The $44,000 question: industry insider responses (Derek Greenwood)

This is in reference to Melissa Heyboer’s article, “The $44,000 question,” which appeared in Issue 13, 2010. The following is Derek Greenwood’s responses in their entirety.

Question 1: How will this affect the chiropractic office? i.e., do you think this program is beneficial?

A: The biggest benefit to this program is how it puts attention on computerizing an office. There are many gains to be made in the typical office by implementing software that goes beyond simple billing. This government program is designed to get doctors to modernize and start reaping the benefits of a more digital office.

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: They will need to be fully computerized from billing to documentation to document storage. They also need a company that is stable and has survived the test of time.

Costs are going to depend a great deal on what software they already have in their office. If they are lucky they will simply be able to update what they currently have and then just add document storage or documentation. Expect 3 to 6 months to implement a full digital solution from scratch. Cost wise, the government program is actually not designed to make the doctor money. The reimbursement was designed to cover part of the cost. If you are frugal it can cover the costs entirely. Where you will really make money is in future efficiency and increased production with the same or reduced expense. Remember this government program will go on for years with more and more software required for compliance over the years. Really, don’t computerize to just receive the money. Computerize because you want a more efficient office that will keep you competitive into the future. Then the money is just a nice bonus.

Question 3: Will all chiropractic offices qualify? Can cash-based practices benefit?

A: You have to bill either Medicare or Medicaid to be eligible for the payments. You will get paid 75% of what you bill to either Medicare or Medicaid up to the maximum allowed that year. So a cash practice will not receive payments but of course will benefit from a more efficient digital office.

Question 4: When can chiropractors expect to receive payments?

A: You will have to spend the money and install the software. Then demonstrate meaningful use. The government is supposed to pay once a year in a lump sum. When exactly that is, well this is a government program that has never been done before so I would expect delays and some problems.

Question 5: What questions should chiropractors ask their providers (insurance and software) to ensure they are being compliant?

A: The real question here is can they pass the meaningful use test. If they can they are doing well. If they can’t is the software provider standing behind them to provide the software that will make it possible. Remember, meaningful use is the test for being compliant and the ultimate responsibility will be with the doctor. The software company can and most will provide software to make it possible but the doctor has to do it.

Don’t make the mistake thinking that this is a trivial point. The doctor will have to work at it and change many of his established in office flows and policies to meet meaningful use. The only real question then is will the software vendor provide software that will allow you to meet meaningful use? And will they have training available to allow the doctor to learn how to use it?

Question 6: What new products or services do you think will come out of this incentive?

A: The biggest change will be the increased use of electronic documents and documentation. The storage and transmission of electronic documents will become main stream. The day of paper file folders is ending, which is a good thing. Fully digital offices will become the norm instead of being used only by the most progressive doctors.

Since more people will start using full digital software solutions, vendors will be able to spend more money on development which will continue to make them more and more powerful with more and more of the office tasks handled by software. Even though this software will cost more, it will reduce overall costs and increase productivity.