Vericle®, the technology behind Genesis’s service, has over 2 Million Rules (and growing) that are used to validate claims prior to submission.

Bullet Proof EMR/EHR Chiropractic SOAP notes

I have been in the chiropractic software and billing industry for a long time.  Managing a business that develops software to help doctors get paid on time and protect their earnings from an audit is one thing.  When your income is tied to your clients income, like it is for many of my clients, that is another thing.  I have both perspectives.  If a doctor does not get paid I don’t either.  If they get audited, and lose, we all lose.

A lot is said by software vendors out there about their SOAP notes.  They are the “best”, the “fastest”, “bullet proof”.  I question how many of them have tried to get a claim appeal won with the notes their systems generates.  I can say lots of things if I were just selling software one time but clients of mine buy, or do not buy, every day.  When doctors using other software lose and appeal or get audited is their first call to the software vendor?  I think not.  I would like to share real world experience when it comes to audits and SOAP notes, not hot air that will not help you at all, let alone make you bullet proof.

First understand that the biggest money maker (most profitable) for insurance companies today is not higher premiums like you might think.  It is Audits.  A 13:1 ROI has been reported.  If I spent $1 on marketing and got $13 back I would be dumping all of my money into whatever gave me that return.  So here is my prediction.  You, and your bullet proof notes, are going to get audited.  That goes for me too by the way.  I made this prediction 7 years ago before doctors really knew what an audit was.  The frequency and scope of audits has since skyrocketed and broadened dramatically.  So it is coming to a head.

Insurance companies are actively building technology, processes, and gathering the man power to efficiently audit everyone and become even more profitable doing it.  Here is what will happen, if you ask me.

1. Technology
   • There will be automated technology that scans EVERY SOAP note to look for weak points.  Of course that means every insurance company would need a digital copy of every note for every visit.  Have you heard of some insurance companies requesting notes on all visits?  I have.
   • Sophisticated systems are being built and have been around for years to profile what codes you bill and what you charge.
   • Wouldn’t it be nice if the government mandated that every doctor have an electronic health record?  Even better if there was government regulated certification so all the systems worked the same way right?  That would really help patients so much.
2. Process
   • More on the levels of audits in a bit.
   • I am already hearing reports in some states where every doctor who billed a specific carrier got an audit letter.
3. Man Power
   • Insurance companies are hiring outside independent contractors to conduct the audits.  This gives them basically an unlimited number of auditors.  They share a % of the money collected in the audit with these contractors.
   • They are outsourcing claims processing, note review, and appeal processing to India and other countries at a fraction of the cost you would pay to defend against them.

All the stars are alligning.  Every claim, every note,  audited in real time.  There is one final automation that will happen and is actually happening already on some level.  The technology will “pluck” providers and spoon feed them to audit teams.  The audit team will on lower levels be more computers.  The computers will generate threatening letters.  Some doctors will pay just to avoid the hassle.

With this in mind your question should be “How do I minimize the chance that when the technology scans my profile, I do not look like easy pickings”.

Check back for part 2 of this series

Article Source: http://EzineArticles.com/?expert=Brian_Capra

Article Source: http://EzineArticles.com/7201671

Marketing Chiropractic: Free Report Teaches How To Gets New Patients From Your Online Chiropractic Marketing

Online chiropractic marketing consultant Bob Dale announces his new free report “Google+ Local For Chiropractic Clinics: How Google+ Local Helps Marketing Chiropractic” . According to Google, one in five searches includes a “location,” which prompted them to create a solution that will help marketing for Chiropractors and assisting them in attracting new local customers. That solution is Google+ Local, which is a portal of business profile listing pages that replaced what was once known as the popular “Google Places.”

Similar to Facebook pages, Google+ has already gained massive popularity in the social networking arena due to the fact that it is owned by the largest and most powerful online search engine; Google itself. Therefore, Google+ Local is expected to receive the same level of success as it creates a unique, yet effective way in marketing for Chiropractic.

When local patients go online to search for Chiropractors in their local area, most of them stop in the Google+ Local section to find Chiropractors who can meet their needs. Chiropractic clinics are learning from this free report “Google+ Local For Chiropractic Clinics: How Google+ Local Helps Marketing Chiropractic”" to add to their chiropractic marketing.

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Foundation for Chiropractic Progress Points to NASA Update: Chiropractic Included in Expert Panel Addressing Health Concerns of Nation’s Astronauts

Prior to advancing its human spaceflight sector, the National Aeronautics and Space Administration (NASA) addressed the heightened risk of musculoskeletal injuries threatening astronauts, and discussed its concerns during a Spinal Deconditioning Injury Risk Summit. Among experts invited to the Summit was University of South Florida’s John Mayer, D.C., Ph.D., a supporter of the Foundation for Chiropractic Progress (F4CP), who believes chiropractic care represents advancement in prevention and protection protocols.

“Possible options to enhance safety measures for astronauts can include everything from developing new equipment to altering spaceflight exercise procedures to new healthcare practices,” says Dr. Mayer. “The use of an effective specialized musculoskeletal care, like chiropractic, may ultimately prove to be effective in reducing the incidence of injuries for individuals exposed to a variety of physical demands, such as astronauts.”

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ClinicApps.com introduces “instant” chiropractic websites with a web store option

ClinicApps.com introduces an easy way for chiropractic clinics to add an extra revenue stream online with a simple 3 step process for creating a chiropractor website instantly. ClinicApps.com is the industry leader in developing websites that are specifically designed for a chiropractor’s needs.

Today the chiropractic industry is very competitive, and having a website can determine the success or failure of a chiropractic clinic. ClinicApps.com is focused on helping chiropractors with its chiropractic specific applications that increase the functionality of chiropractic websites through educational videos, 3D consultation and education pieces, newsletter, and other applications for patient education and retention.

One of the major advantages that ClinicApps has over other chiropractic web development companies is the ability for chiropractors to add an extra source of income to their website by providing a fully stocked web store option.

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Keeping Hands Out of the Cookie Jar: How to Avoid Practice Embezzlement

It seems that every day we read about another sensational, fraud-ridden scandal. Companies like Enron and Worldcom, and names like Madoff and Stanford, have become virtually synonymous with fraud.

While these scandals involve large companies and billions of dollars, fraud most often occurs in smaller businesses – and it occurs with surprising frequency in chiropractic practices.

The Association of Certified Fraud Examiners reports that losses due to fraud in small companies are 100 times greater than those incurred in the largest companies. I can’t remember a time when the frequency of fraud and embezzlement was as great as it right now within the health care industry. It’s difficult to know exactly why the frequency of fraud has increased. It could be due to tougher economic times creating desperate personal circumstances that are causing more people to steal. Whatever the reason, there are significant steps that you can take to decrease the likelihood that your practice will be a victim of fraud.

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Chiropractic Offices: iPad or Not?

While in the airport, I stopped at a news stand to buy a magazine and saw on the front page of Laptop magazine: iPad or Not? I thought this was a terrific question for the chiropractic field and thought chiropractors would be happy to hear the pros and cons of using an iPad or any other tablet computer in their office.

ipadOne thing is certain: iPads are the flavor of the day. They are thin, light and have thousands of applications available. These applications are very easy to download and are free or inexpensive. iPads and tablets are touch screen, which makes them easy to use. They are also portable and capable of surfing the internet, and are invaluable for accessing social websites and email.

In reality, can we use an iPad all day long in a chiropractic office as part of our Electronic Health Record system? Probably yes. But doctors need to be aware of the negative situations they may have to face when using them for daily operations in their office. I’d like to share 5 of them.

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“A billing service is a must for me.  When I looked around for other options there were a few that said they had a billing service they could refer. Genesis Chiropractic Software and Billing was light years ahead in this category.”

Dr. Deed Harrison - CEO Chiropractic BioPhysics

Why I Chose Genesis Chiropractic Software and Billing

Automation

Genesis’ Billing Service, Billing Precision, has processed hundreds of thousands of insurance claims for chiropractors through the billing engine powered by Vericle technology.  As claims are sent through the central database and their payment, underpayment, or nonpayment is analyzed.  When a claim fails the system routes the claim to a biller for follow up rather than having billers look for claims in AR reports.  Rules (over 2 million currently) are built into the technology to “flag claims” up front if a claim looks like it will not get paid or needs attention.  In an environment where insurance companies are constantly changing their rules Genesis provides the infrastructure to leverage all of the claims data and optimize billing performance.  This means that doctors using this system actually work as a team to beat the insurance companies at their own game just by using the system.  All of the members submit our claims through this engine and it improves as we go.  Whether it is 20 or 2000 doctors, this is a solution that can scale as more doctors join the network.

Dynamic Reporting

The massive undertaking of managing billing for hundreds of chiropractic offices forced Genesis/Billing Precision to create a dashboard that not only looks great but is functional.  They use the same dashboard to manage their operations as practices us to manage their practice.  The dashboard gives a high level visual representation of what is happening across key billing and patient relationship metrics.  It is like a fighter jet cockpit.  It highlights major threats to billing and patient relationship management.  At first glance it can be overwhelming.  That is why the Genesis Profitability Coaches are there.  To help you asses the danger and right the course when needed.

High level reporting is important as you fly but sometimes you have to stop and see what’s under the hood.  Again, Genesis/Billing Precision uses the same reports you do to analyze billing performance. They have developed some unique reports that are not seen in other systems.  One is called a MOS or Month Of Service report.  This means you can see how much you billed month by month and, of what I billed how much is unpaid based on the moth it was billed in.

Referring you friends has 2 Benefits

1. $ – It makes you money
2. Better System – The more doctors we have using the system, the more requirements we gather, the better the system gets.

When you refer your friends and they sign as clients, you will receive REAL MONEY, every month, for 5 years.

How it works:

1. Refer your friend
2. Your Friend signs an agreement with BP
3. You receive $50/month for 5 years for referring that friend = ($3,000) in referral fee

Let’s break it down

• Your Technology fee = $239/month
• $3,000/$239 = 12.55 months of technology fee back to you for EACH referral you make.
• There is NO LIMIT to the number of referrals you make.

All you need is ONE of your FRIENDS to sign up PER YEAR and you more than pay for the system! = FREE System +

CLICK HERE TO REFER

Enter all of your friends now or someone else will!

Thank you for being a loyal client of Genesis Chiropractic Software and Billing a product of Billing Precision, LLC!

Guarantee!  No Regret is what you really want.

I bought an iPad about three months ago and it is obsolete today.  Sound familiar?

Imagine if it cost $15,000?  What if your software is obsolete in 3 years?  Don’t believe that can happen?

Things are changing faster than you think.   I’ll come back to this.

• I am about to show you the how “owning” chiropractic software is not only a misnomer (Sales ploy used to make you “feel” good about spending your hard earned money) but one of the riskiest investments you can make in your practice.  While companies promise you it protects you, it actually leaves you and your practice vulnerable.
• I will debunk the big fat myth that it costs your less money to “own” a software, (which you actually never do), and show you how you can

guarantee that you will not regret your software decision.

• We will discuss the REAL cost of  the two main types of systems and pricing models.  Web bases systems VS Client Server (The one they say you” own”)
• Data Protection – The biggest lie told today is that somehow your data is safer in your office.  It is it better to backup your data offsite regardless.  It is useless without the software anyway.  Just ask doctors who were in the path of Hurricane Sandy which is better.
• In the end I will show you how web based systems like, Genesis Chiropractic Software and Billing, pay for themselves and possibly even put some money back in your pocket.

Price Comparison

SaaS (Software as a Service) – Is a pricing model.   Today it is usually reserved for software that is web based.  In the past other chiropractic software used this model and charged upwards of $700 per month.  They got away with it for years and eventually switched to the “purchase” model.  SaaS charges a smaller monthly fee with little to no upfront fees.

Let’s do the simple math

Some systems on the market are as cheap as $12,000.  Compare that to the cost of a SaaS product at $250 per month.

$12,000/$250 = 48 month.  In other words, at $250/month  it will take 4 years before you pay the same amount!  Read on and you will see how you can go from 48 months to 60, 100 or unlimited months.  Meaningit will never cost you more than $12,000 to use a system like Genesis.

But then I own it after 4 years!  Really?  Do you own the code?  Can you tell the company what to build next?  What if they go out of business two years later?  More importantly REMEMBER the iPad…

• When you “purchase” you are not buying software, you are buying a license to use the software.  The company that supports that software could be gone tomorrow.  Big Difference.  If that happens your license is useless.  Unless you want to buy the code.  I promise you, it isn’t cheap.
• When you “purchase” you still need to pay for upgrades.  $50 per month.  Subtract $50 from the $250 that SaaS offers since upgrades are included in the SaaS model (that’s the service part of Saas).  With that factored in 4 years becomes 5 Years
• Remember the iPad.  I know what you are thinking, I get upgrades.  True you get upgrades.  You can buy new computers and they will send you the upgrades so what’s the big deal.  Here it is.  There are actually 3 things you need to be concerned about.
  • The hardware -  That is the actual computer.  Those will need to be replaced on an ongoing basis regardless of what type of system you buy.
  • The software code –   This is what words are in the code, if you will.  In other words you can add new paragraphs to a document in the English language.  With software more words equals updates.   The system adds function, features etc.  That is great.
  • The language - The breath of options is limited to the language the software is built in.  When you buy a software you buy it knowing full well that the language your system will be written in 5 years from now has NO Chance of being upgraded.  The language is the language.  The reason Google is so successful is due, in part, to the fact they are constantly evolving the language they use.  It’s not just the words.  The capabilities are increasing because the language is changing.  Since they are also web based they can upgrade their systems and you don’t see they difference.  Just amazing new function.  This is the same with your practice software.  Software you buy will be limited in just a few years as web based systems language AND code rapidly change.  Not so with client server systems.  So you are paying a fixed fee because the functionality is fixed in time with today’s language.
• Clearing House Fees -Included with Genesis billing – $50/month with other systems – Now it takes 6 years to pay the equivalent of other systems.
• Network Maintenance - With web based systems, computers do not need to be networked together.  Only connected to the web.   Other systems require a server and network which will cost $1,000-$2,000 to set up.  …..  Figure another $50 per month for upgrades to hardware, maintenance for the computer guy to fix things when they break down, and down time…..  8 years easy.  Are you betting  static software language is going to be as cutting edge in 8 years?
• Data Backup Service - $25/month 8.5 years included with web based systems like genesis
• Peace of mind - Infinite peace of mind.  Genesis data center was in the path of hurricane Sandy and experience zero down time.  Some clients who lost their office where able to be back up and running instantly with a wireless laptop or ipad.  The didn’t lose any data.  Others weren’t so lucky.

Now what if they paid you?  Why not?  SaaS systems have it built into their price to have a referral fee.  We pay clients $3,000 per referral!  Can you send 4 clients over the life of your relationship with us?  If yes there’s $12,000!  Refer one friend per year and pay nothing out of pocket for your system!

Chiropractic Software and Billing Guarantee

Back to the guarantee: 

• If you pay everything to a software company upfront and they have no incentive to keep you happy.  Pay as you go with SAAS.  You can cancel any time and reuse the hardware for you next software.  This is a guarantee.  You will never use our system and not be happy, guaranteed.  Pay only for what you use.  Much less risk and a greater chance the SAAS system will do everything they can to keep your business.
• With client server systems you run the risk of getting a system you are not happy with and by then it is too late.  You already gave away your leverage, your hard earned money!  Guaranteed Risk
  • Risk you will not like it
  • Risk the technology will be out of date in a few years.
  • Risk web based systems will pass them by with functionality
  • Risk your data
• Web based SaaS is less expensive and less risk.

Now all you need to know is will it do what you need it to do?

• Schedule Patients
• Manage Care plans
• Bill insurance
• Credit card and auto debit
• Text appointment reminders
• Fast Chiropractic SOAP notes and compliant documentation
• Touch Screen notes
• iPad and tablet ready
• Patient self check in kiosk
• Reporting
  • Patient Retention
  • Collections
  • Marketing
• Access to entire system anywhere there is internet
• Monthly Caching Calls included
• Much More

Get a consultation today and join the network.

Ask a room full of under 25 year old professionals if they are wearing a wrist watch.  If you are over 25 you will be surprised at how few are actually wearing one.  Why?  The digital world has eliminated the need to look at you wrist to tell the time.  The time is everywhere.  It is on their phone, on their computer, in their car.   For the most part they can find the time at any given time without the major inconvenience of looking at their wrist.

In the past a wrist watch was a status symbol.  It meant you were able to afford the latest technology.  It said, “I am a serious business person”.  I heard a quote one time, “I never trust a man who does not wear a watch”, but why?  It meant they valued their time and yours.  That they lived for more than the present moment and considered the future.  Wearing a watch meant you were forward thinking.  My how tings have changed.

So what does this have to do with Siri and chiropractic software?  Clearly the new status symbol is the cell phone, or now, “smart phone”.  Not only does it say you are cutting edge, but it means you are connected and it even means you are more intelligent   Prediction: 30 years from now wrist watches will be for collecting and old people.

There is another important distinction sown by the modern smart phone.  They are “smart”.  Siri has a name.  Let me say that again, you can name your phone.  Why name it?  Because it talks back!  You actually have a relationship with your phone!  What does the phone tell you?

Forget an appointment book.  Remember that thing you used to carry around?  Gone.  Not needed.  An analog/paper version.  You used to have to memory manage you schedule for the day and tomorrow and next week.   Not anymore.  Just tell Siri.  In the past, busy people, like chiropractors, might have an entire full time or part time employee just to manage their appointments.  Not any more.

From Siri to Smart Chiropractic Software

There was an in between step from the appointment book to Siri (Speech Interpretation and Recognition Interface).  That was a digital appointment book.  Remember the PDA?  Same basic function as the paper appointment book but it saved a lot of space since you could store all of your contacts in it.  There were the Palm, BlackBerry and even the original iPhones.

Genesis Chiropractic Software and Billing

Older chiropractic software like Platinum or Chirotouch rely on the wrist watch concept.  They are not as bad as paper but they are NO Siri.  They are like the Palm or BlackBerry.  You can save lot of space, document digitally, and even make your office more efficient.

The gaps between these types of systems and a system like Genesis Chiropractic Software are many but in this context, there is one glaring difference.  This systems are not going to speak to you.  They are not going to tell you how many no shows you have.  What’s that?  A report?  That’s good but there is a big difference between having to look at a report (Appointment Book or PDA) and the report coming to you (Siri Talking to you).  

Genesis tells you, in the form of tasks, what critical patient relationship risks need to be addressed right now.  It identifies the outstanding issues and assigns them to a specific staff member, maybe even you, automatically.  There can be many types of tasks.  Just to name a few:

1. Missed Appointments
2. Expired Care  Plans
3. No Future Appointments
4. Balance Threshold Exceeded
5. Daily SOAP Notes That Are Not Signed
6. Compliance Red Flags
7. Insurance Claims That Need Immediate Attention

With software that functions more like Siri and less like a Blackberry, you can begin to gain control over all of the important things that need to happen every day because it is not dependent on you looking anywhere.  The information comes to you.  It is like not having to look at your watch or look at a blackberry to tell the time or what appointments you have tomorrow.   The technology speaks to you in the form of tasks.

When all critical tasks are put on one manageable dashboard you can see at a glance you can see who has the most work, what type of problems are happening most, and how much work there is and most importantly, what work did not get finished.

One number lets you know how much work there is to be done.

• Think of the billing software that finds the claims for you rather than digging through aging reports and having no idea if your biller is getting everything finished.
• Think of a schedule that is telling your team what they must to in order to maximize retention…
• Imagine a documentation and compliance system telling you when you put yourself at risk of an audit…
• Imagine a chiropractic software that markets to patients for you based on their specific demographic…
• Imagine how happy your patients will be when you and your team never miss a step…
• Your team is more efficient but at the same time more accountable to you.
• You sleep at night knowing you are safe from a major audit.
• Less time documenting, more time doing the things you love.
• Less stress trying to remember everything that needs to be done, more peace of mind.

Genesis –  The coming into being of something; the origin.

This is a whole new world for chiropractic software.

Genesis Chiropractic Software and Billing

Picture this; you start noticing a strange phenomenon going on in your office. You can’t explain it, but people seem to be disappearing. Every time you think of a particular patient, you look through your chiropractic software for their name, and realize they are no longer in your practice. Another face pops up in your mind, and they are gone too! What is going on? These patients were not “one-timers”. They have been in your office many times. They told you they were ready to regain their health. You thought these people understood the principles of chiropractic. So, what happened?

You have been hard at work ever since you started your practice—,putting in long hours, networking, marketing, getting new patients in the door, then educating and orientating those new patients while trying to cultivate a community of practice members that will be with you to the end! And yet, here you sit, in front of your computer, looking at your office stats for the month and saying, “Where the HELL have all my patients gone?!”…

Does this scenario sound familiar to you?

You may find yourself thinking that maybe it’s just the “name-of-the-game” in chiropractic. Maybe you should just accept the fact that people come and go while you have to work your butt off for the rest of your life to fill the vacancy of every patient who mysteriously disappears; is that it?

I’m here to tell you (thank goodness), “That’s not the case! You don’t have to be the Bermuda Triangle of chiropractic anymore.”

     Something happened to all of those patients, yes. They slipped through the cracks in your office. That’s what happened— some offices have “cracks” and others have huge, gaping holes! Either way, as the captain of your ship you are responsible for finding and fixing those leaks. Leaks in your office could be anything that causes (or encourages) a patient to leave before they should. A “leak” could be caused by one, or more, of four things: poor education, poor service, poor procedures, or poor organization in your office.  

Now, I’m going to show you FOUR TIPS TO STOP LEAKS IN YOUR OFFICE NOW. By following this advice, you will be able to help more people, grow your practice to the next level, and sleep easier knowing your patients will still be there when you go to work the next day.

1) Educate:  Education is key. Most chiropractors educate their patients in some way, shape, or form, but are you really providing the patient with a valuable education in health that will change their life forever? Are you really teaching them the chiropractic story with passion? After all, there are hundreds of thousands of self-proclaimed “health gurus” bombarding your patients with info every single day, but simply “providing info” is not educating! Start passionately educating your patients about the body’s healing power, adding value by instructing them how they can maximize that power!

2) Great Service:  Do you train your staff to give great service to each and every person who walks in your door? Does your staff greet the patient with a smile every time they come in? They should. Great service should start with the first phone call and continue throughout the patient’s interaction with your office. Make sure you and your staff are trained and conscious about giving exceptional friendly service.

Now let me ask you another question related to service: How long do your patients have to wait when in your office? If your patients are spending hours in your office, that is bad service. Even if they love the care they are receiving from you, people just don’t have time to spend hours in a doctor’s office anymore. Get your procedures down and start creating a smoother, more efficient visit for your patients. This single tip could blow your retention through the roof!  

3) Get Your Procedures Down:  Allow me to give you a sports analogy— Do you think there has ever been a world champion team that couldn’t run a proper play? No way.  That’s one of the first things coaches go over in the beginning of a season. If you can’t run a play, and I mean run it with perfection over and over again, then the synergy will be off. If this is the case with your office, be aware that patients take notice. You must have your procedures down and train each your staff members to know their position in your office. If you do not do so already, set up a weekly staff training session where you practice running through office procedures. You may even be surprised by how many questions your staff members have about their specific roles and responsibilities.

  4) Get Organized! This may just be the single biggest reason behind your poor patient retention. Your patients are walking out of your practice, and you don’t even know it! This happens to so many chiropractic offices it’s not even funny. A patient who has been coming in for years suddenly stops coming in, and by the time you realize you have not adjusted Mary in a while and check the schedule, she has been gone for two months. Now, what do you do? Do you call and check on her? Oh yeah, that will look great, “Hi Mary I noticed you missed your appointment.” Mary replies, “Yeah, two months ago Doc. You’re just now calling me?”

Don’t do that to your patients and don’t do that to your practice. The fact is that Mary didn’t just quit your practice two months ago. She started showing signs of leaving way before that. Maybe she started asking you questions about how her spine was doing, and whether she was “fixed” yet. Perhaps she’d already missed an appointment or two. Maybe she didn’t show up to the workshop she told you she would attend. All of those things are just some of the signs of a patient who is getting ready to leave. If you see these signs, you have to stop and remind them why they started coming to see you, restate the value of their care, and reeducate them on the reasons they get adjusted! You failed Mary; she didn’t fail you.  

This is why Genesis Chiropractic Software is such a powerful tool to have in your office. This software is amazing at helping you organize your office and get your patient retention up through the roof! It is designed to detect signs of “distracted” patients, who, if you do not re-educate, will soon drop out of care. The software will send you or your staff a notification (in the form of a “ticket”), giving you the opportunity stop that leak before you lose any water.

The fact is you do not have enough time in your day to patch all the leaks. You need a software program like Genesis that actually organizes your practice so you will be free to give your patients the attention and care they deserve. Schedule a consultation and let one of our trained technicians show you the power of Genesis today.  (Click Here to schedule a consultation today!)

Have you heard about the JImmo v Sebelius case? 

What does it mean for chiropractic?

Big thanks to Dr. Davila for writing this guest post for Genesis Chiropractic Software!  Here are some words of wisdom and caution from Dr. John Davila…

     There has been a Settlement Agreement in the Medicare Improvement Standard case, Jimmo vs. Sebelius. This case clears the way for thousands of Medicare beneficiaries to receive needed health services tomaintain their current level of functioning. The settlement, which represents a significant change in Medicare coverage rules, ends Medicare’s longstanding practice of requiring people to show a likelihood of improvement in order to receive coverage of skilled care and therapyservices. Please understand that this case specifically pertains to “…those with disabilities or suffering from chronic illnesses such as Alzheimer’s disease, Parkinson’s disease, ALS, lung disease.”

While this SOUNDS exciting please pay close attention to the following small details:

1. This case didn’t include chiropractic.
2. This case didn’t include neuromusculoskeletal conditions.
3. Someone will have to become a test case and ask an Administrative Law Judge to apply it to their case after getting denied by the carrier.

To accomplish this goal, here is my list of things you’d need to do in order to take a case to the ALJ to have this case apply:

1. Knowingly document a case specifically meant to show no improvement.
2. Knowingly apply the AT modifier to a case that is not improving.
3. Knowingly accept that billing these services (the way the rules are as of today) is equal to committing fraud. This is because the way “abuse” is currently defined; it is treated as if it were fraud.
4. Knowingly take on a case that will last YEARS before it is finally settled.
5. Go in understanding that an ALJ has the right to accept or deny your assertion that Jimmo v Sebelius does apply to your patient.
6. Accept the fact that if denied, your treatment of the patient would be for free as you couldn’t ask the patient to pay for services denied when the AT modifier is attached to the service.

Dr. John Davila, President and CEO of Custom ChiroSolutions, offers chiropractors sound consulting advice on practice management, billing procedures, Chiropractic compliance, Medicare compliance, treatment programs, marketing, and other strategic and tactical custom solutions to help them run a successful practice. For more information on our services please contact Custom ChiroSolutions at (800) 974-3479 or customchirosolutions@gmail.com.

This week Genesis Chiropractic Software is bring you a blog that will blow the front doors off your practice!  Check it out:

     Every successful chiropractor and business owner has implemented a “deliberate extreme” at some point in their career. If you really want to take your business to the next level, you need to know what a deliberate extreme is, as well as understand the best ways to manage one without causing to much stress to yourself, your staff, and even your family.  

     We have all heard the empty talk about how you should try to create balance, and how you shouldn’t work too hard out of fear of getting burnt out. But this type of philosophy simply isn’t true! Furthermore, it can be damaging— especially if you are striving for success and have a business you are trying to grow.

     Disappointing as it may seem, there are times in your life when you are going to have to work your tail off in order to get ahead. Like the beginning of a marathon, the runner knows that if he wants to have a chance at winning the race he has to get out of the middle of his competition. He gives it his all for a short period of time so that he can break away. 

Deliberate extremes, as applied to the business world, are short bursts of hard work that help you grow and get to the next level. The best way to describe how a chiropractor would implement a deliberate extreme is to give you an example.

Example of a Deliberate Extreme:

A chiropractor decides to devote four weeks of hard work to getting more new patients in his office. He splits these four weeks into four different marketing themes, working on one specific marketing theme per week.

Week 1 – The chiropractor will work on setting up more spinal screenings in his community. Every free moment he gets at the office, and maybe an hour after his regular workday is over, the chiropractor will search for and contact local businesses and events that he could set up a spinal screening and interest booth at.

Week 2 – The chiropractor will work on setting up more health talks in his community. He will also use his spare time to call local businesses to offer health talks. He will also have flyers made up that he and his staff members can pass out to his current patients, letting them know he is available for health talks at their own work places or events.

Week 3 – The chiropractor will dedicate this week to getting more referrals into his practice. During the morning huddle with his staff, the chiropractor will select a handful of patients to ask for referrals. To encourage patients to refer, he will also set up monthly themes and/or drawings for his office by giving away gifts to the person who refers the most people to the office that month.

Week 4 – The chiropractor will devote several hours this week to creating a stronger presence for his clinic on the Internet. This week he will shoot several videos on different health topics and post them to YouTube, Facebook, twitter, and of course, his business website. The chiropractor will also look through all the main search engines like Google, Bing, Yahoo, and others and make sure his website is listed and information is correct. He will also have a laptop and a camcorder set up in the office to encourage patients to give video testimonials and write Google reviews for a free gift.

ATTENTION: The next portion of this article is the most important part of implementing a deliberate extreme. Please DO NOT skip this part or you risk destroying yourself and your relationships!

Before starting any deliberate extreme, sit down with your staff at your office and your loved ones at home.

When you meet with your staff, go over your plans and explain to them exactly what you are doing, but also let them know that your goal is to take your practice to the next level, and you want them to be a huge part of it. Tell them that they are going to share in the success and you will give them a bonus for their hard work (Take an average of what you bring in monthly, and then tell them you will give them a percentage of what you bring in over that amount for the following month, such as 10 percent of the increase).

Don’t forget your Genesis Chiropractic Software in your office can help you to implement your deliberate extreme with more effectiveness and less stress!  Genesis Chiropractic Software has a unique built in ticketing system that will help you coordinate tasks between staff members.  There are so many different ways to use Genesis to grow your practice.

When you sit down with your family, explain to them that you are going to be working really hard for the next four weeks (or however long you determine is necessary).  Share your goals with them, but make sure they know it is a temporary situation and that you plan on doing something really special for them at the end of it. Maybe you can plan a weekend trip for all of you. Let them decide where to go and what to do. It doesn’t have to be a big trip, but even just driving to a nearby city and spending the night can be a fun getaway and give all of you a much needed break.

     The key here is to be able to put in a lot of hard work in a short amount of time so that you can “break out of the pack” and take your practice to the next level. 

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     Hello, my name is Dr. Tabor Smith and I have done hundreds, if not thousands, of spinal screenings in different cities across the country. I know how to conduct a successful spinal screening, and unfortunately I also know how to fail miserably at it (been there, done that, got the T-shirt).  

     It took several years of doing 2-3 spinal screenings a week before I actually started seeing consistent, reproducible results with my procedures. I even started to research and implement different neuropsychology methods to help me get the edge, so to speak, when it comes to communication and sales.      

      As anyone who has done spinal screenings before will tell you, “They are not as easy as just putting up a sign.” People of this day and age are so accustomed to being sold-to that any type of service being advertised for free is automatically interpreted as an untrustworthy sales gimmick. So how do we overcome these social avoidance reflexes that have become so ingrained into our society? I’ll show you.

    One day, as I watched hundreds of people walk out of their way to avoid going by my booth, I discovered there are really only two reasons why someone would not want a free spinal screening: 1) They don’t think they need one, and 2) they don’t believe I could help them even if they did stop and get a screening.

     What I began to realize is that there was really not much I could do about the people who didn’t think they needed a spinal screening. After all, you can’t really change someone who is that determined to not receive your services, and arguing with them never solves anything. However, I knew I could definitely do something about the second group. These people knew they needed something, and deep down they really wanted a spinal screening or were at least interested in one — they just didn’t believe I would be able to help them.  

     So, I asked myself, “How do businesses overcome disbelief in their product and show the world that it works?” Testimonials! But instead of just creating a poster with patient endorsements (which I did do), I realized the importance of going a step further.  This extra step is what adds 10-20 MORE new patients into every big spinal screening that I do. I will share this with you in hopes that you too can have better success at every one of your screenings. More success at your spinal screenings means more lives changed, and that means that together we can take the profession of chiropractic to a higher level.

     It starts with making each potential client feel welcome rather than intimidated. The first person to approach a potential client at your spinal screening is your greeter. This person stands out in front of your booth and welcomes people in. The trick to increasing the number of lives you can touch at your spinal screening is to make your greeter a walking testimonial.  

      If you have been in practice long enough, you know what I am talking about when I say, “Ask a sneezer to help you at your spinal screening.” A “sneezer” is a patient who has had such great results in your office that they share it with everyone they meet. This person has referred dozens of people to your practice, and they have already joined in your mission of bringing chiropractic to the world. These people make great greeters at your spinal screenings, so give this strategy a try, and chances are you will see how much easier it makes each screening. For example, sometimes I have people walk into my booth asking me where to sign up, before I even do an actual screening on them. Another great thing about it is that most of the time it doesn’t cost you a dime. My sneezers are happy to trade a month or two worth of free care in my office for a day or two of helping me share the life-changing message of chiropractic with our local community!

Genesis Chiropractic Software is hosting a special invite-only webinar with Dr. Tabor Smith THIS THURSDAY! He will be revealing all of his tips and strategies that have helped him schedule up to 72 NEW patients at a single spinal screening!  Click Below…

>>> Register: Spinal Screening Webinar Tomorrow Night! <<<

     Thanks for taking the time to read my guest blog. A special thank you to Genesis Chiropractic Software for allowing me to post on their blog, and for all the great things they are doing for the profession. I am proud to be associated with them.  - Tabor Smith D.C.

A Paper by Dr. John Davila

Dr. John Davila of Custom Chiro Solutions offered this great paper to our blog followers.  He is constantly asked questions about chiropractic software and compliance.

Since the word “compliance” can mean so many things, he wrote this summary paper help you become better informed before purchasing chiropractic EHR/EMR software.

The four main questions Dr. Davila discusses are: Does your chiropractic EHR/EMR

1. Calculate the length of time my patient is medical necessity?
2. Warn me if I forget to change the Box 14 date to match the latest exacerbation?
3. Check to make sure I am using wellness care codes at the right time?
4. Guarantee that your EHR data and patient records  are backed-up and stored according to HIPAA requirements?

Get the Paper here! CLICK

Chiropractic Software and Compliance Expert

John Davila, D.C., President and CEO of Custom Chiro Solutions, received his degree in 1994 from Palmer College of Chiropractic in Davenport, Iowa. He has served as a Carrier Advisory Committee member for Palmetto GBA where he re-wrote the local chiropractic Medicare policy and trained nurses on documentation and medical necessity. Currently, he works to defend providers from insurance both insurance company and regulatory board complaints across Canada and The United States. His most recent product is a Genesis Chiropractic Software macro set that meets the most stringent requirements for Medicare.

Dr. Davila can be reached at 800-9974-3479

An increasing number of chiropractors have been experiencing anxiety about the future success of their practice. Their concerns span a gamut of issues– from lack of patient feedback about their patient relationships to lack of control of practice management processes to unpredictability of patient flow and cash flow to low profitability.

Shrinking practice profitability is a result of five forces that conspire for a “perfect storm:”

• Rising costs of doing business, from rent to payroll to insurance
• Shrinking insurance reimbursements
• Increasingly stringent regulations and growing frequency of audits
• Delays and underpayments of insurance claims
• Patient flow fluctuations

3 steps to gain control over your practice’s profitability:

Regaining your peace of mind and taking control back into your hands requires a methodical approach consisting of three steps.

1. Measure your case profitability and set a goal for it: Profitability or case profit margin is a ratio of case fees collected minus case costs, divided by case fees collected. Case fees collected is the money spent by the patient in your office over the lifetime of that patient.
2. Measure your patient visit average (PVA): The sad thing about profitability is that there is no way to control it directly. But the good news is that it grows in step with your Patient Visit Average (PVA). In other words, you can control your case profitability indirectly by controlling your PVA.
3. Increase your PVA:  Figure out ways to have your patients commit to more than one visit and keep implementing new ideas until your practice’s profitability meets your goals.

How to determine case fees collected?

The case-fees-collected statistic can be calculated by dividing total collections by the number of cases. This approach has a major shortcoming because it requires the chiropractor to wait until all cases have terminated. For a reliable approximation of the same number without waiting for termination of every patient, follow the two-step approach below:

1. Calculate all collections for a given time period.
2. Divide that figure by the total number of new patients for the same time period.

For instance, if Dr. Joe treated 20 new patients last month and collected $10,000, then his case-fees-collected last month were $500. In other words, the average patient last month spent $1,000 before terminating care.

How to determine case costs?

You can use the same approach to calculate your case costs:

1. Compile total overhead for the same time period used to calculate case fees collected.
2. Divide your total overhead by the total number of new patients for the same time period.

For instance, if Dr. Joe treated 20 new patients last month and his total overhead during the same month was $10,000, then his case-costs last month was $500. In other words, the care of average patient last month cost Dr. Joe $500.

What does Profitability mean?

If your fee to cost  ratio is greater than one then you have a profitable practice. Otherwise, you are losing money.  Common sense dictates that a profitable practice that takes care of its owner manages a 3:1 ratio of fees to costs, or about 67% profit margin.

A common fallacy among many practice owners is the belief that increasing the number of new patients positively impacts profitability. But this may not necessarily be true since increasing the number of patients also increases the overhead, potentially decreasing profitability even further and defeating the purpose of increasing the number of patients.

How to compute Patient Visit Average?

PVA is a measure of your retention, or your ability to retain patients. In other words, it is a relationship quality indicator. The higher the PVA, the better is your relationship with your patients. As in an earlier calculation, the Patient Visit Average statistic can be calculated by dividing total visits by the number of patients. This approach has the same shortcoming as above because it requires to wait until all patients have terminated. For a reliable approximation of the same number without waiting for termination of every patient,simply divide your total visits for a given time period by the total number of new patients for the same time period.

For instance, if Dr. Joe had 300 patient visits last month, including 20 new patients, then his PVA would be 15. In other words, the average new patient returns 15 times to see Dr. Joe.

5 steps for improving your PVA

The way to increase PVA is to create a lifetime-maintenance practice.  Maintenance patients have a greater understanding and appreciation of what chiropractic has to offer.  

1. Create customized treatment plans: Give your patients a customized plan that is tailored to their specific problems at the end of their first session.
2. Block schedule the entire plan in advance: Help your patients understand that you are offering them a complete treatment plan – not a session by session experience.
3. Train your team: Practice “role play,” including specific verbiage and intonation. Without practicing in advance, you leave it to your staff to come up with the right things to say on the spot.  Every mistake they make can keep a new patient from coming back and even more importantly – prevent them from benefiting from your treatment plan.
4. Set goals and display results: What you can measure, you can manage and on the same side of the coin what you measure will improve.
5. Go the extra mile: Send thank you letters for referrals.  Acknowledge special events like anniversaries, graduations, weddings, or funerals.  Thank your patients for being on time, complying with your treatment plan, and meeting payment deadlines.

Genesis’ Vericle billing platform has been updated with G-Codes and C-modifiers to improve compliance for all clients who work with a physical therapist in their chiropractic clinics.

Medicare is now requiring that G-Codes and C-modifiers are included on your physical therapy claims and documentation. This change is very complex and can not be done from memory alone. If these requirements are not met, providers will not get paid by Medicare and these claims will be denied.