YOU are PROBABLY one of them.
*Statistics from:
NON-COMPLIANT DOCUMENTATION puts you at risk of FAILING an AUDIT.
This can cost you tens (or HUNDREDS) of thousands of dollars if you are requested to REPAY previously-paid claims, and can
FREEZE your CASH FLOW for current and
future services.
If you are not ABSOLUTELY POSITIVE that your documentation is compliant, then it is PROBABLY NOT.
WHY WORRY if you are going to be the next of your colleagues to receive an AUDIT LETTER?
NON-COMPLIANT DOCUMENTATION can actually take MORE TIME for
you to complete.
MANY docs put in TOO MUCH of what ISN'T supposed to be in their notes in addition to not enough of what SHOULD be there.
INSURANCE AUDITS are no longer a "rare occurrence" where you hope that 'they' will get "the other guy" and not you.
INSURANCE AUDITS are a part of your contract with your carrier. You AGREED to provide specific information to them. It is no longer an option to ignore this.
INSURANCE AUDITS are a way for insurance carriers to confirm that what YOU, as a practitioner, are putting in your documentation is what meets the CARRIER'S guidelines for "Medical Necessity."
MOST CHIROPRACTORS are NOT CLEAR on what those carrier guidelines ARE for the plans they participate in.
MOST CHIROPRACTORS are AT RISK for not only BEING audited, but of FAILING the audit (based upon Medicare statistics that 82 % of Chiropractors have non-compliant documentation).
MOST CHIROPRACTORS are lacking in 3-5 crucial areas (or more!) of content when it comes to their documentation, and they don't know where to START fixing things. So they DON'T.
There are LOTS of GREAT workshops, seminars, presentations, and expert advisors out there. You probably have been to one, and more likely, several of them.
So WHY would 82% of docs' notes still NOT pass an AUDIT
How to avoid failing an insurance audit
Chiropractors now stand at a rate of 37.3% 'improper payment rate' according to CMS (Medicare), and although that is still over 1/3 of all Chiropractors, that is an improvement! But for my colleagues who are part of that 1/3, NOT fixing your documentation means leaving yourself open audit risk, not just from Medicare, but from other insurance carriers that have broader coverage of services, which means failing an audit can cost you tens or hundreds of thousands of dollars.
There are many EXCELLENT experts and resources out there, and even though you put in the time to attend that workshop, you show up at your office on Monday morning with TONS of notes and the BEST of intentions. Yet, if you are like MOST docs, you quickly attempt AND FAIL at making MEANINGFUL CHANGES to your procedure and EHR documentation.
Because you weren't given a PLAN to IMPLEMENT that information. In short: you weren't given the TOOLS that answered the question: "WHERE DO I START??
WHAT IF...
(That is the NEW REALITY of how practice needs to be, doctor! Suck it up and FIX IT!)
ONCE I started sharing publicly on our Virginia Chiropractic Association Listserve IN DETAIL about my audit experiences, I started hearing from DOZENS of docs asking me for help and guidance. I came to realize:
Most Docs HAD the information that they needed,
and the intention to do the right thing.
But "making it happen" wasn't happening! Why??
"WHAT do I need to do, and WHERE do I need START?"
Register for my FREE 30-minute Compliance Snapshot Strategy Session to:
When you sign up for my newsletter, you will receive my FREE "Audit Action Checklist"!
COMING in SPRING 2020!
I have re-structured my live-format BOOTCAMP into a
self-paced online course!
WHY a course? So you don't have to do this on your own.Have you tried to get compliant before and failed?Don't know where to start? That's why. Because I'm NOT gonna lie, doc, this is going to be WORK! FIXING YOUR NOTES will take DISCIPLINE. FOCUS. EFFORT. DETERMINATION. This course will give you:
BUSY DOCS need a solution that:
They can do while maintaining their busy patient schedule.
Makes sense in today's practice environment.
Will eliminate the FRUSTRATION of trying and failing.
Will let them SERVE their patients with LESS STRESS.
Will bring them FREEDOM from the menace of an AUDIT.
IF you are worried about not passing an AUDIT, you need to get CONFIDENTLY COMPLIANT NOW.
Are YOU sure that your documentation supports:
...ON EVERY SINGLE VISIT? IF NOT... YOU NEED MY:
"My documentation used to take up most of my time, and even then I knew that it wasn't correct. Now I can leave my office at the end o the day ON TIME and with PEACE OF MIND."
"We feel much more confident now in our documentation of therapeutic procedures now that our staff follows a SPECIFIC protocol set by the Doc."
"The custom patient education video about maintenance and active care ALONE saves me and my staff hours of time EVERY SINGLE DAY.
THAT is PRICELESS!"
In December 2019 I SUCCESSFULLY had my own UNJUST audit OVERTURNED. I now spend my time helping offices and providers be PROACTIVE in all-things-documentation compliance, from fixing notes, to confident responsive billing, to challenging AUDIT findings.
Here's what Dr. Ellen had to say recently at a Virginia Chiropractic Association convention, passionately sharing about WHY it is CRUCIAL that we FIX THIS CRISIS in our PROFESSION immediately.
In 2017, my office of 17 years was subjected to a post-payment documentation audit and prepayment review audit. Anthem asked for my EHR documentation from 18 months previous, 10 patients for six-months' worth of care, which was over 800 pages. I heard back 6 months later: they contested some billing codes, asked for some money back (a LOT), made some vague comments about notes that "appeared templated", AND...my office was subjected to "PRE-PAYMENT REVIEW."
Here's where the fun REALLY began!
If you are NOT familiar with what "Pre-payment Review" is:
SOUND SCARY? If it doesn't, it SHOULD.
This will throw YOUR office staff, YOUR office flow, and YOUR mindset into an absolute turmoil, believe me.
If you are even a half insurance-based practice, your CASH-FLOW will be decimated....for at least 6 months, maybe more.
EVEN if you are doing everything right.
Between myself and 12 other close colleagues, we lost a collective $1 million dollars in severely delayed or unpaid claims. Two colleagues closed their doors because they couldn't cover their overhead, payroll, and their own income.
DO NOT LET THIS HAPPEN TO YOU.
Dr. Ellen Fitzenrider
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