At one point in time, virtually every business owner – chiropractors included – has asked the question “How can I improve my income?” Today’s post will discuss this mega-dilemma of nearly all entrepreneurs.
Before we discuss potential solutions, allow me to throw another question at you:
HOW do you want to increase your income? Read More
On November 17, 2011, the CMS (Medicare) Office of E-Health Standards and Services (OESS) announced that it will not enforce compliance with the HIPAA 5010 transaction set until March 31, 2012.
Before you get too giddy about the prospect of your office not having to undergo conversion to the 5010 Format for Electronic Claims submission – think again. Read More
I’ve got three news updates for you today – one positive, one negative, one perhaps can go both ways. Read More
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!”
The 2011 edition of the National Health Insurer Report Cards were recently released and illustrated some disturbing trends.
In case your not familiar with the NHIRC, it’s the 4th annual report sponsored by the AMA looking into financial waste, timeliness and accuracy of claims due to common insurance payer tactics. This year’s segment analyzed claims data from a randomized sampling of over 2.4 million claims. (You can get the full version of the NHIRC here).
Many of the big payers are represented in the report cards – Blue Cross, Blue Shield, Anthem, Aetna, Cigna, United HealthCare and Medicare.
From the findings, it’s likely one or more of these payers are causing you trouble (whether you realize it or not). The report cards allow a glimpse at who is notorious for paying claims late, requiring mounds of paperwork, using underhanded tricks to under-pay contracted fee rates when you’re not looking and more.
Don’t be a victim! Here’s the Executive Summary of what the NHIRC found out: Read More
Some of you may get tired of hearing how dangerous errors in your chiropractic billing, coding or documentation practices may be. I certainly have sat through more than my fair share of seminars where it appeared that the main motive of the speaker was to scare you straight. Furthermore, from the data extracted from most chiropractic reviews done by Medicare and other payers, we have ample evidence that we should be more than a bit worried.
Since I am a bottom line fanatic, let’s look at this from another angle: what could chiropractic billing, coding or documentation errors cost you? Obviously, the flip side of this question is, if you do it right, how can sound strategies in this regard help you improve your business? Read More
One of the most common questions that I get around here is on EMR. Everyone wants to know what’s the best EMR system to use or when is a good time to implement EMR or how to implement EMR. You get the idea.
Those of you who have read or heard my thoughts on EMR know that I dance all around this issue constantly. It’s not that I think EMR is a bad idea. On the contrary, most of my clients utilize EMR in their practice. It helps them improve their documentation, compliance and practice management.
Notice I said, most — not all. Read More
Today I’m going to speak to you about a mandatory format conversion for your electronic billing that you must do by January 2012 or you will not be paid! If 2012 sounds like a long way away, you should know that testing for the 5010 conversion starts now — in April 2011!
Specifically this format conversion is called 5010 and you might’ve heard of it as a HIPAA 5010 Format Conversion or “mandatory claims reformatting.” Lots of chiropractors have been emailing me for advice on what to do, where to go for information and what exactly is required for the conversion.
First — a reality check. Do NOT be fooled by the term HIPAA! One reason I told you up front that you will not be paid and I didn’t mention HIPAA is that I know chiropractors by in large ignore lots of things related to HIPAA. They think, “Well in I’ve never seen a HIPAA policeman” or “this is just some low priority compliance items I can handle later.” This is entirely different!
This 5010 conversion is mandatory if you do ANY sort of electronic claims transmission or electronic billing. Read More
As we discussed in my last post, Expedited Agreements and Other Fee Negotiation Scams Waged at Chiropractors, insurance payers are continually rolling out new tactics to avoid releasing claim payments or to minimize reimbursements.
Accordingly, your standard operating procedures may longer be sufficient to get you paid for all the good work you do. One overlooked but vital tool to accomplishing this is your Insurance Verification Form. As such, now may be time to enhance your verification of benefits to insure that emerging claim processing tactics are identified and thwarted.
Unfortunately, most chiropractic offices are employing few, if any, of these tactics. Instead, they are doing insurance verification, “the way we have always done it” and getting the same (or worse) results. Read More
Many of you have probably received a letter similar to the one pictured below offering you “expedited” handling of the reimbursement owed on an outstanding claim.
This scam is being used by a number of different companies who contract with payers to primarily (but not exclusively) target out-of-network providers. These letters, which are often received by fax, propose to “expedite payment and decrease the patient’s responsibility.”
While this sounds admirable in theory, a quick look at the math behind this proposal will illustrate why you should feed such documents to a hungry shredder as quickly as possible. Look at the example below: Read More
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