Help! That Wasn’t on The Boards

The Business Side of Running a Practice

While you worked your way through the intense and demanding schedule and course load of chiropractic college, you may have prioritized your learning based on what was coming up next –classes, exams, and board tests. For most of us, the demands of school left little time to think about running a practice – how every decision is the practice owners, what forms and EHR to use, which insurance companies to contract with, what services to offer, etc. We did have business classes and documentation training in school, but did we learn all the ins and outs of what it takes to be ethical and compliant in today’s heavily regulated healthcare environment?

Chiropractic schools turn out some of the best doctors in the country, but because time is limited, chiropractic education focuses on anatomy, techniques, diagnosis, and treatment. The unfortunate but unavoidable consequence is that most chiropractors never learn about advanced documentation, Medicare, compliance, and the business side of running a practice, including coding and billing. New doctors often lacking a piece of knowledge necessary to run their practice and take care of their patients with minimal risk. Many times, they are unknowingly violating state and federal regulations.

Be Prepared for Records Requests and Audits

Most doctors come to us because of one of three circumstances; they have had records requested and find themselves in the middle of an audit; they know someone else who’s in the middle of an audit, or they are worried that they are going to be audited. That fear and lack of certainty can weigh very heavily! And with records requests and subsequent audits on the rise, doctors are right to be concerned.

Just as you wouldn’t launch into treatment without evaluating the patient, the first thing we recommend when seeking proactive improvement is to evaluate your practice’s current documentation. Here are just a few of the things to look for:

• A pattern of down-coding: It’s just as bad to under-report the actual treatment you provided as to fudge in the other direction.
• A pattern of up-coding: While your technique may lend itself to full spine adjustments and treating all five regions at every visit, it’s unlikely all those regions are medically necessary.
• Missing information: Whether the date of service or onset is wrong, or the doctor’s signature is missing or incorrect, it’s risky business to rush the process.

The Key to a Successful Practice

Even though we didn’t learn everything in school or get evaluated on how to run a practice by any regulatory entity, it does not mean we get a free pass. Nor does it mean that we can’t learn to do so.

It is amazing that when documentation issues are identified and corrected, third-party rules and regulations are followed, and proper coding and billing are integrated into a practice, the practice becomes streamlined and fun! And when running a safe practice, the result is a successful practice with increased revenue, compliant patients, and an improved sense of value for the services provided.

Dr. Colleen Auchenbach graduated with a Doctor of Chiropractic from Cleveland University Kansas City in December of 1998 and practiced for over 20 years. Her interest in Medical Compliance began when she earned the 100-hour Insurance Consultant/Peer Review certification from Logan University in 2015. She has been a certified Medical Compliance Specialist-Physician since 2016. In November 2020, Dr. Auchenbach joined the excellent team at KMC University as a Specialist and, as part of this dedicated team, is determined to bring you accurate, current, reliable information. You may reach her by email at info@kmcuniversity or by calling (855) 832-6562.