- CHIROPRACTORS and other PCPs
- HEALTHCARE AUDIT DEFENSE ATTORNEYS
- BILLING & CODING COMMUNITY
- HEALTH BENEFITS PLAN ADMINISTRATORS
FREE Webinar! JOIN ME: "Why Carrier Contracts Matter" coming soon!
FREE Webinar! JOIN ME: "Why Carrier Contracts Matter" coming soon!
FREE Webinar! JOIN ME: "Why Carrier Contracts Matter" coming soon!
FREE "PROTOTYPE" Webinar:
(which means NEW CONTENT and
live + unrecorded Q & A at the end)
Coming soon!
We'll be talking about the TWO KINDS of insurance carrier contracts impact both the "provider side" of healthcare (which includes the billing and coding side) as well as contracting entities (self-funded health benefits plan administrators), and the attorneys that find themselves working in this realm, and why EVERYBODY needs to be aware of BOTH.
- TPA-PROVIDER CONTRACTS
- TPA-SELF-FUNDED ENTITY CONTRACTS
BILLING & CODING SPECIALISTS:
FREE Webinar! JOIN ME: "Why Carrier Contracts Matter" coming soon!
FREE Webinar! JOIN ME: "Why Carrier Contracts Matter" coming soon!
FRUSTRATED with your clients who continue to STRUGGLE with non-compliant documentation?
Until now, all you could do was recommend they attend yet one more documentation workshop. They've probably already been to several...
and yet here we still are.
Re-submissions & recurring mysterious rejections? Carrier processing errors (and errors and errors)? Other creative carrier "oops!" scenarios?
STOP accepting carriers' mistakes: fight back!
Please each out! I want to hear your stories!
HEALTHCARE ATTORNEYS:
FREE Webinar! JOIN ME: "Why Carrier Contracts Matter" coming soon!
MALPRACTICE INSURANCE CARRIERS:
Defending ANOTHER provider with bad documentation?
BEFORE you negotiate and sign that settlement agreement, and your client pays a chunk of change to that carrier...
I have interviewed and worked with dozens of healthcare attorneys, as well as OIG and fraud specialists. Reviewing a Provider Contract with the eyes of a provider (and an audited one at that!), I have been able to locate important, relevant details that can be overlooked to help you be on the offense, not just the defense.
- Post-payment audits
- Prepayment review
Carriers ignore contractual elements
ALL the time!
Make sure you attend my "Why Carrier Contracts Matter" webinar, or reach out and let's chat.
MALPRACTICE INSURANCE CARRIERS:
Self-funded Health Benefits Plan Managers
MALPRACTICE INSURANCE CARRIERS:
Yes, Most Chiropractic Malpractice Insurance Policies NOW COVER Audit Legal Defense and I'm taking to YOU:
TIRED of defending ONE MORE provider with bad documentation against a carrier audit? YOU know how many of your audited docs have bad documentation.
YOU know they have been to documentation workshops before.
This is a ridiculous and losing game of Whack-a-Mole that carriers play.
Your doctor probably doesn't need another documentation workshop, the problem probably requires a team solution. And an IMPLEMENTATION STRATEGY.
Self-funded Health Benefits Plan Managers
Self-funded Health Benefits Plan Managers
Self-funded Health Benefits Plan Managers
Are you relying on your TPA...
- to accurately report recoupments/recoveries?
- to confirm adherence to your contracted terms regarding claims processing and other elements that directly impact your plan members, access to benefits, and plan assets?
Are you auditing as often as stipulated in your contract with your TPA?
Are you confident the entity you have contracted with
- is doing a good job and are delving beyond the data to make sure there are no contractural violations?
- does not have a conflict of interest?
CHIROPRACTORS and PCPs:
Self-funded Health Benefits Plan Managers
Self-funded Health Benefits Plan Managers
An AUDIT will throw YOUR office into absolute turmoil if your documentation does not meet carrier guidelines (and that's for the 50% of all DC's who have non-compliant documentation). FAILING an AUDIT can cost you tens, or even hundreds of thousands of dollars.
It is IMPERATIVE that you recognize if this is a problem in your office, ACT, and fix this on your time frame. Don't wait for an AUDIT: Let's talk and set up your compliance strategy together.
(Providers take heed: Legal Defense coverage by your malpractice carrier does NOT cover any recoupment settlement that might be made where you are required to repay the carrier for previously paid services!)
I HAVE INTERVIEWED 100's OF PROVIDERS and attorneys as well as experts from various industries and what I have realized is...
NOBODY seems to be talking to EACH OTHER! If you are reading this, you understand some of the major problems with healthcare today through the lens of your experience, industry, or profession.
In the beginning I didn't expect to be so fascinated speaking with not just colleagues, but healthcare attorneys; billing, coding, and compliance experts; EHR software companies; healthcare data specialists; medical audit and fraud examiners; Chiropractic malpractice insurance carriers; and basically anyone in a related field who will engage in conversation with me, answer my passionate emails, or respond to my spontaneous LinkedIN connection request.
It will take TEAMWORK.
FIXING this problem will require the sharing and collaboration between these MANY diverse individuals and professional communities and industries.
TO BE CLEAR: I am not defending outright and intentional insurance fraud. I am also NOT arguing about the reasonableness (or not) of carrier documentation guidelines
Providers who chose to voice their disagreement with the current state of requirements by ignoring them is a dangerous and ill-advised strategy (and your KNOW who you are). FIX your notes, and work for change in more appropriate and less risky ways.
ELLEN FITZENRIDER, DC
ABOUT DR. ELLEN FITZENRIDER
Hi! I'm Dr. Ellen! I help Chiropractors and other healthcare providers reduce or eliminate their risk of failing an insurance carrier documentation audit by guiding docs and their staff in creating an individualized office-wide implementation strategy to identify documentation deficiencies and
fix them.
I work with EHR/EMR vendors looking to identify barriers to the appropriate use of their software product and maximize happy and compliant customers, as well as with other related industries who have an interest in solving provider documentation compliance challenges.
I also consult with healthcare defense attorneys, and have collaborated in litigation issues in topics such as carrier ERISA violations.
I currently practice in Arlington, Virginia and am a 1991 Palmer College of Chiropractic (Iowa) graduate. I have built 3 highly successful Chiropractic practices in 2 states.
I have interviewed hundreds of: DC colleagues; healthcare attorneys; ERISA claims specialists; billing, coding, and compliance experts; EHR software company representatives; healthcare data specialists; medical audit and fraud examiners; Chiropractic malpractice insurance carriers; and basically anyone in a related field who will answer my emails and shares my passion for healthcare providers' issues, healthcare reform, and justice.
Catch my ACA WebiNARS:
Catch my ACA & ChiroHealthUSA WebiNARS:
More details HERE:https://www.chirohealthusa.com/webinars/this-is-not-a-documentation-workshop/
Fixing your documentation, once and for all, is a TRANSFORMATION for your entire office, from revisiting and changing often long-standing policies and procedures, to staff communication with patients, to modifying patient habits and behavior, to proper utilization of your EHR software, as well as a thorough review and understanding of carrier guidelines by everyone in the office.