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Tonya
08-03-2004, 11:59 PM
Undercover Pooch Helps Nab Alleged Insurance Fraud RingtheKCRAchannel.comCARMICHAELCalif.

- Investigators say they've cracked a huge insurance fraud ring that included a couple of Sacramento-area chiropractors who were allegedly billing thousands of dollars for bogus treatments.

On Tuesday, authorities said they had a secret weapon in the case -- an undercover agent that wagged its tail and could fake a limp on command.

Patients showing up at a Carmichael chiropractic clinic Tuesday were surprised to find a note on the door that read, "closed for unforeseen circumstances."

"I've never had any problem with them. I've been coming here for two years. So it's a shock," said patient Laura Ashley.

Investigators said they've been looking into Baldini Chiropractic for three years after suspecting the staff was billing insurance companies for treatments never that were never performed -- at least not on people.

"What we discovered from one of our other human undercover agents was that the clinic was actually providing services to dogs," said California Insurance Commissioner John Garamendi.

While it's not against the law for chiropractors to treat animals, it is illegal to try to make insurance companies believe that patients, like undercover dog Buddy, are covered under workers' compensation.


"I thought I'd seen a lot of insurance fraud. But I never thought that somebody would be treating a dog and billing it to an insurance carrier," said insurance fraud investigator Dale Banda.

Office manager Kathy Thomas, from Rocklin, and chiropractors Marty Depaoli, from the San Diego area, and Todd Baldini, from El Dorado Hills, face felony fraud charges.

Erica Schulte says Baldini has been treating her family for years, and that she has never seen animals being treated there.

Jeffrey Barlett, from Las Vegas, was also charged. He allegedly referred claims to the Sacramento clinic in exchange for a kickback.

Investigators said some of the referrals were for legitimate patients, but others were apparently for patients that either never existed or walked away on all fours.

"(These are) thousands of files we've seized, and we've got to verify each patient, and to determine whether the patient actually got the treatment, or whether or not the patient was a dog, jackrabbit, whatever," Banda said.

Investigators said the chiropractors got away with $85,000 in false claims, so far.

Tonya
08-04-2004, 12:00 AM
Call me stupid, but I am not understanding this. They did what? Treated dogs and billed them as people under worker's comp? How did they swing that? I am human and I can't even get worker's comp to cover my dang bills. I'm confused. :rolleyes:

DJFyrewolf36
08-04-2004, 10:13 AM
More than likely, they had the forms there and someone would bring in a dog *or in some cases they would just fill the form out* and send it in to the insurance company. If the WC works anything like what I had to deal with when I got hurt on the job, the patient and the company fills out a form. Then the WC place says "Ok, go get treated here" Once the person is treated, then the place in question sends the Insurance place a bill and they pay. Since theoretically the only people sending them bills are places that have been approved, they probibly don't bother matching every person with every place. If they DID bother matching, its easy to send bogus request forms, get them back, and ship off a bill. Its @$$'es like that who make it hard for legitimate cases to go through.