108: Chiropractic Issues and Common Insurance Mistakes

Chiropractic issues and common insurance mistakes. 

That's our topic today on the KC CHIROpulse Podcast, brought to you by Kats Consultants. I'm Dr. Michael Perusich. I'm joined by my co-host, Dr. Troy Fox. 

Troy Mistakes, Hey, they happen, right? 

They do a lot, you know, and it doesn't matter how big or how small your practice is, it doesn't really matter what insurance you're on. What matters is, as a doctor of Chiropractic, you either A, have to have a spouse or somebody that you really, really, really trust that you don't have to sit on top of it at all times, or you need to have your finger in it and at least see what's going on. You need to look at the numbers. You need to know what's going on, and even if you have a staff member or a spouse running it, you should be meeting with them on a regular basis to find out what's going on with insurance.

How are we doing? That's, I would say that's the number one mistake as a lot of docs go, I just want to practice and I really, yeah, we're gonna do insurance, but here's the codes and you guys handle it. I don't wanna mess with it. 

So I'm gonna, I'm gonna pull a line from Shrek on this one. It's all about layers. Donkey. It's all about layers. You know, you've gotta have layered in processes that help you catch mistakes. Cuz I mean, let's face it, mistakes happen, right? But if you've got the right layers in your practice, if you've got the right oversight and not just one set of eyes on everything, At the end of the day everybody's tired, right? It's easy, yeah. To, to miss something In billing, it's easy to let something get, uh, sent out to the insurance company that's not coded correctly. Or if you get a modifier, I'm telling you in in our practice, we had two sets of eyes on absolutely everything. And I was more about, let's make sure we've got it right before we send it.

Even if we have to wait 24 hours, let's put those layers in there. You gotta have those procedures in there. That's what really helps. Yeah, you were, uh, you're probably smarter than me because I don't know about that. What I would say, probably I resemble a little bit of the comment of what I talked about at the beginning, and really initially in practice, one of the mistakes that I made was looking at my checking account to determine whether we were getting paid from insurance.

Now, I know that sounds crazy, but a lot of people do it. Yeah, sure. Then all of a sudden you see the checking account starting to go down and you're like, what's going on? Then you decide to dive into it.  when you're at a critical point. Right. And I'll be quite honest with you, that's exactly what I did. We found out that the insurance follow up wasn't happening to our standards.

It wasn't really happening at all at the time. No . And we ended up with a huge deficit sitting out there that we were chasing down as the checking account went down, which that's kind of an uncomfortable position to be in. You don't wanna have to go to your banker and say, Hey, I need a short term loan because I'm an idiot.

Yeah. You know,  that's probably, beyond coding mistakes, that's another big one that you can make. Well, and I think that brings up the point that in, in our profession, and I'm not gonna just pick on chiropractors here, I, I don't know that it's just our profession. I think it's just having a small business in general, I think it's easy to get caught up in.

We've gotta service the chiropractic patients, we've gotta service the patients. We've gotta, you know, make sure staff is paid. We gotta, and, and we do, we kind of, we kinda look at the checking account to give us kind of the idea of, mm-hmm , are we doing well or not? Is it going up, staying the same or going down? 

Really what we need to be looking at are all of our statistics because it's in the statistics that you begin to see when you are making some mistakes and when cash flow's not coming in the way it's supposed to. Right? Right. And AR is climbing up and you know, really watching those statistics helps you uncover a lot of those mistakes before they become a big issue.

right? Hey, let's talk to our young doctors. She a minute, because a lot of this that we're talking about is, Hey, I'm established. I already should know what I'm doing and I probably do know what I'm doing. How about some of our young docs that go, Where do I even find, like when there's been a change of insurance, or maybe I'm supposed to use a different modifier at a different time on an insurance claim?

What are some resources? I know we're one of them. Obviously. We do a lot of training with our clients and we work with them closely because that's a very important aspect to your practice. I, I think, probably some of the guidance. Chiropractic USA from Chusa has been helpful and we've tooted their horn in the past.

We think they're a great company and I think they help as well. Are there any, any other places you would, you would think that we could seek out resources? Pay attention to NCMIC. They're, they're always on the pulse, especially on the compliance side of the practice. True. Like the legal compliance side.

Pay attention to them. Pay attention to the ACA. They put out good information. ChiroCode book. You need to buy a code book every single year. , it's funny you bring that up, that that comes up because I was talking to somebody a couple of weeks ago and they hadn't bought a, they hadn't bought a code book for like 15 years and the comment was, oh, stuff changes.

Yeah. Every year it changes. You mean, you mean I can't still code with ICD9? I've probably still got that book, or eights somewhere, or eights. I think the first one I had was maybe a nine when I actually bought a book, but I think I've still got that in my library somewhere. Yeah. That's I'm sure someday it'll be useful again.

Right, right. As a doorstop. Yeah.. I think you're absolutely, you're right. Looking here, we are working every year and we're on, we're on the cusp of ICD11.  coming out. Mm-hmm. , which has got used to 10. Mm-hmm.  Now eleven's coming out I think next year. So you've, you've gotta pay attention. A lot of the coding, processes change every year.

And when does it change? It's not on the calendar part of the year. The notice for the change comes out in September or October. So yeah, you've gotta be paying attention, use those resources. ChiroCode book is a great one, and just subscribe to. Chiro Health USA and, and if you're not a member of your state association, you should be, if you're not a member of the ACA, you should be mm-hmm.

So you get those emails and, you know, make sure that you go to you and you don't have to spend a lot of money on this kind of stuff. Make sure you go to just some of the coding seminars and things that are, that are put out there once in a while. Mm-hmm. , you know, it's important staying in the know keeps you, keeps your head out of the sand.

and keeps you from making a lot of the mistakes. And if you're one of those people like me that kind of wants it spoonfed to you because I, if it's, I don't care if it's accounting or if it's coding. . It's not my thing. I don't like either one of those two things. I have a really good accountant that takes care of me.

Yep. And from a standpoint of coding, it's really helpful sometimes to have some coaching or some advice. We talk about coding on a regular basis, and we do, because when changes occur, we don't want our clients stuck with their heads and the sand's going, well, I didn't. I had no idea that that changed.

So we like to make you aware, we typically field questions from people when that happens, because there's gonna be a lot of questions about, well, what about this? Can't I still do this? No. and so we just put a whole series out before the beginning of, u, 2023 date the broadcaster. But before the beginning of 2020, we put a whole series out on all the changes that came down, came down the line.

Coding and E&M structure and yeah, we keep up on that, for Chiropractors. And, and I like your term, we spoon feed it to our clients. We do. So one, we probably, uh, we probably ought to give a shout out to our sponsor. And two, let's find out what we need to do if we want to get a hold of you or I to find out more.

Am I compliant and how do I become compliant? Because quite frankly, we can look and see as well, we can kind of follow the trail and we can help you with that. So, absolutely. How about a  shout out to our sponsor first? So we're very proud to say that our, uh, sponsor today's podcast is the Barlow Brain and Body Institute.

They're helping doctors learn functional neurology without all that complicated stuff. So if you're looking to add things like brain-based therapy to your practice. Check him out. BarlowBrain andBody.com Dr. Andrew Barlow. He's an awesome guy.  and you can check out on their website all their upcoming training programs and some of their resources and things.

So again, it's Barlow brainandbody.com. Now, if you feel like you need some coaching and you need to get plugged into things better and help have some oversight with your practice, that's what we do. Kats Chiropractic Consultants.com. Katsconsultants.com. Go check us out on our website l check out all the resources that we have and all the membership options that we have.

We make chiropractic coaching so simple and it's right at your fingertips whenever you need it. So go check it out. We've got some freebie things on there as well, so,enjoy.

Anything else to add Troy? 

I think that's it. You know, coding, like I said, is no fun and a lot of us wanna stick our heads in the sand.

So probably having your butt 4-feet in the air and your head in the sand is not the way to do this. So in 2023, make a pledge to yourself. Let's get this right and let's not worry all the time about whether we're doing it right or not. Get some help. 

Well said, and remember, it's always good in the hood.

All right everybody. Thanks for tuning in to today's KC CHIROpules podcast brought to you by Kats Consultants. Keeping Chiropractors on the pulse of success.  

We’ll see you next time. 

See ya.