I’m just wrapping up a 6 week, 8000 mile tour (literally via planes, trains and automobiles) of the USA for client office visits.

Instead of the usual hardcore billing, coding, documentation, compliance fare, here are some of the insights I’ve gleaned along the way to help you better your business.

Myths Are Alive and Well

Unfortunately, chiropractic billing, coding, documentation or compliance myths appear to be alive and well no matter where you live.  Some chiropractors are the victim of urban legends, some ignorance, some just plain bad info. Some recent non-sense I have heard with no foundation in fact:

  • (Myth)  I don’t have to respond to an audit (or documentation request) because the insurance didn’t include a HIPAA release form. (Reality)  If you are asking for third-party reimbursement, the insurance company has a right to obtain all information necessary to process their claim.  That right remains in effect before they pay or after.  By the fact that the patient is also a part of this relationship and also wants to have the insurance pay their claims is an endorsement (realized or not) of the insurance companies claim administration and auditing practices.  In other words, go ahead and send them your notes or respond to that audit request.  Your HIPAA standoff will get you nowhere except in trouble for not complying with the documentation or audit request.
  • (Myth)  You will be audited if you call insurance to verify too many claims, codes or patients. (Reality)  The CSR’s who man the phones doing verification may not even know where the audit department for their insurance plan lives – if it isn’t outsourced entirely. They don’t get brownie points for handing over would be criminals (Hey Yolanda, you’ll want to put this one on your list to audit) nor do they have the authority to instigate an audit (Go get ‘em Leroy, this office was incredibly rude and asked me way too many questions, they deserve to be audited!). Yes, I used to work for an Insurance Company (pre-chiro days) and some other rumors you may have heard about insurance companies may be true, but this one needs to die quickly, as it is needlessly scaring staff from getting the required info they need to do their jobs well.
  • (Myth)  You have to wait until you receive the EOB to collect co-pays or co-insurance. (Reality) Most insurance contracts stipulate that you must collect a co-pay or co-insurance but they does not state that you must wait until you receive the EOB to coordinate those benefits.  That’s what Insurance Verification is all about.  And if that were the case, Insurance Verification would be unnecessary.  Truth be told, one of the new requirements for the 5010 Conversion is that Insurance companies must be more forthcoming and provide more detailed information about coverage, not less.  This should help OTC collections and not force an extra 30, 60 or 90 day delay until you can get your money OTC or otherwise.
  • (Myth)  Medicare states that you can (or cannot) do {insert a great forbidden here}.  (Reality)  In God we trust, all others bring data.  Don’t TELL me Medicare (or any other payer) states that you can or can’t do something, SHOW me the policy, contract, or document that contains that rule.  Interpreting billing, coding, documentation or compliance regulations is difficult enough without hearsay from some well-intentioned but misguided would-be-know-it-all.

Get the Facts FIRST

This year, I’ve seen more great chiropractors than ever fall victim and become nearly crippled thanks to the lunacy of some “experts” who dispense bad advice with a healthy dose of doomsday predictions, all in the name of their status as would-be gurus.

Sure, there are audits occurring everywhere in chiropractic.  Agreed, most chiropractors can improve their documentation.  Admittedly, their billing and coding practices may also need improvement.  But most DC’s are well-intentioned, decent, honest doctors who are trying their best to comply with a myriad of changing requirements.  Most are not frauds, hucksters or potential inmates awaiting the issuance of their pinstripe suit.

To have chiropractors believe they are all going to jail and that all their money needs to be refunded is a gross exaggeration in most cases and gross negligence in an attempt to establish necessity for one’s existence as an “expert.”

Call me strange but, in my opinion, the real value of having a billing, coding, documentation or compliance expert in your camp is so that you can be compliant AND get paid better for what you do — not to scare the bejeebees out of you until you don’t even want to practice.

Success Abounds , But Gloom and Doom Speaks Louder

Like most news reports, 99% of all the latest info we hear is negative garbage —  some is hyped up, some is grim reality.  To listen to most newspapers and TV news, the country should have sunk deep into the abyss long ago and everyone is hanging on by the skin of their teeth.  Sure, the economy is not as vibrant as it was years ago, but the truth is that not everyone is suffering pure misery.

My latest trip illustrated time and again, real living, breathing examples of successful chiropractic practices in every US time zone (yes, when you travel as much as I do, everything starts to be filtered through time zones), cities big and towns small, practices of all diversities.

I’ve had the privilege of watching staff scold the chiropractor for talking to me for several minutes too long to the degree that they had a line out the front door (Central Time Zone).  Another client (Eastern Time Zone) is also “suffering” under a demanding schedule that bursts with too many patients and too little time to see them.  In the Mountain Time Zone, I had the pleasure of consulting with a chiropractor whose niche is bringing him patients from a massive, almost unfathomable radius.  During my visit, my unscientific calculations found the average patient to have traveled 56 minutes to his office (with some driving over 4 hours).  Finally, in the Pacific Time Zone, I am helping a client photocopy himself; he’s about to launch his third practice – in less than a year’s time.

You see, it’s just not possible that all the doom and gloom is true.

What’s even more amazing (if you listen to the naysayers) is that this is not some weird anomaly only true of my Strategic Chiropractor clients. Sure, I may have more than my fair share of successes, but you’re not dumb enough to believe that I have a monopoly on it with only my clients.  On the contrary, many of these successful chiropractors have successful friends in other industries as well.

Common Bonds Observed

Over the past 6 weeks, I’ve eaten at a wildly packed pizza place in the middle of cornfields owned by a 40 year old brilliant entrepreneur who was nowhere to be found (he’s never there, but I bet he draws a nice paycheck). I bought some kitsch from an 80 year old business whose success was ignited way back when with one good (free) idea.  I met an even younger business owner whose brilliant idea is pulling in enough money that he can sit home in his underwear for the next three years and still pay himself well enough to live a comfortable lifestyle.  Or how about the Alaska bush pilot whose flying business and internet DVDs are selling well enough to fund his wanderlust?   I think I met him in Montana and he could barely answer where he was from thanks to his near constant (self-imposed) travel schedule.

In my travels, I observed several common bonds of all of these docs (and other entrepreneurs):

(a)    None of them go it alone: All have a coach, consultant or mentor – many have several.

(b)   None of the DC’s live in a “chiro-bubble”:  All take vacations, spend time with family and mastermind with other successful business people OUTSIDE of chiropractic.

(c)    All of them have a concrete plan:  Obviously, you can’t “arrive” at success if you haven’t defined what that is.  For many, this is why they have a consultant – to help solidify, objectify and quantify their plan.  Their plans may differ widely, but they have one in place.

Am I just a complete oddball that only runs into these rare birds?  Oddball perhaps, but statistically speaking, the chances are astronomical that I would have such privilege to only meet wildly successful entrepreneurs from chiropractic and every other random profession.  A more accurate guess is that these folks have found what works, they improve it and they stick to it – regardless of their profession, style, or niche.

And here’s the beauty in that statement – you can too.

Stop Whining and Start Planning!

The only people profiting from all this negativity are the media.  Death and destruction sells. Success stories, hometown boy makes good and local hero stories are nice, but they just don’t bring in the crowds. Rubbernecking may be our national pastime, but it doesn’t pay the bills unless you are in the towing or collision repair business.

So, stop whining about the economy.  Stop blaming the insurance companies, the feds, your state association or the fact that another chiropractor moved into your town.  Sure, none of these entities may be helping your game, but in reality, we are our own biggest enemy.

In this I am not just advocating a bunch of self-improvement fluff.  No amount of staring yourself in the mirror repeating PMA aphorisms will help you out of your Accounts Receivable nightmare.  Listening to Tony Robbins may help you feel like you can conquer Medicare, but if you don’t actually address your shortcomings, they may still eat you for lunch.  Seeing your psychotherapist for depression may help you cope with your floundering practice, but getting your business in gear may do wonders as well (unfortunately, 36 sessions later, your therapist still may not tell you this).

Instead, run yourself out of excuses and start planning for your success! If you need help along the way, get it. You may wish to start with my FREE Practice Analysis.  There’s no charge for my analysis, nor any obligation to use my services.

Invest in yourself, your dreams and your chiropractic practice. If you can’t decide whether such things are worth it, then you may be in the wrong business.  There’s no “right way” to practice chiropractic other than your way and with passion, focus and a sound business strategy in place.  The passion can’t be manufactured, but the focus and strategy certainly be designed.

Believe it or not, this is your time.  I can say this with certainty, without knowing you and with absolutely no knowledge of your personal circumstances or your local afflictions.

I say this because if this is not your time, when will it be?  Next week, next year, next decade?  Why wait?!  The starts will never line up.  Do your history homework.  Great businesses have been built in every economy, in the most inconvenient of places at the most inopportune times.  Sure, the media can try and convince you of otherwise – but that thinking is part of their business plan, not yours.

Start today to plan and build a strategy that will benefit YOU, your practice, your family and your dreams!