How Chiropractors Can Fight Back Against MedPay Write Downs

Personal injury cases come with their fair share of financial hurdles, but few are as infuriating as MedPay write downs. Insurance companies routinely pressure providers to accept reduced payments for services, masking these cuts as “customary” or “fair.”

The truth? These reductions are calculated moves to erode your bottom line—and they succeed only when chiropractors allow them to.

It’s also complete nonsense because chiropractors are the unsung heroes in personal injury cases. You’re the ones who bring patients back to health, helping them recover from injuries that disrupt their lives—whiplash, soft tissue damage, spinal misalignments, and more. Your expertise restores mobility, function, and quality of life, all while providing attorneys with the critical documentation they need to prove medical damages and win fair settlements. Without your care, patients suffer longer, cases fall apart, and justice gets delayed.

Insurers may try to undermine your role, but the truth is clear: Chiropractors are essential to both patient recovery and the success of personal injury claims.

So it’s time to stop letting insurers dictate your worth. Fighting MedPay write downs preserves your revenue and ensures that your patients receive the care they need to recover fully while strengthening their legal case. This is your opportunity to protect your practice, defend the critical role of chiropractic care in personal injury treatment, and position your personal injury segment as the most lucrative revenue stream in your practice.

Understanding MedPay Write Downs

MedPay, or Medical Payments coverage, is a type of auto insurance designed to cover medical expenses regardless of fault. It functions similarly to PIP (Personal Injury Protection) but with key differences. While both cover medical costs stemming from an accident, MedPay is often more limited in scope, typically excluding benefits like lost wages or childcare expenses that PIP might include. MedPay is also optional in most states, offered as an add-on rather than a mandatory policy like PIP in no-fault states.

Unlike bills on lien, which are paid upon the eventual settlement of a personal injury case, MedPay is supposed to be paid quickly and directly without regard to who was at fault for the accident. Providers submit their bills, and MedPay funds are dispersed up to the policy limit, ensuring patients receive care without delay.

The concept seems straightforward: Providers treat the patient, submit their bills, and insurers reimburse fairly.

In practice, however, insurers frequently underpay and justify reductions with vague excuses like “above customary rates” or “not in line with local standards.” Insurers may send reduced checks with minimal explanation, or none at all, leaving you with two options: accept the shortfall or challenge it.

The path of least resistance might seem appealing, but accepting these reductions undermines your role in the personal injury case. It diminishes the value of your work in the eyes of insurers, attorneys, and patients, while signaling that chiropractic care is negotiable. This has real consequences for both your practice and the success of the personal injury case.

Here’s what’s at stake:

• Your revenue: Reduced payments limit your ability to invest in your practice, staff, and resources, ultimately affecting the quality of care you can provide to PI patients.
• Patient outcomes: Over time, MedPay write downs discourage providers from accepting patients on MedPay, shifting the culture away from prompt treatment to a reliance on liens or other deferred payment options. As a result, patients may face reduced access to treatment, delayed recovery, and diminished settlement values.
• Professional standing: Allowing insurers to undervalue your services weakens the perception of chiropractic care as a critical component in personal injury recovery. When providers routinely accept reduced payments, it reinforces a damaging narrative that chiropractic care is secondary, optional, or negotiable, undermining its role as a primary driver of recovery for injured patients.
• Case strength: Insufficient compensation undermines your ability to produce comprehensive documentation that proves the medical necessity and value of your care—key elements for attorneys building a strong case. Thorough, well- documented care strengthens the patient’s legal claim, but write downs compromise your resources and limit the ability to deliver the level of care and evidence attorneys rely on to secure fair settlements.

This last one is a big one, so let’s take a look at it.

Why Fighting Back Helps the PI Case

MedPay write-downs directly undermine the strength of a personal injury case by devaluing the care provided and diminishing the perceived severity of the patient’s injuries. When insurers arbitrarily reduce reimbursement rates, they send a signal that the treatment was excessive or unnecessary.

This creates a ripple effect: Opposing attorneys and insurance adjusters seize on these reductions to argue that the overall claim lacks merit, jeopardizing the patient’s settlement. The undervaluation of care casts doubt on both the provider’s credibility and the legitimacy of the injuries.

Comprehensive documentation is one of the most powerful tools attorneys have to establish the medical necessity of treatment and justify higher settlement demands.

MedPay write-downs make it harder for chiropractors to invest the time and resources needed to create detailed records that demonstrate the progression of care and the patient’s recovery journey. Without robust documentation, attorneys lack the evidence needed to counter insurer tactics, weakening their ability to build a compelling case and secure a fair settlement.

Moreover, when MedPay reimbursements fall short, patients may face limited access to care, incomplete recovery, or longer treatment timelines. These delays and gaps in care often provide ammunition for insurers to argue that the injuries weren’t serious or that the patient failed to mitigate damages by seeking timely and consistent treatment. The end result? Reduced settlement amounts and a diminished perception of chiropractic care as a critical component of personal injury recovery. MedPay write-downs hurt not just your practice but also your patients and their legal outcomes.

Strategies to Combat MedPay Write Downs

If you’re ready to stop insurers from dictating the value of your work, here’s how to take control and secure fair reimbursement—all while enhancing your role in the personal injury case and winning over the attorneys who need your medical records as the backbone of the personal injury case.

Know the Law
A strong understanding of MedPay regulations in your state is essential. Research your state’s MedPay statutes or consult with a legal expert. Then, use this knowledge to challenge reductions and ensure insurers comply with the law.

Many states have protections that limit insurers’ ability to arbitrarily reduce payments. Familiarizing yourself with these laws gives you a significant advantage when disputing reductions. For example, some states require insurers to reimburse at a “reasonable and customary” rate. If your rates align with industry standards and your documentation supports medical necessity, insurers have little legal ground to stand on.

Strengthen Your Documentation
Insurers often exploit vague or incomplete records to justify reductions. Detailed, precise documentation makes it harder for them to challenge your claims.

Focus on:

• Medical necessity: Clearly explain why each treatment was essential to the patient’s recovery.
• Scope of services: Provide thorough details about the treatments and their outcomes.
• Consistency of care: Highlight how your approach aligns with accepted medical practices and supports rehabilitation.

Push for Transparency
Insurers often rely on ambiguity to push through reductions. Don’t let them get away with it—demand full transparency for every write down. Request a detailed breakdown of the rationale behind the reduction, including how it aligns with state regulations and industry standards. To save time, write a standard response to write downs, and use it as a template.

Here is an example:

“Please provide a detailed explanation of this reduction, including how it complies with state statutes and recognized industry benchmarks.”

Force insurers to explain their actions in writing, putting the burden of proof back on them.

Engage in Negotiation
Negotiating with insurers can feel daunting, but it’s often necessary to protect your work’s value. Frame your arguments around the critical role your care plays in both the patient’s recovery and the success of their PI case. Again, consider developing negotiation scripts or key phrases that emphasize your contributions to the patient’s recovery and the attorney’s case.

For example:

“These treatments were essential to the patient’s recovery, as documented thoroughly. Reducing payment undermines both the patient’s access to care and the integrity of the rehabilitation process.”

Partner with Attorneys
Ethical personal injury attorneys value chiropractic care and recognize its importance in building strong cases. Collaborating with these attorneys strengthens your position when disputing write downs and ensures your role in the case is fully understood.

Identify attorneys who respect your billing practices and collaborate with them. Provide detailed documentation that demonstrates how your care supports their cases.

Attorneys can then advocate for the full value of your services, adding credibility to your claims and challenging insurers’ tactics when reductions threaten the case’s success.

Refuse Unjust Reductions
Sometimes, standing firm is the most effective strategy. Insurers often expect providers to accept reductions without a fight. By refusing to compromise without valid justification, you send a clear message that your work is not negotiable. To this end, create a clear policy for handling write downs within your practice. Train staff to escalate unjust reductions to a designated point person for resolution.

This approach protects your revenue and discourages insurers from targeting you with reductions in the future.

The Bigger Picture: Strengthening Your Case and Protecting Your Patients 

Challenging MedPay write downs goes beyond securing fair compensation—it reinforces your critical role in personal injury cases. Comprehensive care and robust documentation aren’t just beneficial for the patient’s recovery; they’re essential to the legal case, strengthening settlement negotiations and ensuring justice for your patients. When you fight back, you show insurers, attorneys, and patients that chiropractic care is an invaluable part of personal injury recovery. This enhances the success of every case, elevates your practice, and ensures that personal injury remains your most lucrative revenue stream.