Practice Finances

More and more, third-party payers have written medical review policy deeming roller table type traction as experimental, investigational, and unproven. However, because it is usually billed as 97012, Traction, the payer wouldn’t know that the service performed was roller table and would likely pay it. It’s up to the provider to be aware of these kinds of rules. Billing with a deceiving code could be dangerous.

When it comes to reimbursement, most chiropractors and team members believe they are not being paid every dime they deserve. Third-party reimbursements have indeed been shrinking while documentation requirements have increased. As a result, it has become practically impossible to thrive in an insurance only practice.

Should you verify the patient’s insurance before the first visit? On the first visit? Before the Report of Findings (ROF)? Do you perform a Financial Report of Findings (FROF) first? Or do you submit the claim and wait for the Explanation of Benefits (EOB) to come. All of this uncertainty could be solved with a simple insurance verification.

Electronic claims processing is still the fastest, most efficient way to file insurance claims, where possible. However, there are times when a paper billing process still applies for your practice.

Every parent knows (and dreads) when it’s time to have “the talk” with their kids. Some of us do a better job than others—and the same is true for those of us tasked with having “the talk” with our new patients. In fact, for some of us, discussing the birds and the bees can seem like a walk in the park compared to actually having to talk to new patients about—gulp—money.

As healthcare costs rise, some patients are left without health insurance coverage and are unable to afford out of pocket costs for much-needed chiropractic care. The provision for a hardship fee schedule within a practice’s fee system is perfectly legal when set up properly with policy and procedure.

Are you stuck, as are many practices, with claims that have never been paid? You sent them out the door after you did your part and waited… and waited… and waited. Or maybe you have noticed there is a shortage of money in the practice compared to last year even though you have added many new patients and services.

There once was a day when third party collections were simple. Nice as it is to reminisce about those days, we all agree they are long gone.