WOW! Kathy s. Words of Wisdom. The Compliance Corner. In this issue: December 2013 Theme: Collections. Kathy s Opening Message. The Compliance Corner

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1 Kathy s WOW! Words of Wisdom December 2013 Theme: Collections In this issue: Kathy s Opening Message The Compliance Corner KMC University s Q&As Upcoming AnswerCall and Live Webinar Information ICD-10 Coding Countdown KMCU Receives Special Award The Reimbursement Room Humor Product of the Month December is upon us and if you are anything at all like I am, it s easy to look both backward at the amazing year that is almost over, and forward to 2014 and the possibilities that it holds. A Reuters poll shared that 68% of year end goals written include financial goals for the next year. And certainly, we can assume that these goals are about how to INCREASE income! Even in today s economy, there is no reason to think that annual increases are out of the question. This month, we explore one particular area of the financial performance of your practice. Making sure that patient finances are managed correctly can and will transform your practice. It s my opinion that when patients pay toward their care, they improve more quickly. Use these tips in this month s newsletter to maximize your patient financial systems and take the first steps toward meeting those 2014 financial goals! The Compliance Corner Medi-care Doesn t Equal Freebie-care! We are often asked about Medicare what s appropriate to charge your patient; can services be discounted or given away? Because we offer such extensive training on Medicare and have numerous Medicare specialists on our team at KMCU, we pride ourselves in being able to answer even the most difficult questions regarding Medicare billing, treatment, and documentation. Myth: You can see Medicare patients without a Medicare PTAN (without being enrolled in Medicare) if you have them sign a waiver and just pay cash. (Many offices have a patient sign an ABN to say not to bill Medicare for Active Treatment BIG NO NO!) Fact: Chiropractors are not able to Opt-out of Medicare and still see Medicare patients. You may not see Medicare patients under private contract. You have to be enrolled and equipped to bill Medicare if you are going to treat Medicare patients, even for maintenance care. You MAY Opt-out, not be enrolled, and turn all Medicare beneficiaries away.

2 Myth: It is ok to give away or deeply discount exams and therapies to Medicare patients because they can t afford it, and because that is what all the chiropractors in my area are doing. KMC University s Q&As Q: Can I waive the patient s copay if I want to? I think they are unfair and sometimes my ChiroHealthUSA fee is lower than the copayment! Fact: If you give away care to a Medicare patient, you are violating the inducement regulations. This regulation is in place to keep one numerous reasons: 1) Your provider contract likely states that A: I would warn you against waiving patient copays for provider from being able to entice a patient to you MUST charge patient copays, as this is an agreement the patient has made with their carrier. 2) When you bill to an come to your office rather than the chiropractor down the street (by giving away care). Keep you have a contracted fee. When you don t charge copays you insurance company you are communicating your charges and in mind, a patient can get discounted prices are essentially defrauding the insurance company to believe you have charged the patient their portion to make up the legally by enrolling in a DMPO (like ChiroHealthUSA) that the provider is participating with try to find ways to NOT get paid for the services you perform. contracted fee agreed upon in your contract. 3) You shouldn t for the services they receive that they don t You deserve reimbursement for your services. Find legal and compliant ways to make the payment EASIER on your patient have coverage for. This is our opinion of the by offering pay plans and/or legally discounted fees on noncovered services. However, there may be opportunities to safest and easiest way to offer your Medicare patients a legal discount and remain compliant work with your patients who elect to self-pay rather than using insurance, when the copayment is higher than your with federal regulations. ChiroHealthUSA capped fee. We ll be happy to help you work Medicare is a federally regulated system and must that out. Just ask! be taken seriously, insuring compliance. You want to make sure you and your team understand the rules and regulations and follow them properly to avoid any issues regarding treatment and documentation as well as billing of Medicare and its beneficiaries. If you need additional training on Medicare, visit us for a-la-carte or in-depth training and implementation of Medicare systems in your practice. Upcoming AnswerCall and Live Webinar Information AnswerCall December 10, :00 PM EST Front Desk Collections Strategies Live Webinar December 17, :00 PM EST (NOTE: Date is moved from normal schedule, due to holidays) Streamlined and Effective Patient Collections: On-the-Spot and After-the-Fact Some exclusive KMCU benefits are available only to our monthly CCP subscribers. Want to know how to get in on the action for only $99 a month? Live Monthly Webinar Stay updated & build a training library - available for view multiple times Monthly Answer Call Training and Live QnA with our KMCU Specialists HelpDesk Ask a question, get an answer it s that easy and there are no limits Discounts Enjoy a 33% discount on products and services, as needed, from our KMCU store Newsletter Exclusive tips and updates with our monthly CCP Newsletter, members only! Call X105

3 ICD-10 Coding Countdown As we begin the preparation for transition to ICD-10, stay connected to KMC University as we keep you in the know and on track! If you haven t started working on ICD-10 at all yet, here are some action steps to begin with this month. Commit to doing a little each month to ensure you are on the right track. As always, KMC University is here to have your back and help you through the transition! Assign the team member that will serve as ICD-10 Project Manager. Join the mailing list for the ICD-10 Industry Updates from CMS by registering here: Create an ICD-10 Transition electronic and/or paper file system to serve as a receptacle for all your ICD-10 training and transition materials. By now, your software should have been upgraded to Version 5010 for electronic transactions. If not, do it now. Contact your practice management software vendor and find out their plans and timelines for ICD-10 transition. Contact your electronic billing clearinghouse and find out their plans and timelines for ICD-10 transition. Contact your Electronic Health Records software vendor and find out their plans and timelines for ICD-10 transition. Update your implementation timeline as needed based on the findings from your billing and software vendors. Make a list of, or gather together, all contracts the office holds with third party payers. Create a plan to contact each of them to find out their plans and timelines for ICD-10 transition. Begin to gather resource material to become familiar with ICD-10 and how it will affect your practice. Based on the findings from your vendors and partners, identify a budget necessary to fund changes to your software, necessary upgrades, technical support, doctor and staff training, etc. Consider a plan to begin socking away extra savings on a monthly basis throughout 2014 to accommodate overhead impacts of disruptions in your revenue cycle during the transition. Set a goal for at least 3 and probably 6 months overhead to be set aside by October 2014, in case claim processing interferes with proper payments to physicians. DEC 13 JAN 14 FEB 14 MAR 14 APR 14 MAY 14 JUN 14 JUL 14 AGO 14 SEP 14 ICD-10 CODING COUNTDOWN TEN MONTHS TO GO! KMC University Receives Special Award KMC University was chosen as Business Partner of the Year by the Association of New Jersey Chiropractors! The award was presented to Suzanne Ball, our Director of Business Development, on November 16th during the ANJC s Fall convention in East Brunswick, NJ. We thank the Association of New Jersey Chiropractors for this recognition, and we look forward to continue helping the Chiropractic community in the state of New Jersey make and keep more money!

4 The Reimbursement Room Having Financial Policy = Having Answers Have you ever stumbled for an answer when a patient requests their balance? Did you ever respond with Well, the insurance hasn t paid yet so we aren t really sure what you owe.? This lack of information puts a sense of unease in your patient s mind, and could cause a patient to shy away from continuing care in your office. If they can t be given at least a quality estimate of the fees being charged, the discomfort from not knowing what costs they are incurring could be enough to keep them from returning for care. Put yourself in your patient s shoes. Imagine going to an amusement park where there were no prices on anything. Would you feel comfortable eating and drinking all day with your family, riding numerous rides, and taking souvenirs from the gift shop? Imagine going into the shows offered by the park and having your pictures made with live characters and being told We will tally it up after you are done and let you know what the costs are. We will send you a bill. It s unlikely that you would put your trust in a system such as this when it comes to your finances, and your patients feel the same! A chiropractic office with written policies and procedures for collections, and all other areas of focus, is a team with answers. When your policy is to always do a quality verification of benefits resulting in a clear picture of the patient s financial responsibility, you are able to answer these types of questions easily. You are able to understand and charge your patient balances appropriately to their ledger as you go because you understand what the third party will pay and what your patient owes. Not only does this help the team be in control and confident in responding to patient s questions, but your patients are always at ease knowing your team has the answers! Another benefit of policies and procedures is your bottom line. Owning a chiropractic office is a business. You have two goals: 1) Care for people and support wellness in your community and 2) Make a living for yourself and your family. If you are only meeting goal 1, something is broken. Your office deserves optimal reimbursement for your services, and team members deserve a clear understanding of how to run the business of reimbursement on the doctor s behalf. (And this should be applied to all areas of focus in your practice, treatment, payment and operations) Be sure to be on this month s KMCU Live Webinar Streamlined and Effective Patient Collections: Onthe-Spot and After-the-Fact to learn how to improve the over the counter payment systems of your Billing & Collections Department with policies, procedures and well trained staff. Call for more details on how you can be on live, and watch multiple times later for additional training! TEAM.KMC HUMOR

5 Product of the Month Third Party Verification for Optimal Results $50 OFF!!! NOW JUST $199! USE CODE DEC2013 AT CHECKOUT Does your verification process lack luster? Many offices state that the verification process they use is we get the benefits we can when we can and simply hope for the best. The verification of patient benefits is a HUGE reimbursement component of your business! Understanding WHAT information you need to know from each carrier is as important as getting paid for the services you render. An incomplete or chaotic verification process can leave you stuck with unpaid services and unexpected lulls in reimbursement. Get your office verification up to speed and watch the results unfold! You will work through the step by step guide to establish your understanding of how to use KMC University s expertly designed Major Medical, Medicare, Personal Injury and Worker s Compensation verification forms. You will customize each form for use in your office and create a master template that ensures the necessary information is always obtained when verifying benefits. Then, you ll write policy and procedure for this process in your office, helping established and new team members understand exactly how important this task is for new and returning patients. If you want to quit guessing what a policy will reimburse and crossing your fingers that services will be paid, this succinct and easy to understand program is quickly executable in your practice, providing instant results and peace of mind. This kit contains: Step-by-Step Digital Training Guide, to follow as you implement Overview Instructional Webinar Training, giving you specifics on the importance of quality verification (4) Customizable Verification Forms - Major Medical, Medicare, Personal Injury and Worker s Compensation (4) Specific Trainings- detailed instruction on how to properly utilize each of the 4 KMCU Verification Forms in your practice Expected Outcomes: Create Master Major Medical, Medicare, Personal Injury, and Worker s Compensation Verification Forms for continuous use in your office. Understand the most thorough verification process for leaving no stones unturned when it comes to patient benefits. Write your verification policy Establish standard operating procedure for the verification policy in your office Enjoy confidence when explaining coverage to patients, improving patient relations Get the Product of the Month here: Helping Chiropractors make and keep more money.