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Why Your Chiropractic Assistant, Fraud, & Insurance Verifications are Ruining Your Revenues ( & What Chiropractors Can Do About It)
Why Your Chiropractic Assistant, Fraud, & Insurance Verifications are Ruining Your Revenues ( & What Chiropractors Can Do About It) avatar

Written by Tom Necela on October 2nd, 2012

These days, it’s tough to tell where problems start.  Some of you know you, doctor, are the primary contributor.  For others, it’s the staff.  Still others feel it’s insurance or even healthcare at large.

You all may be correct – which is why this article may help point you in the right direction…

Recently, I saw an interesting graphic that depicted the impact of identity theft on healthcare fraud. The graphic illustrated a little mentioned problem in the hunt for fraud and the audit frenzy that is occurring in today’s healthcare:  thieves can steal a person’s (or doctor’s) identity and bill for services to receive reimbursement.  And it’s happening all the time. Witnessed the millions recovered by Medicare for fraudulently billed DME (for example, wheelchairs provided and paid for by Medicare to dead people).

Before you think chiropractic is immune, think again of a larger issue that enables fraud to happen: patient’s no longer understand their health insurance.  And if they don’t understand insurance, they are not only more apt to be victims of crime but also to not reap the full benefits due them.  They are more likely to encounter problems that may get them upset at you.  And, in turn, less likely to want to use their insurance for your care, thus, reducing your income.

With that in mind, below are a few vital, proactive strategies that chiropractors can employ to minimize our audit risk and to preserve good patient relationships: Read More


How to Survive a Chiropractic Audit (Part 2)
How to Survive a Chiropractic Audit (Part 2) avatar

Written by Tom Necela on August 22nd, 2012

In Part One of this article “How to Survive a Chiropractic Audit” we focused on what to do if and when you get notification that your chiropractic practice is being audited.  My primary focus in that article was to prevent you from having a heart attack, from fleeing to a fortress in Slovenia, from unnecessarily declaring bankruptcy or from throwing in the towel and ending it all.  Unfortunately, in my work helping chiropractors with their audits, I’ve seen all of the above

(Ok, maybe not fleeing to Slovenia, but if you’ve got to leave the country, it’s a nice place to be, especially around Lake Bled in the summertime…But I digress.)

In Part Two, we are going to focus on being a little more proactive than having your passport ready or your fingers crossed.  Let’s focus on preventing the audit. Read More


Chiropractic E/M Challenges: When a NP Isn’t, When Mod -25 Just Won’t Do & More!
Chiropractic E/M Challenges: When a NP Isn’t, When Mod -25 Just Won’t Do & More! avatar

Written by Tom Necela on August 2nd, 2012

One that you can say about billing, coding & documentation for your chiropractic services is that it is constantly changing.  This certainly may cause frustration to many DC’s who believe they are doing things right only to find out that their claims are suddenly rejected, additional paperwork is requested or – in the worst case scenario – a post-payment audit demands money back.

I’m not much of a conspiracy theory guy but it does indeed look, at times, as if the insurance payers are constantly changing the rules to cause us to stumble. Fortunately, I am sick and twisted enough to enjoy watching  THEM and reporting new changes and challenges to YOU.

Here’s the latest in the way of insurance shenanigans that is making its way across our country in the form of your E/M codes. Read More


How to Correct Chiropractic Billing and Documentation Errors
How to Correct Chiropractic Billing and Documentation Errors avatar

Written by Tom Necela on May 22nd, 2012

Mistakes happen. The average busy chiropractor either fails to bill, code and document services correctly and unfortunately, their staff also misses it. The claim hits the insurance company with the bad info intact.

Next, the DC contacts me with a series of questions, depending on the situation… Read More


7 Medicare Documentation Errors From Recent Chiropractic Audits
7 Medicare Documentation Errors From Recent Chiropractic Audits avatar

Written by Tom Necela on March 27th, 2012

Medicare has been particularly active lately in attempting to educate chiropractors about errors that we have been making in respect to billing Medicare for chiropractic services.  Over the past month or so, several Medicare carriers (Noridian, Palmetto, NGS, etc) have held training sessions, webinars and teleseminars dedicated to reviewing “the rules” for proper chiropractic billing, coding and documentation in Medicare.  All told – these carriers represent approximately 50% of US Chiropractors – so it may be worth paying attention to what they are saying.

Below are quotes from the auditors conducting CERT reviews for these carriers as to why services were denied, billing was incorrect or documentation was considered substandard. Read More


The Feds Giveth & Taketh Away: More Changes Awaiting Chiropractors!
The Feds Giveth & Taketh Away: More Changes Awaiting Chiropractors! avatar

Written by Tom Necela on February 21st, 2012

If one can judge a year by the amount of changes taking place, 2012 is sizing up to be a big one.

In this, we received word of two significant items for which chiropractors should take note. Read More


How Can You Increase Your Chiropractic Income Without Working More?
How Can You Increase Your Chiropractic Income Without Working More? avatar

Written by Tom Necela on January 24th, 2012

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


What Chiropractic Errors Are Costing You: 2011 Update
What Chiropractic Errors Are Costing You: 2011 Update avatar

Written by Tom Necela on May 17th, 2011

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


Why Some Chiropractors Chase $44,000 Only to Lose $544,000 or More
Why Some Chiropractors Chase $44,000 Only to Lose $544,000 or More avatar

Written by Tom Necela on May 3rd, 2011

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


Chiropractic Documentation Date Dangers to Avoid
Chiropractic Documentation Date Dangers to Avoid avatar

Written by Tom Necela 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


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