Written by Tom Necela, DC, CPC, CPMA, CCP-P on July 6th, 2011
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
Written by Tom Necela, DC, CPC, CPMA, CCP-P on March 22nd, 2011
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
Written by Tom Necela, DC, CPC, CPMA, CCP-P on March 9th, 2011
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
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! 
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Written by Tom Necela, DC, CPC, CPMA, CCP-P on January 25th, 2011
Too many chiropractors have a lingering problem with debt in their office — and it is literally killing their practice and their profits.
By debt, I am not talking about how much you owe on your student loans, your credit card or even how much business debt you may have due to capital expansion loans, lines of credit, etc.
The debt to which I am referring is bad debt, as in, uncollected accounts receivable. In other words, services you have already performed, but for which payment has not yet materialized. 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 August 3rd, 2010
When faced with decisions on major life purchases – house, car, building purchase, even expensive remodels or repairs – most of us responsible adult chiropractors tend to do some comparison shopping. We may go out and get three or four quotes, make a list of the pros and cons and then pick the best choice, right? Read More
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Written by Tom Necela, DC, CPC, CPMA, CCP-P on July 20th, 2010
I’m on the road for the next couple weeks traveling for a number of on-site consultations with clients so this blog post will be a summary of random thoughts on the most common questions that repeatedly brought to my e-mail inbox. Read More
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