2017

Feature Do you know everything you need to know about documentation and coding to enable your claims to be accepted the first time? According to the Office of Inspector General (OIG), nearly $360 million—or approximately 82 percent—of the $440 million paid by Medicare in 2013 for chiropractic services was unallowable. After this investigation, “We, as chiropractors, have been on the OIG workplan since then. OIG is going after the top 10 percent of all Medicare healthcare providers.” But the vast majority of chiropractors are honest, professional practitioners. So why are these issues occurring?

Legal Ease Almost two years have passed since the U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) announced that Phase 2 HIPAA audits would happen. For those who have been selected as part of the audit process, the wait is almost over. This article sets out to explain the purpose of the Phase 2 audits, how they differ to the Phase 1 (pilot) audits, and outline some of the key steps organizations should take to prepare. Unlike the Phase 1 audits, which focused solely on covered entities and were completed in 2011 and 2012, the Phase 2 audits will also assess the business associates of those covered entities.

Money Management When it comes to managing debt, creativity is often required. For example, the interest paid on borrowed funds is deductible by a borrowing chiropractic practice. However, funds directed to equity investment are not. According to a report issued by the Joint Committee on Taxation (JCT), “the after-tax effect of debt financing is more favor- able than equity financing because of the deductibility of interest. To expand, grow, or even exist, it is often necessary for a practice to use a variety of financial resources, initially broken into two categories: debt and equity.

Practice Central Imagine that you are interacting with a patient who is visibly upset. After a bad experience with her MD, this particular patient has come to your clinic for help. She had explained to her MD that her toes would sometimes turn blue. She needed someone to acknowledge that this was indeed the case, and listen to her concerns. Ostensibly, her MD had dismissed it as a matter of chance, and had sent her away fuming. Frustrated that her doctor had not taken her seriously, she is now in your office. When you find yourself in this position will you respond with your own frustration, or will you seize the opportunity to turn this patient into a raving fan?

Practice Central Like many people, you might personally be a huge fan of Groupon, Angie’s List, and similar discount sites. You can use these for car detailing, housekeeping services, dining out, and many other things. It’s a great way to market new and small businesses—unless you work in healthcare. When we put chiropractic adjustments on the same playing field as a pedicure or car detailing service, how much value are we placing on chiropractic care in the minds of the public? No matter how you feel about that aspect, we are not allowed, as a profession, to dramatically discount our services.

Money Management Are you carrying any balances on credit cards? Do you have any practice debt? Is your X-ray system and other equipment paid for? Do you owe any back taxes? How much do you owe on cars, trucks, boats, and other toys? How much do you owe on your home? How much interest on debt are you paying every month compared to how much interest you earn? DCs tend to avoid thinking about these numbers, because they don’t like the feeling that debt brings.