INSURER SUES CHIROPRACTOR FOR $8 MILLION.

Byline: Lee Condon Daily News Staff Writer

An automobile insurer on Thursday filed a civil lawsuit against a Glendale chiropractor and his medical clinics for $8 million in damages, alleging he overbilled the company in a scheme known as ``upcoding.''

Woodland Hills-based 20th Century Industries sued David Neff and his two Glendale-based medical clinics, the Jackson Chiropractic Clinic and the Harvard Chiropractic Clinic, in Los Angeles County Superior Court in Glendale.

Neff could not be reached for comment Thursday.

In the complaint, 20th Century alleges that Neff overbilled patients for procedures covered by the company. Ric Hill, a spokesman for 20th Century, said Neff and his clinics claimed they had performed more expensive treatments on patients than were actually administered. In some cases, claims were made even though no treatment had been provided, Hill said.

``You use a medical code that represents a higher level of payment than the treatment you are actually giving,'' Hill said, explaining the process of upcoding.

Hill said he is not certain how much Neff and the clinics were accused of overbilling. However, he said under state law the company is able to sue for damages of $10,000 per claim plus three times the value of any fraudulent claims.

Hill said information from the company's investigation was turned over to the Los Angeles County District Attorney, the California Attorney General and the California Department of Insurance Fraud Bureau. However, Hill said that so far none of those organizations have taken any action against Neff or the clinics.

Victoria Pipkin, a spokeswoman for the district attorney, said she was unable to determine whether the office is pursuing a case against the clinic.

Hill said 20th Century last year took action against people who submitted a total of $100 million in fraudulent claims.

``Ultimately, it all goes back into the rates we pay,'' Hill said.