You’ve seen the term “Administrative Defense Coverage (ADC),” but do you really know what it is and understand why it’s so important to your practice?
An administrative claim is very different than a malpractice claim. For example, ADC provides defense for board actions brought against you, whereas malpractice insurance provides defense and indemnity for liability actions.
So why is ADC important? Because an administrative claim could cost you your livelihood! If your podiatric medical license is revoked, you’ve lost your ability to practice. Your professional reputation is irrevocably damaged and your medical career is over. Let that sink in.
Take a look at what PICA’s ADC covers. It’s included in your policy at $100,000 per policy period and in the aggregate.
- Administrative disciplinary actions
- Hospital peer review actions or attempts to restrict or revoke privileges
- MCO de-certification or contract terminations
- Actions brought by government payers such as Medicare or Medicaid
- Actions by state licensing boards
- Investigations involving billing and coding practices
- HIPAA complaints - actions by the Office of Civil Rights
- Potential HIPAA matters - lost or stolen medical records
At some point in your career, you will be audited. In most instances, the first appeal of an administrative claim will fail. But did you know you could be able to appeal a Medicare claim up to five times? Because PICA knows how devastating an ADC claim can be to a podiatrist's practice, we will be there for you at each of the five levels of appeal allowed.*
Other actions may be covered, too. Check your policy for complete details. If you have any questions, call us! In fact, when you receive any notice--legal or otherwise--please call your PICA Risk Management Department as soon as possible for a confidential consultation at (800) 251-5727, and press 7. We will be with you, every step of the way. If you are not insured with PICA, fill out our online form to get a no-obligation quote.
*An appeal from a final disposition of an administrative action against the covered insured shall be considered part of an administrative disciplinary proceeding, provided that the covered insured has the right of appeal under any applicable law, statute, or regulation.
The information contained on the PICA Blog does not establish a standard of care, nor does it constitute legal advice. The information is for general informational purposes only. We encourage all blog visitors to consult with their personal attorneys for legal advice, as specific legal requirements may vary from state to state. Links or references to organizations, websites, or other information is for reference use only and do not constitute the rendering of legal, financial, or other professional advice or recommendations. All information contained on the blog is subject to change.