Kathy “KMC” Weidner reflects on a lifetime of changing the face of compliance coding, documentation and reimbursements in chiropractic
A LIFE-LONG SEVERE ASTHMA SUFFERER, Kathy Weidner, better known professionally as Kathy Mills Chang, was changed physically, personally, and professionally 40 years ago when she entered the chiropractic field. The journey began working for chiropractors before establishing a business that has become a juggernaut in health care compliance coding and providing guidance on proper documentation.
In 1983, Weidner became a chiropractic patient and a chiropractic assistant (CA) in the same day, with startling results that sold her on chiropractic care.
“As many providers do, I was onboarded as a new employee by taking me through the new patient experience,” she said. “Because I had several health challenges, including severe asthma, my experience was especially eye opening, since the doctor was able to show me that what he found on my examination directly correlated to issues in my lungs and thoracic spine. I saw an amazing turn around in my health over the first two years of working there, receiving regular adjustments. Within a year, the handful of daily pills and the inhalers I used were cut in half. By the end of two years, I was off all my asthma medication, other than keeping a rescue inhaler with me. My long-time pulmonologist who had cared for me for a decade had no explanation for my improvement, even though I knew.”
Thrown into the fire
After only a week on the job, the trainer she had been hired to replace gave birth early, and she was left to her own devices in servicing a practice that saw up to 300 patients a day.
“I point to this genesis of my career as a big favor to me, rather than a problem,” Weidner said. “It taught me how to think for myself, and more importantly, to research with payers when I didn’t understand something. I waited on a lot of hold [calls], but always managed to come away from the call wiser and more educated on how insurance worked.”
It was the beginning of a 16-year run managing multiple high-volume chiropractic and multidisciplinary practices throughout the country in their financial operations management, from billing and collections to compliance coding and patient financial management.
Eventually, marriage to an emergency responder and the adoption of a child saw Weidner looking to reduce her hours, which led to working with a doctor who was starting a practice from scratch.
“I wanted to spend more time building a family, and when the chance came for a former doctor starting his own practice, he invited me to help,” she said. “I appreciated the fewer hours they were open. It was a lot of sweat and effort, but he made a beautiful practice. Again, I learned important skills, like credentialing, the benefits of being in or out of network with payers, and going back to helping as a front desk CA.”
Another practice change brought about an opportunity to work with a practice where she could make her own hours and, upon request, started teaching CA workshops at conventions. “That’s when the bug bit me to teach,” she said.
Building a framework for a compliance coding business
Through her workshops and talks she came to the attention of Arlen Fuhr, DC and founder of Activator Methods, and was asked to develop and teach his nationwide Chiropractic Assistant Training Course. During this time, she was also creating products with Activator that sold to DCs such as the The Quick Script Flip-Chart.
“I was using this time to create training methods and honing my presenting skills, and I learned that by taking my systems directly to doctors and staff, I could impact larger groups at one time.”
But just when business was building, life delivered another surprise. “My husband was transferred to New York. I was in shock,” she said of the move from Arizona. “I could still teach the CA classes nationwide because I could travel from anyplace. But what about work? But as is often the case, all things in divine order.” Familiarizing herself with the New York chiropractic landscape, she found a need with the largest group practice in the state as a central administrator to oversee the billing department for all their offices. For five years at the end of the 1990s she served as director of income and practice administrator to the groups, successfully overseeing their conversion to multiple, profitable multidisciplinary practices.
It was during this time that her love of teaching, and her growing education in health care compliance coding, came together.
“At any given time, this company had 10-20 doctors between 4-7 offices,” she said. “This was a big, busy operation and I was pleased to jump right in. As the practices decided to add MD and PT to selected offices, I participated in all the research on coding, billing, and credentialing. I began to formulate the process for conversion of the billing offices to include the MD and PT with the chiropractic. This is where my interest in health care compliance took hold, as we had to dance on the razor’s edge of compliance in a way that I never had before.”
In 1999 she was forced to start over again when her husband was transferred to Washington, D.C., leaving the New York chiropractic group despite their offer to pay for part-time commuting and an apartment.
“I considered this offer, but with a young child, it didn’t feel like the right thing to do,” she said. “So, I’d start over again.”
Relocating to D.C. meant another job of familiarizing herself with the chiropractic landscape and hoping for a timely opening. But Weidner also knew D.C. as the home of the American Chiropractic Association (ACA), and a chance to serve the profession at large.
“I was asked to come in for an interview, and at the time there were not specific people at the ACA headquarters who had direct chiropractic experience besides the executive director and another executive,” she said. “Others in the building were experts at their specific role in serving the profession. When I arrived for my interview, I found that all five vice presidents asked to interview me. The natural fit was in the department of professional development and research, and that is where I landed.”
Providing for the nation’s chiropractors
In her new role, Weidner served as the ACA’s primary staff contact for coding, insurance, Medicare, and other practice management issues. There she learned about critical compliance issues from the very leaders who formulated the policy, and the learning curve was steep.
“One of the biggest changes to coding affecting the profession happened that year, when CPT code 97140, Manual Therapy, was introduced, replacing five other codes that many DCs used,” she said. “I learned from the middle of the fire how to deal with these kinds of changes and how they affect the entire profession. I served as staff liaison to the Coding Committee, the group of ACA delegates that actually works with the CPT Editorial Panel and supplies two DCs to sit on the committees that work with coding. The research I did there and preparing for those committee calls elevated my knowledge of coding 10 times.”
During her two years at the ACA she also served as staff liaison to the Medicare, Senior Citizens and other committees, including working with the committee that each year put together the ACA’s annual Coding and Billing Manual.
“This is where I honed my content development skills,” she said. “I was made available to state associations as an expert speaker and was also tapped to present for the ACA at events like the annual House of Delegates meeting, and the National Chiropractic Legislative Conference (NCLC) each year. It was during one of those seminars I taught that I met Dr. Mark Sanna.”
It was here again that industry connections would change the path of her career. The owner and CEO of Breakthrough Coaching, Sanna complimented Weidner on her presentation and made a recruitment pitch – if she ever needed a job, to let him know.
“Little did he know then, I was told we’d be moving to Denver for another job change for my husband,” she said.
After the move she worked remotely for the ACA for 12 months, then in 2001 took Sanna up on his offer, serving as a senior coach for Breakthrough Coaching, working directly with hundreds of practices during her years there, providing training in ethical and unique practice-building techniques.
“For 40 years, Kathy has been teaching the chiropractic profession how to do things the right way,” Sanna says of Weidner. “She is a go-to resource for all things concerning documentation, coding, and compliance. When things go right for a practice, Kathy is often the one to thank. When things go wrong, Kathy is certainly the one to call.”
It was during her time at Breakthrough Coaching that the Health Insurance Portability and Accountability Act (HIPAA) was introduced, and the Office of Inspector General (OIG) introduced the Compliance Guidance for Small and Group Practices. Weidner took the opportunity to become an expert on the two laws and was speaking at 30-40 state association conventions and meeting across the country each year.
“This certainly raised my national prominence and recognition, and I became known as a national expert in Medicare, compliance, billing, coding and documentation,” she said.
Making the leap
It was at this time, with Sanna’s blessing, that she began the research and groundwork to invest in her own expertise and experience in education chiropractors and their employees.
“Because I was already working as my own business as a contractor, I began to explore whether I wanted to jump into the entrepreneurial pool myself,” she said. “Dr. Sanna had graciously allowed my contractor agreement to include no provisions for non-competition for any of the knowledge I brought with me. This allowed me to consider forging out on my own. Although I loved my time coaching at Breakthrough, I resonated much more with the documentation, compliance, and billing aspects of my coaching than the general practice management areas.”
In 2007 she launched KMC University, assembling and leading a team of professionals to deliver cutting-edge training and curriculum for doctors of chiropractic and other health care professionals. Since then, her online training library seminars and materials have helped hundreds of practices across the country tighten-up their documentation, reimbursement rates, compliance coding and more, while also giving back to the industry and chiropractic education.
“We originally aimed to be an on-demand company for help with training, questions, and auditing — then we decided we needed to codify this information in an online, subscription-based catalog of training,” Weidner says. “I was tapped to be a consultant and advisor to many industry giants, and over time I became a member of these speaker bureaus and continued to speak throughout the profession.”
It was after speaking at several chiropractic colleges that she became interested in giving back to student education, eventually providing training for student business classes, assisting with compliance training, and during the COVID pandemic quickly deploying desperately-needed online training content to assist various colleges.
Her desire over the years to stay on the cutting edge of coding and compliance has resulted in certifications as a Certified Medical Compliance Specialist (MCS-P), Certified Chiropractic Professional Coder (CCPC), and Certified Professional Compliance Officer (CPCO).
Now at the 40-year mark in the profession and currently weathering an industry that has fought through frustrating health care changes and COVID-19 over the last few years, Weidner says she is ready to take more time for herself and her family.
“Each year I sit with my thoughts and ask if this is the last year for me,” she says. “We are a large team, and I don’t have to do it all myself anymore. My husband and I have a plan to begin to wind down in the coming years, golf more, travel more, and enjoy being a ‘nana’ to my sweet granddaughter Madison.”
When all is said and done, Kathy “KMC” Weidner says she would like to leave the industry seeing doctors of chiropractic rise to meet a threshold of high-level compliance and business excellent, despite the industry challenges.
“If I could wave a magic wand, I’d love to see this profession and its doctors realize that you must be congruent with your integrity both on the clinical and business side of the practice,” she says. “While all the rules may be frustrating, they are still the rules of being in the business of health care. If there could be one big change that would affect the profession most greatly, from my vantage point, it would be to allow chiropractors to opt-out of Medicare to level the playing field. It’s about parity and equity. Go ahead and allow the scope of practice to expand as well — and because this is still America, give the doctors the choice in how they practice.”
RICK VACH is editor-in-chief of Chiropractic Economics.
