Do You Know Where Your Reimbursements Are?

Dr. R. A. Foxworth, FICC, MCS-P

It’s October—do you know where your reimbursements are?

If you’re reading this, you already know that October 1, 2015, came and went, and the earth did not open up and swallow us whole. It’s possible, though, that doctors who found themselves down to the wire and unprepared might now wish it had.

Procrastination, while not ideal, was understandable. The ICD-10 transition offered plenty of lead time, but many DCs felt they’d been fooled in 2014 and wondered if ICD-10 implementation would be postponed yet again. If you were one of them, or did your best to get ready but are finding yourself struggling with how to submit claims using the new codes, you can still find lots of helpful information on ICD-10 through a number of our archived webinars.

Even practices that followed every recommended step for preparedness may find things to be a bit wobbly for the next few weeks or even months. There’s a reason the American Chiropractic Association (ACA) has been recommending that chiropractors put aside a reserve fund of anywhere from three to six months’ worth of revenue, depending on overhead. The claims process is likely to be slower, and while CMS has promised not to kick back claims if the only error is the wrong ICD-10 code, that gracious offer is only relevant if your ICD-10 code was in the right coding family. In other words, you’ll be given a grace period if you tried your best and came close. If you got it just plain wrong, you can expect rejected claims and delays while you resubmit.

Meanwhile, the implementation date is now in our rearview mirror, and it’s time to regroup and focus on the rest of your practice:

• Compliance – Where do you stand with HIPAA and the Office of Inspector General (OIG) of Health and Human Services (HHS)? Do you have compliance programs in place for both, and are they up to date? Is your team fully trained on what compliance means in your practice?
• Documentation – Speaking of the OIG, their 2014 Work Plan outlined the many ways in which the governmental body and its auditors will be scrutinizing chiropractic practices over the next couple of years, and likely beyond. Are you sure that your documentation is complete, supports medical necessity, and is beyond reproach?
• Billing and Collections – Of course you’re focused on ICD-10 and reimbursement from third-party payers. But don’t let collections from patients who pay out-of-pocket fall by the wayside. If you don’t have a system in place for contacting patients about overdue balances, it’s imperative to put one in place, with tickler reminders so that you don’t end the year with uncollected revenue still sitting on the table.
• Patient Finances – Conversations with your patients about how best to give them the care they deserve at a cost they can afford should be a regular part of your practice. ICD-10 hasn’t changed that. Make sure your front desk staff is current on patient scripting for encouraging your patients to join ChiroHealthUSA.

You already know that ChiroHealthUSA offers you a way to give your patients legal discounts based on your actual fee schedule. What you may not know is how much more we have to offer you in the above critical areas in terms of training, news updates, marketing advice, and support. Keep an eye out for e-mails promoting our upcoming webinars on a variety of topics designed to lead you through ICD-10 and beyond.