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Chiropractic EHR Traps to Avoid
Chiropractic EHR Traps to Avoid avatar

Written by Tom Necela on April 4th, 2014

As the stimulus window winds down, the chiropractic EMR race has really heated up here lately with companies competing for your dollars and as much stimulus funding as possible.

To answer your first question, YES stimulus money is still available!  So 2014 is a good time to consider EMR.

On top of that, ICD-10 requirements will definitely push things over the top in terms of motivating many to get an EMR system.

In your search for the best fit EMR system, be careful of a few “traps” that are hiding in the fine print or in dark shadows.  Just as every industry has ways to pump up profits and “upsell,” here are a few things to be aware of when trying to compare apples to apples. Read More

ICD-10 Delayed for Chiropractors Until 2015. Now What?
ICD-10 Delayed for Chiropractors Until 2015. Now What? avatar

Written by Tom Necela on April 1st, 2014

ICD-10 delayed

As you may have heard, the Senate voted to delay ICD-10 implementation until October 1, 2015. Although the bill still has to be signed by the President, since it passed the House and the Senate, most are anticipating that it will become law.

Some of you may be breathing a sigh of relief, while others are asking…now what?!

Perhaps the most disturbing part of it all is the fact that the issue is not settled yet.  Even if the President signs this into law, the legislation for the ICD-10 delay only affects Medicare.  Private payers may choose to implement anyway.

In the meantime, here are a few thoughts and recommendations:

Chiropractic Considerations Regarding the ICD-10 Delay

If you follow the news headlines, you can easily see that the issue to delay ICD-10 was very controversial.  Many entities have spent a lot of time and money already in preparation. Largely, the most unprepared group was individual physician practices and, of course, chiropractors are in that category.

At this point, most experts feel that ICD-10 is inevitable and that those in favor of the delay gained their last victory. The payers , EMR systems and even the government (Medicare) was ready or close.  In other words, expect the October 2015 to happen as their may be no more room for physicians to whine about their lack of time to get ready.

Recommendations to Prepare Your Chiropractic Office

1.  Don’t procrastinate.  If the whining is justified, it’s because ICD-10 is a major undertaking and affects your coding, your billing AND your documentation.  Oh and don’t forget — your bottom line.  It’s not a quick fix conversion and takes time.  If you wait for another last-minute delay and it doesn’t come, you’re sunk. Consider our online ICD-10 course to get you ready – from the convenience of your own home or office — and on your own time.

2.  Work on your documentation.  In some expert opinions, the single biggest challenge for ICD-10 will not come from coding but from accurately documenting your services to match the new codes.  Fortunately, you can begin to practice this without even using the new codes.  Review the training materials on documentation and begin to make the necessary changes now towards ICD-10 specificity.   That way, when the time to implement the new codes comes, you will have already been used to your “new” documentation style.

3.  Build Your Nest Egg NOW.  Much of the anxiety about ICD-10 stems from the fact that no one believes it will be a seamless transition.  The delayed date will not remove this obstacle, although it could certainly lessen the impact – if you prepare.  Start tucking away some money now just in case.  Ideally, if you can have a cash reserve of at least 3 months operating expenses, you should be able to weather most storms.  That may sound like a lot of money, so do it in small chunks…starting now.

4. Stay Alert for MORE Changes:  As mentioned above, this legislation only affects Medicare’s implementation of ICD-10.  In theory, private payers could decide that they want ICD-10 anyway.  And they could decide the date of implementation as well. Likely?  Not very.  But…in that mess of a scenario, you would still have to prepare for ICD-10 for your regular insurance carriers.

** NOTE:  For those taking our Chiropractic 3.0 Seminars, we will still be teaching some ICD-10 materials that you can implement now to get you ready, but we have added more content on business strategies to help you through the changes of Obamacare and the current healthcare marketplace.

ICD-10 Delay Stalled? Marching On?
ICD-10 Delay Stalled? Marching On? avatar

Written by Tom Necela on March 27th, 2014

ICD-10 moving forward

Noon EST

This morning, House members rejected a quick-fix attempt at delaying ICD-10 implementation and creating another band-aid on the ol’ SGR and instead, decided to delay the vote on delaying ICD-10. The issue was fiercely debated but there was not a sufficient quorum present to take action.

Several House members spoke out against the bill, including Sandy Levin (D-MI) who also noted that they just received the proposed bill 24 hours prior. So, as it stands, the ICD-10 implementation date remains October 1, 2014 for chiropractors, medical doctors, hospitals and every manifestation of health-care practitioner who chooses to use any manner of third-party reimbursement for which the new code set is required.

{Updated post}

3pm EST

Looks like the delay is now up to the Senate. Such is the government. Keep posted.  Eventually (for now) they will settle on something.

One thing to Consider Regardless

Most of those protesting the implementation of ICD-10 in October 2014 are up in arms about the fact that they do not have enough time to adequately prepare and train.  If we keep delaying ICD-10, most docs will succumb to their procrastination and delay their training as well.  Disaster can be averted simply by biting the bullet and learning ICD-10.



Mandatory New CMS 1500 Claim Form Starts Soon!
Mandatory New CMS 1500 Claim Form Starts Soon! avatar

Written by Tom Necela on March 25th, 2014


In case you haven’t heard or just plain forgot, there’s a new claim form in town that you are required to start using April 1, 2014.

The CMS-1500 Claim Form has been recently revised with changes including those to more adequately support the use of the ICD-10 diagnosis code set. The revised form will give chiropractors (and all providers) the ability to begin the transition towards ICD-10. Read More

Medicare Reveals Exactly How to Get Audited in Latest Chiropractic Review
Medicare Reveals Exactly How to Get Audited in Latest Chiropractic Review avatar

Written by Tom Necela on March 18th, 2014

8392215_sCMS carrier Palmetto GBA Railroad Medicare (who administers claims for Railroad Medicare beneficiaries nationwide) recently conducted a “widespread review” of chiropractic services submitted between October and December 2013. Specifically, Railroad Medicare reviewed 21,109 services that were submitted by chiropractors for CPT codes 98940 and 98941.  As you can see below, the results were eye-opening. Read More

The Chiropractic “Tension Point” and Overcoming Fee Resistance
The Chiropractic “Tension Point” and Overcoming Fee Resistance avatar

Written by Tom Necela on March 11th, 2014

ScreenHunter_06 Mar. 10 19Most chiropractors and their staff have an idea about the level of care they would most like to be giving their patients.  If you poll DC’s you will also find that many (if not the majority) of docs would love to be rendering either comprehensive or wellness based care.

The “comprehensive” DC would like his patients to understand the need for care beyond the patch phase and incorporate a restorative plan of care which may also include spinal rehabilitation, therapeutic massage and other services in addition to chiropractic geared towards spinal correction.  The “wellness” DC takes a different route towards their version of comprehensive care which may include nutrition, weight loss, body work or other holistic complements to their chiropractic care. Obviously, some chiropractors combine all of the above and more.

Few DC’s would truly admit that they like to treat the patients solely for pain and have them exit from their offices after a few visits, never to be seen from again. Read More

5 Factors to Consider BEFORE Buying a Chiropractic Practice
5 Factors to Consider BEFORE Buying a Chiropractic Practice avatar

Written by Tom Necela on March 5th, 2014


Many chiropractors wonder if they are entrepreneurial enough or whether they have “what it takes” to run their own business. There are many factors that are affiliated with chiropractic business success such as motivation, business savvy and clinical skills – among others.

Specifically, financial lending institutions will consider many “tangible” factors beyond those mentioned above.  Here’s a quick list of the most important things that the banks will be looking at. Read More

Medicare Auditor’s Reveal 2 Biggest EHR Weaknesses That May Lead to “Fraud”
Medicare Auditor’s Reveal 2 Biggest EHR Weaknesses That May Lead to “Fraud” avatar

Written by Tom Necela on March 4th, 2014

12066883_sBuried amidst a flurry of OIG recommendations, targets and auditing hoopla are two gems that can help us as chiropractors reduce the possibility of EHR-induced documentation problems.

 The news is riddled with stories about the cost of health care “fraud” (current guestimates put this between $75 billion and $250 billion) and are starting to spook even the most jaded of practitioners. Unfortunately, while the widespread growth of EHRs has helped on one hand by enabling chiropractors to efficiently create much better documentation, there is a downside as well. EHR may also enable more widespread problems when used improperly.  To this extent, Medicare recently identified the two biggest EHR taboos that could lead to “fraudulent” billing practices.

Read More

Can You Afford To Buy a $500,000 Chiropractic Practice?
Can You Afford To Buy a $500,000 Chiropractic Practice? avatar

Written by Tom Necela on February 26th, 2014

money maze

You’ve heard the old adage, “You’ve got to spend money to make money.” Perhaps you’ve even debated that when it comes to the possibility of purchasing a chiropractic practice or starting your own from scratch.

Unfortunately, in our profession, that advice is tempered by the reality of chiropractic school debt, which often exceeds $150,000.  It is understandable, then, that young, responsible, and prudent chiropractic professionals are conflicted over assuming additional debt to move toward goals they set while in chiropractic school.  In other words, you may dream about owning a thriving, million dollar practice “someday.” But the burden of student loans, mortgages and everyday living expenses may cause you to doubt your ability to reach that dream, at least anytime soon. Read More

Are You Violating HIPAA Compliance By Using Windows XP in Your Chiropractic Office?
Are You Violating HIPAA Compliance By Using Windows XP in Your Chiropractic Office? avatar

Written by Tom Necela on February 25th, 2014

HIPAA compliance threat chiropractors

If you are using computers that run Windows XP in your chiropractic office, you need to be aware that you may soon be creating a HIPAA violation by doing so.  In case you haven’t heard, Microsoft plans to end support for Windows XP on April 8, 2014 which will effectively and finally put the beloved operating system in the grave. If you are asking “what’s the big deal?” then you definitely need to read on.  If you understand that this IS a big deal and that your HIPAA security may be compromised by using Windows XP, read on. Read More

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