to initiating care other than a co-pay or co-insurance. If electing to not use insurance, then I would just caution you. Would you buy an expensive vehicle without test driving it first? How hard is this chiropractor going to work to get you better if he/she has already made the sale?
2. Fear-Based Sales Tactics
Pain can be scary. With that being said, most back pain and neck pain is not related to serious pathology. If you feel like your new chiropractor is all doom and gloom then you should look somewhere else. Fear is an extremely powerful motivator and many chiropractor scammers use this to their advantage. When it comes to musculoskeletal pain it is important to stay positive and stay moving. Find a chiropractor that is optimistic and knowledgeable enough they don’t need scare tactics.
3. No History or Examination
Did your chiropractor examine you? Did this include a proper history in addition to a physical examination? If not, then I would run for the hills or at least a different office. Just because most back pain is not due to serious pathology does not mean that a proper history and physical examination is not warranted. At best they are guessing, at worst they are reckless. The trouble is that a proper examination and history takes time, and most chiropractic scam artists move too quickly to take the time to do it right. No history or exam means they are probably going to do the same thing to you as the other five people in the waiting room, you deserve better.
4. Bait and Switch
When looking for a new chiropractor, I generally recommend staying away from Group On or Facebook ads touting prices that seem too good to be true. You may get lucky and find a good one but theses places are crawling with chiropractic scammers. Oftentimes, the ad is the bait, and the switch happens using points 1, 2, and/or 3.
5. Subluxations, Innate Intelligence, and the Almighty Nervous System
Chiropractic scamming practices have long occurred under the guise of ‘Chiropractic Philosophy’ because it’s not something the layperson has any previous encounter with. If the language of your chiropractor involves subluxations, innate intelligence, and the almighty nervous system…..RUN! I realize that’s a lot to digest so let’s dive in a bit.
Subluxation is a term coined by chiropractic historians that is, fortunately, falling out of favor with the majority of the profession who are pushing chiropractic forward into a mainstream and evidence-based profession. Essentially, a subluxation proposes that ‘spinal misalignments’ put pressure on spinal nerves resulting in decreased function and/or pain.
Although your body is resilient and adaptable, the whole idea of innate intelligence and chiropractors allowing it to flow fully and freely after manipulating the spine is complete and utter nonsense.
Lastly, the almighty nervous system. I am not going to argue that the nervous system isn’t incredibly important, it clearly is. The problem lies in how this has allowed generations of chiropractors to believe they can treat conditions that are outside of their scope of practice. For example, with the recent coronavirus many unethical chiropractors are claiming adjustments can boost immune system function by 200 percent. Simply put, chiropractors’ scope of practice is limited to musculoskeletal conditions.
Customer Complaints after visiting AFC Chiropractic
