Medicare carrier Palmetto GBA released their 4th Quarter (2010) Medical Review Findings which details the deficiencies they have been noting in terms of billing, coding or documentation errors. These findings are not exclusive to chiropractors. In fact, since chiropractors are only paid for one service in Medicare, we probably should not even make this list. But we did (again). Read More
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
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
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
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
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
I have been receiving lots of questions lately about these continual PECOS notices that we have all been getting from Medicare. If these enrollment “warnings” have been getting under your skin or just getting you plain confused as to whether these apply to you or not, keep reading.
Here’s a summary of what is going on: Read More
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
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
Last year, I posted an article on co-pays, coupons, and discounts – essentially what to do and what not to do.
This subject remains one of the most popular questions I still get asked.
As we recently have celebrated the freedom of the USA with Independence Day, I thought it fitting to re-visit the “freedoms” (or lack thereof) that we are challenged with inside our chiropractic practices.
Unfortunately, when freedoms are abused, trouble sets in. Keep your nose clean and re-visit the post
Chiropractic Co-Pays, Coupons and Discounts – When Free Isn’t
(click the link above to see the post)
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