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Many offices love to meet potential patients through public chiropractic screenings. But what is a screening? Is it legal or is it an inducement? And what’s the purpose of doing a Chiropractic Screening for marketing purposes? The definition of a Screening, courtesy of our friends at Screening Experts, is: a process of surveying and evaluating an individual in order to detect distinct warning signs or symptoms of specific non-optimum physical conditions, the results of which action are:

  • Detection and intervention early enough to allow recommended treatment to be most effective
  • Referral of detected cases to appropriate practitioners for actual diagnosis and treatment
  • Raised awareness in the individual for future detection of warning signs
  • Education on prevention
  • Education on treatment options
  • Ultimately, improved health conditions for individuals and communities

Where Good Doctors Go Wrong – Chiropractic Screening Offer

The purpose of doing a health screening for the public is to introduce potential patients to you, the doctor, and the services you offer. There’s nothing wrong with that! The mistake most commonly made in our profession is that the chiropractic screening comes with an offer–and in doing so often induces the potential patient into the office with some type of a discount or a free item or service. That is where good doctors go wrong. Unfortunately, a defense of, “but everyone does it,” will not serve you when questioned for healthcare law violations.

One of the safest ways to perform a chiropractic screening is to offer a service that actually exists in your practice. This will allow you to offer a valuable service and stay out of hot water. Another common mistake is to offer a ‘free consultation.’ Unfortunately, there really isn’t a service called a ‘free consultation’ and most times, that consultation turns into a free examination and other free services on the initial visit. Here is a great alternative, outlined step by step:

  1. Create an actual chiropractic screening service in your practice. Apply the correct CPT code to the service and make it a regular part of your master fee schedule.
  2. Name the service: Preventative medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately ___________minutes. Include the service in your fee schedule as follows, based on time. This service includes face-to-face encounters for new or established patients and is based on time.
  3. Code the services as follows:
    • 99401 (include named service above): 15 minutes
    • 99402 (include named service above): 30 minutes
    • 99403 (include named service above): 45 minutes
    • 99404 (include named service above): 60 minutes
  4. Set policy that states what this service includes in your practice. The definition of the service in the CPT manual includes:
    • Administration and analysis of a health risk assessment
    • Healthy diet, exercise, alcohol and drug abuse
    • Services provided by a physician or other qualified healthcare provider for the purpose of promoting health and reducing illness and injury
  5. Set a fee schedule for each of these services. For example, 99401 = $20, 99402 = $25 and so on.

You Have an Actual Service With an Actual Fee and Correct Coding

Here’s what is possible when using these codes as your screening codes. The following options are available to maximize your public screening experience:

  • Option One: SELL Your Chiropractic Screening Services: When screening in public, sell your screening service that is performed in your office. It’s usually the lower level, 99401, but adjust this according to your screening process. If your fee for 99401 is, for example, $20, collect the $20 as a deposit to schedule the patient’s screening appointment back in the office. Or, you can offer screening services on the spot, such as screening with a Subluxation Station, Foot Levelers’ 3-D Body View Scanner, Posture Screenings, Nutritional Evaluations, General Health Assessments or other non-Evaluation/Management (E/M) screening tools used in your office.
  • Option Two: SELL Your Screening Services but Make a Donation: This option is the same as option one, but, rather than collecting the fee and keeping it, set up your screening day to benefit a charity of your choice. For example, each $20 fee collected is donated to the Humane Society, or Susan G. Komen, etc. You are selling a legitimate service but choosing to include the donation as a public service. We recommend you include written policy in your compliance program with wording to the effect of, “This office regularly offers screening events for our community where we offer our practice service usually coded as 99401, preventative medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes. During these events, we may elect to offer these screening services in exchange for a donation to a local charity. This service is never billed to third-party payers.”

When the patient receives this service in the office, follow your prescribed screening process, complete with initial intake paperwork. After the screening, report to your potential patient whether they are a good candidate for care and make your best recommendations. If they elect to continue, provide the full CPT-coded E/M service necessary to become a new patient. This may include additional history-taking to meet the minimum requirements of the CPT code selected. That more complete evaluation may be charged on the same day, as the parameters of the 9940X code series allow for same or different day E/M services. At this point, continue with your in-office procedure for a typical new patient visit and charge your usual fee schedule.

Because your screening was provided as a legitimate service within your practice’s offerings, with a set fee schedule, this offer makes it easy to convert these patients to members of your practice, while steering clear of unnecessary inducements.

Not sure about the legality of your marketing? Call (855) 832-6562 or click HERE to learn more about Discovery Consultations with a certified specialist to get your questions answered.

Posted by Kathy Weidner on Jun 12, 2019

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