case audit settlement enhancement
e-book

NOTICE TO ATTORNEYS:

I am a contributing author and trained Auditor whose sole purpose is to assist in the reversal of unfair, undervaluation of injury claims.

I am a member of a select group of chiropractic physicians trained as an Auditor and Knowledgeable Observer to independently audit and provide medical validation when it is believed there is an undervaluation of an injury claim with inadequate explanation of the legal and factual basis for so low a valuation. The independent audit is for the correction of any omissions or misstatements of the claim by either the claimant or defense or rebut the engagement of any “Unfair Claim Settlement Practice Acts” or violations of the “Ethics Codes of the Adjuster” that result in unfair, undervaluation of an injury claim.

I am available to audit, consult and provide data to assist plaintiffs' attorneys in the benefits of P.I. Claim Audits to reverse low ball injury claims. I offer free subscriptions to: eBulletin series, eBook, Audit Report, Audit Brochure, Audit Magazine and CLE Accreditation.

I can provide the most thorough education presentation with CLE credits available for Ethics, via screen share or "meet & greet" presentation.

Free Audit
Andrew Jones, D.C.

Andrew Jones, D.C.

(608) 359-0120 •  (608) 526-9366 • drjoneschiro@yahoo.com

814 S Main St Unit, Holmen, WI 54636

The Medical Records Are the Insurance Company’s Primary Source of Data Which They Use to Determine Settlement Valuation. One of the Single Most Important Considerations That Determine Settlement Valuation is derived from “Value Drivers” and "Decision Points" that Insurance Companies Use to Determine the range of worth of an injury claim. There Are 26 Value Driver sections, and 67,880 decision points. The insurance companies refuse to release their decision points to the public making it difficult to navigate the claim. The audit however, contains a search engine to detect overlooked value drivers and decision points and exchange them in the correct language, format and sequence to interface and input added valuation into the injury claim, and reverse claims that have been undervalued.

We engage a proprietary softwarein our audit process to make the same medical determinations as the insurer's software's. Using ambient intelligence technology, our software features a rare Computer Aided Decision-making functionality (CAD) and Decision Support System (DSS). This ability is no match for the human mind and this technology advancement is a key component of our ability to reverse undervaluation's on injury claims.

As an auditor and 'Knowledgeable Observer', we apply MECE standards to our audits. MECE = Mutually Exclusive / Collectively Exhaustive. This essentially means that we are mutually exclusive as an injury claim auditor and exhaust all methods to audit 26 sections and 60 factors on each claim in order to reverse undervaluations of injury claims.

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Clinic Assets
  • I am proud to have studied to acquire a very high level of skill and confidence in accident related cases.
  • My staff and I are very Knowledgeable, friendly, dedicated and eager to help with your treatment and injury claim processing.
  • Our patients know that when they choose our office, they can feel good that they have made the right decision.
  • Our patient satisfaction rating has been consistently high and our patients realize that we care about them and we are thoroughly knowledgeable in auto accident related treatment & case representation. This is based not only on our successful treatment and resolve of a patient’s condition and claim representation, but also because people need to know their doctor cares about them as much as he is knowledgeable about their injuries.
Auditing Services
  • I am proud to have studied diligently to acquire a very high level of skill and confidence to become an auditor of accident-related injury claims and subscribe to the "Observer Rule of law and Empowerment."
  • We are eager to assist when injury claims have been undervalued and there is no legal or factual basis for so low a determination.
  • We want our plaintiff's representatives to feel that when they choose our audit services, you have made the right decision.
  • We understand how frustrating it is for all plaintiff's parties to be on the low end of a settlement valuation. No one should have to go through that — and we are truly grateful that you are allowing us the opportunity to bring a more favorable resolve to this issue of unfair, injury claim undervaluation.
  • We strive to keep our satisfaction rating high and show that we care. The human mind is no match against the insurers software's, therefore we have acquired the CASE Audit Settlement Evaluation software that makes up to 600 decisions and determinations to match the insurers software's and exchange decision points, interface and input added valuation into an injury claim.
  • Thank you for being our valued customer. We are grateful for the pleasure of serving you and meeting your injury claim audit and enhancement needs.
Curriculum Vitae
EDUCATION AND LICENSURE

  • Doctor of Chiropractic, Licensed in the State of Oregon, License # 3223, 2000-Present
  • Doctorate of Chiropractic, Western States Chiropractic College, Portland, Oregon, 2000
  • National Board of Chiropractic Examiners, Part II, 1999
  • National Board of Chiropractic Examiners, Part III, 1999
  • National Board of Chiropractic Examiners, Part IV, 2000
  • Undergrauate Studies in Pre-Medecine, Clackamas Community College, Oregon City, Oregon, 1993 - 1996


SELECTED POST- GRADUATE EDUCATION and ADDITIONAL CERTIFICATIONS

  • Whiplash Injury
    Module 1: Advanced Topics; The Fundamental Science “In depth review of current state of knowledge of whiplash phenomenon, including all factors affecting injury risk and outcome. In-depth biomechanics, traumatology, epidemiology, review of outcome studies and common sequelae of whiplash, including brain injuries, pain syndromes, Thoracic Outlet Syndrome, Carpal Tunnel Syndrome and chronic pain disorders. Risk Analysis I”, Arthur C. Croft, Spine Research Institute of San Diego, 2014
  • Module 2:
    Advanced Diagnostics, Treatment and Auto Reconstruction: Management Principles in Personal Injury, “Critical history taking and physical examination skills. Radiographic and advanced imaging, including CT, MRI, scintigraphy, PET, SPECT and others. Electrodiagnostic testing and their applications in whiplash. Therapeutic approaches to successful management of whiplash and mild traumatic brain injuries. Risk Analysis II.”, Arthur C. Croft, Spine Research Institute of San Diego, 2014
  • Module 3:
    Narrative Report Writing and Practice Development; Principles of Impairment Rating and Forensic Documentation. “Comprehensive and compelling narrative report construction. Learn today’s critical forensic documentation skills and impairment requirements.” Arthur C. Croft, Spine Research Institute of San Diego, 2014
  • Module 4:
    Medicolegal Issues; Fundamentals for Practitioners and Forensic Experts. “Foundations for successful outcome in medicolegal cases. Use of demonstrative evidence. Gain total confidence in all medicolegal proceedings”, Arthur C. Croft, Spine Research Institute of San Diego, 2014
  • Radiology Case Studies & Clinical Corrections. “Differential Diagnosis of conditions of the spine. Understanding clinical implications and the development of treatment methods for conditions of the spine”, Wisconsin Chiropractic Association, 2014
  • Chiropractic Treatment of Common Athletic Injuries. “Extensive understanding of the physics and biomechanics involved with athletic injuries. How to properly diagnose and treat athletic injuries”, Fetterman Events, 2012
  • Gonstead Seminar. “Full spine analysis, diagnosis and treatment of the spine and extremities. Analysis of entire spine utilizing the examination, radiographic interpretations and palpatory findings including how to properly treat conditions.”, Gonstead Seminar 2012, 2014, 2015
  • Interdisciplinary Treatment Planning, “Explore the development of interdisciplinary treatment plans for patients and specifically address alternatives to standard treatment pathways that often lead to surgery”, NeuroSpine Center of Wisconsin Oshkosh, WI 2015
  • American Academy of Medical Legal Professionals, “Foster a collaborative effort between medical and legal professionals in an ethical relationship. Its purpose is to support on a national level through research, dialogue and practice excellence, professionals in the medical-legal arena.”
  • Advanced MRI for Chiropractic, “State-of-the-art program will enhance the knowledge and skills of the chiropractor in the evaluation, treatment and rehabilitation of musculoskeletal disorders. Select case studies will be used to illustrate the role of diagnostic imaging to confirm and document NMS conditions.” La Crosse, 2018
  • Ligament Injury Institute, “AOMSI certification.” Salt Lake City, 2020
  • The Whiplash Group, “Certified specialist in Personal Injury & Whiplash injury” 2021
  • Personal Injury Training Institute, “Certification in Motor Vehicle Collision Occupant Injury.” 2021


CONSULTING AND PROFESSIONAL ASSOCIATIONS

  • Wellness Expert – Wellness Champions 2015 – Present


SELECTED MEMBERSHIPS

  • American Academy of Medical Legal Professionals 2014 - Present
  • Everest Coaching Systems 2014 - 2016
  • Wisconsin Chiropractic Association 2010 – 2012
  • Zeus Claims – 2020 – present
  • The Whiplash Group – 2021-present
  • Professionally Integrated Care - 2019-present


SELECTED MEMBERSHIPS

  • American Academy of Medical Legal Professionals 2014 - Present
  • Everest Coaching Systems 2014 - 2016
  • Wisconsin Chiropractic Association 2010 – 2012
  • Zeus Claims – 2020 – present
  • The Whiplash Group – 2021-present
  • Professionally Integrated Care - 2019-present


CONTRIBUTING AUTHOR

  • The $66,000 Neck Injury….And How Not To Be Misdiagnosed
  • Insurer Conduct In Unfair Claims Acts
  • Prevent & Reverse Adjuster & IME Bullies From Undervaluing Injury Claims
  • P.I. Maximizing Settlement Value in a Colossus Environment For Medical Legal Providers – Turning Your Head During An Accident...Could Fracture Your Neck


SELECTED LECTURING and TEACHING

  • Lecturer, “The Stress Free Lifestyle”
  • Lecturer, “Healthy Living to 100”
  • Lecturer, “The 100 Year Lifestyle”
  • Lecturer, “Stress….Less”
  • Lecturer, “Lifestyle According to Misty May Treanor”
  • Lecturer, “The 5 Factors of Health”
  • Lecturer, “Injury Prevention and Treatment”


SELECTED COMMUNITY SERVICE

  • Chamber of Commerce
  • Rotary International
  • Kiwanis Club
  • Elks Club
  • Christine Ann Domestic Abuse Center – Board Member
  • Make A Wish Foundation, Voluntary Fundraiser
  • Winnebago County Literacy Council – Board Member
  • Race for the Light – Volunteer
  • Men Who Cook – Chef
  • Oshkosh Chili Cookoff – Chef
  • Winneconne Men’s Club
  • Holmen Business Association – President
  • Invictus Business Group
  • Wisconsin River Trail Volunteer
  • Food Truck Friday in Holmen - Organizer
Certifications
  • How G-Forces Relate to the Diagnosis of Accident Related Trauma Injuries of the Head and Neck: The physics of the auto accident, including G forces and the effects of impact. A review of the variables in the mechanisms of the; side, rear, front and oblique impacts and the forces that can be transferred to the occupants of the vehicle causing damage to the occupants. Parker College of Chiropractic - Dallas, Ligament Injury Institute, Tampa, FL 2018
  • Significance of Spinal Anatomy and Tissue Damage to the Delicate Structures in Accident Related Trauma Injuries of the Head and Neck: The anatomy of the cervical spine, including the role of mechanoreceptors, proprioceptors andNocieceptors in the function of the spine. How the ligaments, tendons, facets and discs respond to the impact and the damages that are caused. Parker College of Chiropractic - Dallas, Ligament Injury Institute, Tampa, FL 2018 Diagnosing Concomitant Injuries in the Presence of Accident Related Trauma Injuries of the Head and Neck: The injuries that accompany the CAD that cause permanent impairment to the spine. The concomitant injuries include: AOMSI,Uncinate Process Fractures, MTBI, Posterior Cervical Sympathetic Syndrome and Vertebrobasilar Insufficiency. An overview of the diagnostic testing required for diagnosis and evaluation. Parker College of Chiropractic - Dallas, Ligament Injury Institute, Tampa, FL 2018
  • Understanding AMA Guides in the Diagnosis of Accident Related Trauma Injuries of the Head and Neck: Tthe AMA Guidelines for the diagnosis of AOMSI (Alteration Of Motion Segment Integrity). In-depth analysis of the ligamentous structures of the cervical spine, traumatically induced, with focus on the 4 main ligaments that are damaged in a cervical- acceleration –deceleration injury of the head and neck. Employing the the exact requirements for the AMA Guides for Permanent Impairment Ratings. Parker College of Chiropractic - Dallas, Ligament Injury Institute, Tampa, FL 2018
  • Certified Impairment Rating Attending Physician
  • Certified in Injury Model Examination Protocol
  • Certified In Electronic Medical Injury Record System
  • Certified by Ligament Injury Institute
Special Information

Your health is my first concern and you've entrusted it to me after your accident. I take that seriously. When you're involved in an accident, there is accompanying stress and anxiety over your injuries, your future prognosis and the implications that arise from insurance issues. I have trained in the medical-legal aspects of trauma medicine and will treat you and your injuries with the highest care possible and process your case according to the highest standards so be confident that you are in caring hands and thank you for trusting me.