Bill For What You Do!
Gold standard billing advice: Bill for what you do, but back it up in writing! Insurance companies will play an interesting game with you. They will usually pay for most of the procedures you bill for, if you use the proper codes of course) and they might put up a little fight for reimbursement, but they will generally pay out.
Here’s the kicker. They come in months to years later and ask for all documentation supporting your rationale for the prior treatment rendered and reimbursed for. If you do not have sufficient S.O.A.P notes to back up your clinical decision making, they WILL ask that all the prior patient payments made to you be refunded to them within several days or immediately. Most chiropractors live hand to mouth and do not have sufficient funds to make payment, so the insurance companies have full legal right to wipe out the assets of the doctor, and he/she is forced to shut down the office.
Morale of the story: Take the time to back up your clinical decision making. NO TRAVEL CARDS! They do not have adequate room for proper documentation. Do so at your own peril. Gone are the glory days of documenting subluxation listings, “same as previous visit” and “schedule next visit.” Make sure to document for ‘CASH ONLY’ patients. Why, the State can audit you and you want to back yourself up in case of litigation or malpractice suit. Be smart. Oh and don’t be dumb enough to adjust someone at any event outside your office without a proper evaluation. Otherwise, you may end up in court. DTA- Dont’s trust anybody when it comes to simple adjustments. Pessimistic, yes. Realistic oh YES!
Dr. Perry Nickelston is VP of Practice Devleopment for K-laserusa and Clinic Director of The Pain Laser Center in Ramsey, NJ.
1-866-595-7749 Ext. #2
Discussion Area - Leave a Comment