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Don't miss the July 2023 edition!

We know you count on us to keep you up to date with the most important information in the profession. We have compiled updates, blogs, and news for you into this convenient digital publication.

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Dr Alan Sokoloff 1

New Course Available!

This course explains the significant role chiropractic care can play in the sports industry and how a DC can succeed as a Sports Chiropractor. Start your steps to success here!

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Telemedicine

Need more guided help? Work with a KMC coach 1-on-1

Sometimes you need more than a self-service, on-demand program and need an expert to analyze your issues, train the corrections, and help you implement the changes, so they stick

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OIG

There's no need to fear the OIG. We've got your back!

The most effective chiropractic OIG compliance programs are scaled according to the size of the practice!

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Illegal Inducements

Chiropractic discounts, the right way

The Patient Solicitation Anti-Inducement Provision Section 1128A of the Social Security Act, enacted as part of the Health Insurance Portability Act (HIPAA), provides for the imposition of civil monetary penalties against any person who offers or transfers to a Medicare or Medicaid beneficiary any remuneration that the person knows or should know is likely to influence the beneficiary’s selection of a particular provider, practitioner, or supplier of Medicare or Medicaid payable items or services, and may levy civil money penalties of up to $10,000 for each wrongful act.

“Remuneration” includes, without limitation, waivers of copayments and deductible amounts (or any part thereof)and transfers of items or services for free or for other than fair market value. (See section 1128A (I) (6) of the Act.). Of course there are provisions for those with financial hardship that has been properly verified, but that’s not what we’re talking about here.

Practices that routinely discount or provide services for free, outside of documented financial hardship, are in violation of this rule. This means you may not routinely discount statutorily non-covered services, such as exams, x-rays, therapies and durable medical equipment. It can be seen as an inducement to get them to come to your office in order to bill for the covered service, Chiropractic Manipulative Treatment.

It’s our recommendation that providers join a Discount Medical Plan Organization (DMPO) such as ChiroHealthUSA in order to legally discount these items to its members. Medicare and other federally insured patients may join this DMPO to become eligible for discounted fee schedules offered through the network for their non-covered services.

Have questions? Book a 10 to 15 minute Quick Consult with one of KMC University’s reimbursement and compliance experts to discuss your specific situation.

Go Back to Medicare

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I just wanted to touch base and let you know how much you have helped my daily routine. I just can't tell you how much time and effort I have put in trying to figure out and correct the modifiers on our claims. We have been putting those in by hand and as you can well imagine there were many errors and many times our claims were stopped or just not paid. It seems to me half my life was spent trying to figure out just why we weren't getting paid. I am in awe of how you just clicked buttons and made my life so much easier. I can't thank you enough. I have a pile of old corrections to fix and after that I am done with this issue for good. I am working hard on my homework and although it is extremely difficult and tedious I do see light at the end of the tunnel. Just want you to know I appreciate more than you will ever know. Thanks again.

Peggy Mitchell