Chiropractic Insurance Seminar
Managed Care, Workmen's Compensation, Personal Injury, Chiropractic Business Practices and much much more.
The practice of chiropractic is subject to many rules and regulations. Failure to adhere to these rules can result in severe penalties - even jail time. It is a huge mistake to operate your practice and not be aware of these rules.
A cash practice does not exempt you from having to follow the insurance regulations. Just because you do not accept assignment, it does not mean that you cannot or will not be audited. If an insurance company determines that they have overpaid on a claim, they can demand repayment from the doctor even though payment was made to the patient.
At a FormSmith insurance seminar we will teach you how to process insurance properly. We cover documentation, coding, billing, Medicare, managed care, workers compensation, personal injury, chiropractic business practices and much much more.
Without this information, you will learn to process insurance the same way we did - one mistake at a time. And let me assure you, this is the most expensive and most frustrating way to get this highly specialized information.
Properly Code Your Services & Use ModifiersAn in-depth discussion of the CPT and HCPCS coding systems will enable you to properly match your services and fees.
Master the Evaluation and Management (E/M) Coding SystemLearn what the codes mean and what services you must perform in order to justify using each level of code. Using the proper code helps justify your services as being medically necessary thereby reducing insurance questionnaires and denials.
Set Fees ProperlyOne of the big mistakes we see chiropractors make is that they are charging too little for their services. This drives down the value of chiropractic as a whole and only does a disservice to the profession. We will give you some fee ranges so you can choose the proper fee to charge in your office.
Verify CoverageProper insurance verification is the bedrock of insurance assignment. Learn how to ask the "right questions" to eliminate surprises.
Navigate through Managed CareLearn how to maximize benefits even when the doctor is out-of-network. Learn how to pre-certify your services and avoid pitfalls.
Learn the Entire Process of Proper DocumentationStep-by-step instructions and examples of how to record and document patient care. Proper documentation applies to all patient care, insurance or cash.
Learn how to Render a Proper Treating DiagnosisMany a doctor of chiropractic has jeprodized his claim by not understanding the icd 9 codes.
The icd9 codes are organized by catagory and the catagories have meaning. Some individual icd codes should not be used as your first or primary diagnosis.
We will teach you 20 rules for choosing the proper icd9 code and supply you with a code list suitable for the chiropractic office.
Doctors Learn Treatment PlanningYou are required by Medicare to have a treatment plan in the patient's record.
Learn the Secrets of a "Clean" ClaimMost insurance companies are using scanners to process claims. Clean claims get processed and paid ahead of "dirty" claims which have to be hand processed.
Dr Hodges..... |
I have to brag.... just finished inputting a check from Medical Mutual..... 15 days from mail box to mailbox!!!!!!!
How to Recover from MistakesNo matter how good you get, eventually you will make a mistake. Learn how to properly re-rile claims. Plus, get copies of narratives and reports that get doctors paid when it looked impossible.
MedicareStep-by-step instructions to take the uncertainty out of the process with specific examples for each state attending.
Auto AccidentWe will teach you about liability, med-pay, comprehensive, priority of policy, uninsured and under-insured motorist, contributory negligence and many other terms that you must know . Also, how to successfully deal with attorneys even if you are mousy and shy.
Complete Manual with Common CodesEach attendee receives a complete manual with the CPT codes, HCPCS codes and ICD 9 codes that most offices will need. These code books purchased alone would cost over $150.00. Our manual contains all the codes that most chiropractic offices will need.
Forms for Office OrganizationEach office will receive a packet of forms to streamline the information flow in your office.
State Specific InformationYour office will be provided a current, state specific Medicare fee schedule plus examples of how to complete the Medicare claim form properly. Plus state specific information for your workmens compensation and automobile accident laws.
Plus much, much more!This is not a workshop just for Georgia chiropractors. Hundreds of chiropractors from 44 states have taken this course. Each office will receive information specific to their own state for Medicare, workmen's compensation and personal injury. Every chiropractic office benefits regardless of the doctor's technique or management style.
What if One Piece of Information Could Keep You from Making a HUGE Mistake?
It is a HUGE MISTAKE to operate your practice and not be aware of the rules that you are subject to. If you don't understand this, you could find yourself in trouble with the Office of Inspector General, federal or state attorney general, your board of chiropractic examiners or your state insurance commissioner.
Let me tell you about some of the HUGE MISTAKES we have seen chiropractors make:
I run a Cash Practice
Just because you do not accept assignment, it does not mean that you cannot or will not be audited. If the insurance company determines that they have overpaid on a claim, they can demand repayment from the doctor even though payment was made to the patient.
Doctor, you are making a HUGE MISTAKE if you think that you are not involved with insurance in your office or that running a cash practice somehow exempts you from having to following the rules. It is the doctors job to determine:
These items are required on every patient regardless of the means of payment and should not be delegated to untrained staff.
You must file the claims for the patient or provide them with sufficient information to file their own claim (usually some sort of superbill). That means that if you make a mistake the patient won't get reimbursed properly - this can lead to premature patient dropout.
Even cash practices must process requests for additional information. Improper record keeping can make this a huge problem.
Another HUGE MISTAKE is allowing the patient to file their own claims. If you don't understand the process of insurance is it logical to expect that your patient's do? Another pitfall in allowing your patient to file his own insurance is the increased possibility that your patient will start filing for dates that they didn't receive services thus dragging you into a fraud investigation.
If you want your patients to be reimbursed fairly, you must simply learn the rules of the game!
I Don't Have Anything to do With Medicare
My Medicare Patients Just Pay Me
This may be the worst HUGE MISTAKE. Medicare eligible patients are protected under federal law and chiropractors cannot opt-out of the Medicare program. If you treat them, you must apply to Medicare to be a provider and follow all the rules including filing the claims for the patient.
I Give My Cash Patients a Discount
Charging a higher fee to insurance patients than you do to cash patients is a dual fee schedule. It's ILLEGAL and a HUGE MISTAKE. This includes not charging cash patients for their therapy. We have know doctors that got into trouble with the board of examiners for this offense. They were reported by the very patients that got the discount.
I Encourage My Patients to Pre-pay for Their Care
Pre-pay plans can be problematic. It is a HUGE MISTAKE to offer a fixed fee and accept a risk that the patient will get more care than he actually pays for. This places you in the business of insurance and unless you qualify as an insurance company, you are violating insurance law.
I Use the 10 Minute Code for My New Patients (E/M 99201)
First off, each Evaluation and Management code (E/M) consists of 7 elements - time is not one of the key elements. It is a HUGE MISTAKE and considered fraudulent to bill an E/M code without performing the services that the code describes.
Using too low an E/M service indicates to the insurance company that there is nothing much wrong with the patient and that they don't require much care. HUGE MISTAKE. Especially if the patient has a serious problem and needs extensive care.
The Salesman Showed Me how to Bill for the Hydro-therapy Table
Equipment salesman will stretch the truth to make a sale (a polite way to say lie). It is a HUGE MISTAKE to rely on an equipment salesman for coding advice simply because it is not their license that is on the line - it's yours!
Just so you know, a hydro-therapy table should not be coded as either whirlpool, massage, hot packs, aquatic therapy or Hubbard tank. It should be considered a non-covered service.
I'm Getting Paid
That may be true, but the insurance companies are in take-back mode and chiropractic is the "low hanging fruit." Just because you are getting paid today does not mean that you will get to keep the money. Are you certain that you are properly documenting? Do your records include a treatment plan? Can you justify the need for care? Could your practice withstand an insurance audit? If not, you are making a HUGE MISTAKE.
I Don't do Auto Accident Cases Because I got Beat Out of My Money Once
The processing of auto accident cases can be frustrating. However, it is a HUGE MISTAKE not to accept auto accident cases for two reasons. This first is monetary, auto accident cases can be good for your bottom line. Secondly, auto accident victims desperately need chiropractic care. The short and long term effects of a hyperflexion-hyperextension injury can adversely affect health, well being and subsequently even entire families. To successfully process an auto accident case you must first understand the process. The different types of insurance coverage and the law that applies to them in your state. Keep reading ...
I Got My Code List from the Chiropractor Across Town
It is a HUGE MISTAKE to depend on your chiropractic colleagues for coding advice. In reviewing claims and offices for many years, we have found a high error rate (up to 40%) in the coding and pricing of services as well as in diagnosis coding.