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Foundations of the Billing and Collections Process

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As the Mercury Falls

In the snow belt states, the annual migration of the snowbirds heading to warmer locales begins. What are snowbirds? These are people who usually head south for the winter to escape the cold and snow of their home state. There is also a variation of the snowbird called a “snow flake” who are people who spend portions of the winter in the south and head back north at various times.

Penguins

Time for a Reactivation Program

Snowbird season presents a number of wonderful opportunities for doctors who see them. If you have not already done so, now would be an awesome time to implement a reactivation program reminding your seasonal patients that you are still around, and to come in for a spinal check-up. Post cards, letters, email, and social media can be perfect choices.

Don’t Forget Medicare Patients

There are some items to be aware of, however, when treating this population. It would be reasonable to assume that a considerable proportion of snowbirds are Medicare beneficiaries. If these patients have also been treating with chiropractors in their home states, this could raise possible red flags. The Office of the Inspector General (OIG) has made this a topic of their current work plan and could increase the risk of an OIG or Medicare audit. Is this a reason to shy away? Absolutely not!

Billing for Medical Necessity

Make a call to the treating doctor in their home state to confirm how many visits and for what diagnoses the patient was treated. With signed authorization, request appropriate records from the treating doctor to be sure you have the full picture of your patient’s chiropractic experience. As with all patients, be 100% certain that you only bill for services that are medically necessary and that your documentation meets those standards. Additionally, take steps to ensure that patients who are receiving care that might not meet the standard of medical necessity (maintenance) and are Medicare beneficiaries have a properly executed Advance Beneficiary Notice (ABN) on file. The ABN is arguably one of the most misused pieces of documentation in all of chiropractic. Not using this form properly makes for easy pickings in the event of an audit.

You can refresh your knowledge on medical necessity and proper ABN use by logging into the KMC University Library. If you are not yet a member of the Library, please click here to learn more.

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By Team KMCU

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