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MT. VERNON, Ohio, October 31, 2007 -- Chiropractors across the
nation commonly are victimized by third-party payers either through
delays or denials in settling bills for treatment performed or postpayment,
when the insurers audit and contest their charges,
according to Bharon Hoag, senior consultant with the ACOM
Chiropractic Consulting Group. But doctors can and should fight
back, he is telling chiropractors in seminars at a series of autumn
conferences.
The tools that doctors need are straightforward, Hoag says:
knowledge of the law, the facts about coding properly to prove
medical necessity and confidence in their own billing accuracy.
On November 17, Hoag will address the FCA Winter conference of
the Florida Chiropractic Association, with a seminar entitled
"Proving Medical Necessity through Your Coding"; and then on
December 1, another entitled "Understanding Documentation and
How to Implement It," at the Annual Seminar of the Advantage
Chiropractic Network, an affiliate of the Iowa Chiropractic Society.
October appearances included the 2007 ISCA Fall Conference of
the Indiana State Chiropractic Association (October 12) and the
OSCA Northeast District Fall Meeting of the Ohio State
Chiropractic Association.
"It is absolutely ethical to bill for the services you performed, but
many doctors fail to do so because they don't know how to bill
properly, or they down-code for fear of an audit," he tells his
audiences. "This leads to one of two scenarios: the doctor cheats
him/herself, or the insurance company detects questionable billing
procedures and challenges the request for payment. Insurance
companies are not in business to pay claims. So be assured that
they won't call attention to underbillings, but understand that they
will certainly demand repayment if they feel that medical necessity
has not been demonstrated."
Hoag's primary message to doctors is that to survive and prosper,
they must cultivate a detailed understanding of chiropractic coding
and documentation and how to implement both. The message
resonates, as indicated by responses at October meetings.
Examples:
".the seminar provided a solid understanding of insurance and
managed care, as well as ways we can stand up for our patients so
they can receive the healthcare they need."
"Finally a program that cuts the fat and leaves the meat.the proof
is in the CPT, not just in an 'uh.try this' coding seminar."
"The fact that you gave us the code and explained how to use
it, document it - made this seminar the best I have ever
attended in 21 years of practice."
".this was not a lecture, it was like a comprehensive
discussion and it allowed me to learn a lot more than I would
have.great method."
"It was refreshing to listen to someone that was promoting
morals and ethics and not get-rich ideas ... finally, a business
consultant that is not a greedy con-artist!"
According to Hoag, the first thing doctors must realize is that
they have the resources they need to fight back. They simply
have to recognize them and put them to use.
"The way in which the profession has evolved has left
chiropractic an easy target," he said. "We can rectify that
situation by dealing with the law and with the facts, but too
often doctors are only given opinions that do not help them at
all. We do not recommend anything that doctors are not
entitled to, but at the same time, we do not want to see money
left on the table when it is justifiably due for treatment
performed."
About ACOM’s Healthcare Business Consulting Group
The ACOM Chiropractic Consulting Group, a professional
services unit of ACOM Solutions, Inc., offers a suite of
consulting programs for educating, equipping and empowering
healthcare providers for success. Group consultants diagnose
practice problems and provide options for improving
chiropractic office operations and addressing the critical
coding and document issues that are unique to the profession.
The Consulting Group's two-fold mission is to enable doctors
to make more money ethically by collecting fully for all services
performed while protecting themselves against audits,
payback demands and possible legal actions.
For information on ACOM’s Chiropractic Consulting
Services:
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