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Avoiding Chiropractic Documentation Slop & the Slap That Follows (Part 8 of 13 Things Series)
Avoiding Chiropractic Documentation Slop & the Slap That Follows (Part 8 of 13 Things Series) avatar

Written by Tom Necela on February 7th, 2013

Despite all the warnings, ranting, raving and rumors about audits, there is still a lot of — for lack of a better term — chiropractic  documentation “slop” out there.

I use the term “slop” as opposed to “sloppiness” because I am not simply referring to messy or illegible handwriting on chiropractor’s notes, although there is definitely plenty of that to go around.  Instead by “slop” I am referring to a much more broad-based problem that encompasses a lack of legibility, lack of completeness and a lack of effort.

Yes, sloppy, incomplete and lazy documentation will get you in trouble.  Worse, there is little to no defense on your part.  No auditor is ever going to call you up and ask you to translate your hieroglyphics that are masquerading as your notes.  No nurse who is reviewing your notes (yes, many nurses and few DC’s will ever see your documentation) and ask you to explain exactly what you mean by your chiro-speak.  And unless you are very unfortunately called into court, you will not get the chance to explain your rationale for care, the kinetic chain and why you adjusted the patients big toe when their only chief complaint was neck pain (and if you are, you may be even less fortunate than the DC whose care was just denied in the first place).

Here it is, served up unadorned on a tin platter for your eatin’: like it or not, in 2013, you’ve got to change your documentation “slop” — or else.

Now that we got that big glass of cheer out of the way, here’s how: Read More


Deadline Detours: HIPAA 5010, EHR Incentives, ICD-10 and more!
Deadline Detours: HIPAA 5010, EHR Incentives, ICD-10 and more! avatar

Written by Tom Necela on April 10th, 2012

In case you haven’t heard, several deadlines have been detoured lately – some pushed back, some here, some coming who knows when….  Here they are, followed by some commentary: Read More


New Rules & Regulations For Chiropractors Anger 39 Healthcare Associations
New Rules & Regulations For Chiropractors Anger 39 Healthcare Associations avatar

Written by Tom Necela on June 15th, 2011

If you think the pace of all the new rules and regulations is a little too much like a runaway train, you are not alone!

EHR, HIPAA 5010, ICD-10, OIG Compliance, Medicare PRQI, etc, etc

In fact, 39 different healthcare associations have told the Feds to just slow down and quit interfering with our businesses by giving us new hoops to jump through.

Unfortunately, some of us won’t even know what hit us when these new rules go into effect.  Some pack fines, others will cripple your cash flow. Still others we should delegate or dump altogether.

While I don’t have the space in this blog to go over every potential rule/regulation affecting chiropractors, here’s the Executive Summary of the ones to pay the most attention to: Read More


Maximize Your Chiropractic Income, Minimize Audit Risk WEBINAR!
Maximize Your Chiropractic Income, Minimize Audit Risk WEBINAR! avatar

Written by Tom Necela on February 18th, 2011

By request, we have taken our popular seminar  and brought it into your home/office via WEBINAR! Read More


Chiropractic Seminar Freebies You Missed! And Your Chance to Profit From Them…
Chiropractic Seminar Freebies You Missed! And Your Chance to Profit From Them… avatar

Written by Tom Necela 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


Dangerous Data from the Chiropractic Comparative Billing Report
Dangerous Data from the Chiropractic Comparative Billing Report avatar

Written by Tom Necela 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


How to Interpret Your Chiropractic Comparative Billing Report (Part 2)
How to Interpret Your Chiropractic Comparative Billing Report (Part 2) avatar

Written by Tom Necela 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


How to Interpret Your Chiropractic Comparative Billing Report
How to Interpret Your Chiropractic Comparative Billing Report avatar

Written by Tom Necela 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


Medicare Audit Letters Hit Chiropractors Starting August 2010
Medicare Audit Letters Hit Chiropractors Starting August 2010 avatar

Written by Tom Necela on August 17th, 2010

Every Medicare carrier in the country has been assaulting my inbox recently with “ALERT” emails designed to make chiropractors aware of studies being conducted by the Comprehensive Error Rate Testing (CERT) program.  I am not sure if we are at the equivalent of Code Orange or Code Red at this point, but the profession is definitely on Medicare’s “elevated risk” alert system in some fashion.  So, in case you haven’t heard, may this post serve to Paul Revere the chiropractic community to be on guard — Medicare is coming, Medicare is coming! Read More


Are Your Chiropractic Revenues Tied to Emotions or Logic?
Are Your Chiropractic Revenues Tied to Emotions or Logic? avatar

Written by Tom Necela 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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