Disturbing insights

This issue features the results of our 8th Annual Fees and Reimbursements Survey. I always approach conducting the survey with a bit of trepidation.

Much like a teenager who is giving her first party and wonders, “Will anybody come?”, I worry if enough chiropractors will take the time to complete the survey.

Fortunately, many of you — just shy of 600 — wanted “to come to our party.” Thank you. Your continued participation allows us to report statistically reliable results.

When I began to report the results from this survey three years ago, I wanted to do more than just provide numbers. I wanted to identify evolving trends. This year we can see one, and it’s not pretty.

For the third consecutive year, reimbursements have declined — both in dollar values, as well as in rates.

We asked Marty Kotlar, DC, president of Target Coding, and Mark Sanna, DC, CEO of Breakthrough Coaching, why this trend might be occurring. Two words sum up their responses: Managed care.

Dr. Sanna told us, “Many chiropractors feel forced into accepting the rules [low reimbursements and limited coverage] for fear of being closed out of the third-party system and not having access to large groups of patients. Many chiropractors have become intimated by third-party payers and do not appeal denied claims. Many medically necessary claims that have been properly submitted go unreimbursed.”

He continued, “Chiropractors must not allow themselves to be forced into a pain-relief paradigm by third-party payers. They must focus on objectively documenting the functional improvements gained through chiropractic care.”

What can you do to stop the downward trend? Here are some action steps:

• Get involved. “Supporting your state and national associations may be an answer,” says Dr. Sanna. “Hopefully through professional unity and a strong lobbying effort a change can be brought about.”

• Don’t undercharge. Use a fee schedule to set fees so that you will achieve a 75 percent to 80 percent reimbursement, suggests Dr. Kotlar.

• Accept that patients will pay cash. “A patient’s insurance will pay but a portion of the actual costs of healthcare,” says Dr. Sanna. “We need to learn that patients are willing to pay cash for the balance of their necessary healthcare.”

I hope you’ll run with these suggestions. Next year, I would have no greater pleasure than to report that the trend of declining reimbursements has been stopped in its tracks.

Until next time,

Linda Segall, Editor-in-Chief