Ray Foxworth, D.C., FICC, MCS-P
Despite every effort that we make to be compliant when it comes to billing, coding, documentation, and discounts in our practice, we are still human, and mistakes will happen. We know that audits are on the rise and that fines and penalties are enough to break a practice. I have heard stories of fines at $250,000 up to $3 million. These stories can keep you up at night.
For years, I knew there had to be another way to protect my practice. I have malpractice insurance and business liability insurance, but what I really needed was insurance to protect me in the event of an audit. That is why ChiroHealthUSA® and NCMIC—two companies committed to supporting the chiropractic profession—are now offering a new product: CHUSAdefense™.
CHUSAdefense™ is audit insurance available through NCMIC that pays for defense costs, civil fines, and penalties arising from allegations of improper billing and violations of HIPAA, EMTALA, and STARK. What sets this product apart from the rest of the market is the broad availability of coverage—up to $1,000,000—arranged by NAS Insurance Services, LLC, coverholder of Lloyd’s. Most professional liability policies offer only $25,000 of protection. This is rarely enough to cover the financial damage an audit can create for your practice. CHUSAdefense™ adds an additional layer of protection that has previously not been available to the chiropractic community.
In today’s regulatory climate, it’s not a matter of IF you will be audited, but WHEN. I think most of us know more than one colleague who has undergone an audit or investigation of some type. The press makes it clear that even MORE audits and investigations will occur. Why? It’s simple. Follow the dollar. For every $1.00 put into health care fraud investigations, over $7.10 is recovered. It’s called recoupment, and it’s BIG money for the government and insurance companies.
CHUSAdefense™ covers costs for government and commercial payors, qui tam plaintiffs, and voluntary self-disclosure. An additional endorsement may be added to include up to $100,000 of legal expense coverage for disciplinary proceedings by state licensing boards.
CHUSAdefense™ may only be purchased by providers who maintain professional liability coverage through NCMIC and maintain active status with ChiroHealthUSA®. Because NCMIC and NAS have determined that ChiroHealthUSA® providers have already taken steps to reduce risk in their practices, active CHUSA providers can get up to $1 million in audit coverage at a substantial discount. As a ChiroHealthUSA® provider, you already have a more compliant financial policy. Now you can have the additional peace of mind that comes with carrying CHUSAdefense™.
With today’s unending flow of information, we can’t go a day without seeing headlines, posts, and tweets about providers across the healthcare profession being audited, fined, and some even convicted. We tell ourselves, “It won’t happen to me.” The reality is that it easily could. Your license is your livelihood. Your families, employees, and patients are depending on you. As a ChiroHealthUSA® provider, you are already taking steps to minimize risks in your office. It only makes sense to include an extra layer of protection with audit insurance. Click here to learn more.
Why is the Discount Challenge prize amount $11,181? Because that is the average “per-occurrence” fine for Medicare inducements. That’s not $11,181 per patient, that’s not per provider, that’s PER VISIT. Stinks, doesn’t it? To us, the prize amount is worth the investment if we can help our profession better understand proper discounting.