Written by Tom Necela, DC, CPC, CPMA, CCP-P on September 15th, 2011
On September 26, 2011 the Centers for Medicare & Medicaid Services (CMS) will release a national provider Comparative Billing Report (CBR) aimed at the chiropractic profession…again.
No, you are not vicariously having some sort of “senior moment” or bad flashback due to your younger and wilder days. Yes, Medicare did in fact conduct a chiropractic CBR last year (2010). This round is a similar study equivalent to the one distributed last fall except this current study will focus on 2010 data. Read More
Written by Tom Necela, DC, CPC, CPMA, CCP-P on August 17th, 2011
The emails have been pouring in, my phone ringing constantly.
So many, MANY chiropractors want to know the same thing:
“Why the sudden increase in Medicare denials?”
“What happened? This past week we got flooded with 67 requests for documentation!”
“Are we doing something wrong? We received over 50 requests for detailed notes in one batch!”
Read More
Written by Tom Necela, DC, CPC, CPMA, CCP-P on March 31st, 2011
Recently I received an email from an auditing group to which I belong that offered some nasty little tips that auditors can use to easily recoup money from physicians, including chiropractors.
First, let me pause and clarify one point. Although I do have a certification as a professional medical auditor (and as of this writing am the first and only chiropractor to do so), I do not use this to audit chiropractors. In fact, I received this training so that I can more fully understand what auditors are looking for and to protect YOU. Today’s blog post is a perfect opportunity to use this. Read More
Written by Tom Necela, DC, CPC, CPMA, CCP-P on February 18th, 2011
By request, we have taken our popular seminar and brought it into your home/office via WEBINAR! Read More
Written by Tom Necela, DC, CPC, CPMA, CCP-P on February 10th, 2011
For those of you who did NOT attend my recent seminars in the Northwest, here are a few items you missed!
For those of you who attended, as promised, here are the specific references and places to go for the information that was not included in your notepacket.
Tom
P.S. If you did NOT attend my recent seminar, be sure to read the bottom of this post for a Special Offer!!
P.S.S. Seminar attendees — I used this picture above to stimulate your memory to…stop giving it all away! 
Read More
Written by Tom Necela, DC, CPC, CPMA, CCP-P on November 16th, 2010
For those of you who are wondering why I am devoting three blog posts to the Chiropractic Comparative Billing Report, it is this: even if you did not receive a CBR, there is a wealth of opportunity and danger in the data derived from the CBR. Put simply, Medicare has sent the CBR as warning signal (for some of you) that what you are communicating to Medicare (and other payers) may not comply with guidelines and meet the requirements you need to get paid.
While none of your results from the tables or graphs from the CBR should be viewed as a problem in and of itself, there are a few “dangerous” conclusions that you definitely do not want drawn from your practice patterns – whether or not you received a CBR. Read More
Written by Tom Necela, DC, CPC, CPMA, CCP-P on November 12th, 2010
In Part One of this post, we discussed how to interpret some of the data from the Chiropractic Comparative Billing Report issued recently by Medicare to 5000 DC’s around the USA as well as made some proactive suggestions for improvement.
In this installment, we will discuss the data from the remainder of the Comparative Billing Report (Figure 2 and 3) as well as how to draw some conclusions from the CBR data about your practice. Read More
Written by Tom Necela, DC, CPC, CPMA, CCP-P on November 2nd, 2010
This past week or so, 5000 chiropractors nationwide received a “present” in the mail in the form of a Chiropractic Comparative Billing Report (CBR). Even though I had previously reported that this would happen (see my previous post “Medicare Releases Chiropractic’s Comparative Billing Report Pilot”), my email inbox now knows what it must feel like to be a postal carrier during the holiday season.
Although, the CBR is not punitive or an audit per se, the report has certainly stirred up strong feelings in our profession and got a whole lot of people suddenly worried about their billing practices and level of audit risk.
At this point, it is not humanly possible for me to respond to all the emails that I have received on the CBR from the profession at large.
However, I will offer the following blog post to address many of the common concerns and questions I have received from chiropractors wondering what to do about their CBR. Read More
Written by Tom Necela, DC, CPC, CPMA, CCP-P on October 14th, 2010
Doctors, your “report card” is now available.
This past week (10/4/2010), chiropractors in the state of Wisconsin were the “pilot” program subjects who began receiving a “Comparative Billing Report” (CBR) produced by SafeGuard Services who is under contract by Medicare (CMS).
Don’t worry Wisconsin DC’s, they’re not just picking on you — the national release of the CBR is anticipated to be be sent three weeks later to 5000 chiropractors nationwide. Read More
Written by Tom Necela, DC, CPC, CPMA, CCP-P on September 21st, 2010
Medicare carrier Noridian Administrative Services (which administers Part B claims in Alaska, Oregon, Washington, Arizona, Montana, North Dakota, South Dakota, Utah and Wyoming) recently updated and reprinted a notice on Chiropractic Software-Generated Documentation that I think can serve to educate us as a profession.
Incidentally, although your specific carrier may not be Noridian, you should take note that most Medicare carriers generate the exact same news releases, alerts and notices each week so I wouldn’t be surprised if you don’t receive a similar “reminder” from your carrier. Even if you don’t the information contained and summarized below can be crititical towards getting claims paid as well as avoiding denials and postpayment audits.
Apparently, the piece was generated because Noridian has seen an increase in the use of software-generated documentation for chiropractic services. In and of itself, there is certainly nothing wrong with using EMR or even any form of computerized notes. So what’s their beef? Read More
