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September 2010
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The $44,000 question: industry insider responses (Kenneth Murkowski)
This is in reference to Melissa Heyboer’s article, “The $44,000 question,” which appeared in Issue 13, 2010. The following is Kenneth Murkowski’s responses in their entirety.
Question 1: How will this affect the chiropractic office? i.e., do you think this program is beneficial?
A: Once we all understand all the Federal rules & regs (New Revised July 13,2010) & how they will be implemented and the adoption of same or similar guidelines by all 3rd party carriers benefits for DC/CA and patient documentation will soon be seen by all. Literally all Chiropractic offices will have to deal with this issue of EHR/EMR eventually by 2015 Federal Medicare Target Date. All 3rd Party carriers are Formulating Future Regs & Rules Now Also.
B) Yes, I think the HITECH Act of 2009 and the Federal Stimulus ($44K) If applied equally and fairly for D.C / D.O/ M.D / D.D.'S etc. Will be very beneficial for D.C's to update and manage their offices for better diagnosis, documentation and accurate billing, sharing patient info, etc.
Question 2: What do chiropractor’s need to take advantage of this incentive? How much will it cost, as far as time and money, to implement?
A: If you mean what do D.C's need to do to take advantage of this incentive-A) Read Federal 25 objectives of Meaningful Use(Revised 07/13/10), 2nd research software companies & programs that are here now. (ie ACOM) some companies are stated ready to be reviewed for A Comprehensive(CCHIT/ARRA Certification)
B) The initial cost will be tiered (staff time – computer input) & the basic outlay for a new software comprehensive program is to be expected, One Must for the DC Office is be sure now your system will be certified by the Federal Government in the future, My recommendations get your new software company to give you a written guarantee, they will be certified or you get all your money back + interest & keep the software program for free - The Stimulus money is 44K 2010-2014, based on how long the Stimulus Money will last up to 2014(when it’s gone no more money)so when you put in your program in place & when you were compliant is important, Start ---- Now 2010 to Take Advantage of all the Stimulus Benefits.
Question 3: Will all chiropractic offices qualify? Can cash-based practices benefit?
A: No I don't think "ALL" D.C offices will qualify for Federal Stimulus (Re Read
B) Can cash based practices benefit, Difficult Question. If we approach this from a "Legal Definition, cash practices don't take care of the following types of patients; BCBS, AUTO, PERSONAL INJURY, WORKER'S COMP, GENERAL HEALTH INSURANCE, HMO, PPO,PPA, MEDICADE, MEDICARE ETC.
Question, Who is left, especially with new National Health Insurance coming,?
Also The HITECH 2009 Stimulus program is geared for Medicare & Hospitals. The Stimulus is not just about EHR-EMR Software, But Medicare & Meaningful Use.
Remember “Super Bills” don't count for Medicare, D.C's cant opt out of Medicare, However, you can choose on an Individual Medicare patient to be Non-Par D.C and check “NO”, Box 27 on CMS 1500 Form. Again, The Stimulus is to have a basis for how many Medicare Patients you treat. (Daily, weekly, monthly to be determined)
Question 4: When can chiropractors expect to receive payments?
A: D.C's can expect payments in 2011 for service in 2010 IF & ONLY IF their software programs are good and meet all Federal Regs, Rules and "Meaningful Use" is adhered to for Documentation,Also your software company and program is to be certified (ie CCHIT/ARRA Certification). Remember Medicare's goal is by 2015, To penalize all Doctors who are not compliant with EHR-EMR Rules by 2015. I predict other 3rd party carriers will also adopt similar standards by 2014 or before.
Question 5: What questions should chiropractors ask their providers (insurance and software) to ensure they are being compliant?
A: Some questions to ask: Are you HIPPA compliant: Is your company & software program in line with "Meaningful Use" 25 points, Is your software - EHR-EMR SOAP PROGRAMS ETC going to be certified (ie CCHIT/ARRA Certification): Is there a money back guarantee if your program is not certified: Does the software company have a in house office “Coach , Consultant” Chiropractor Who is knowledgeable regarding regs, rules, compliance, diagnosis, documentation etc. ( See Dr. Murkowski’s Articles – You can also contact him at: Dr.Murkowski@yahoo.com Office – 517-784-9127 Regarding Diagnosis, Documentation, Compliance and Audits.
Question 6: What new products or services do you think will come out of this incentive?
A: New products will obviously be new computer software programs, new in office self audit Programs/ Seminars for Compliance, Compliance Office Certification, New Office Manuals & CD for Self Auditing,Plus Online and Personal Coaching Consulting regarding compliance EHR - EMR + Diagnosis Documentation and Risk Management to name a few.
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