Welcome to the KC CHIROpulse Podcast.  

This week’s topic: Verifying Chiropractic Benefits

The KC CHIROpulse Podcast is designed for Chiropractic professionals ready to elevate their practice to new heights, and is hosted by Kats Consultants CEO - Dr Michael Perusich and billing expert Sara Colby-Amburgey, both seasoned experts in Chiropractic care and business development.  This podcast provides invaluable insights and actionable strategies to help you create a flourishing and sustainable Chiropractic business.

In this episode, we discuss:

 

• Why insurance verifications are so important

• How verifications can help you collect more money

• Why verifications done properly help you follow the insurance rules better

• How simple insurance verifications can be

• How to get your patients on board with verifying their benefits

• …and so much more…

 

 

In each episode of KC CHIROpulse, we delve into crucial aspects of building a successful Chiropractic practice, covering topics such as establishing a strong foundation, adopting a patient-centric approach, mastering marketing techniques, achieving financial fitness, fostering effective team building and leadership, integrating technology and innovation, and navigating common challenges in the field.

 Whether you're a seasoned chiropractor or just starting your practice, the KC CHIROpulse Podcast offers a wealth of knowledge and practical advice to help you navigate the intricate world of Chiropractic business. Join us on this journey as we explore proven strategies, share success stories, and connect with industry experts to empower you in your pursuit of building a thriving Chiropractic practice.

 Don't miss out on the latest insights and expert guidance. Subscribe now and unlock the secrets to taking your Chiropractic practice to the next level. Your success is our priority at Kats Chiropractic Business Advisors.

DISCLAIMER:  The information presented in this broadcast is for educational purposes only and is not intended to offer legal, investment, accounting, or medical advice.  Seek the consultation of a professional for advice in those areas. And remember…your results using this information may be different than described.

 

Podcast Record with Sara Amburgey (2024-03-25 10:43 GMT-5) - Transcript

Attendees

Dr Michael Perusich, Sara Amburgey

Transcript

This editable transcript was computer generated and might contain errors. People can also change the text after it was created.

Dr Michael Perusich: Doctors are you verifying patients insurance? Hi everybody. Welcome to the KC carapults podcast brought to you by Katz consultants and Cairo Health USA. I'm Dr. Michael perusich. I'm your host today and I'm joined by my good friend ra Did I say it right? amburgey, I always So Sara,…

Sara Amburgey: Amburgey, it's okay. Yeah.

Dr Michael Perusich: and we've known each other for longer than I'm gonna say. Because I don't want to date both of us.

Sara Amburgey: right right

Dr Michael Perusich: And so I always want to call our buyer maiden name still so I don't know if that's a good habit or a bad habits bad habit because you're married to a great guy anyway.

Sara Amburgey: Yeah.

Dr Michael Perusich: Sara tell us a little bit about yourself because I want to dive into this whole thing about insurance billing and whether or not we should be verifying insurance benefits. And anyway, I'll stop talking. Tell us about you.

Sara Amburgey: Thank Thanks for having me back again. I love doing these with you. So I'm Sara Amburge I think everybody knows It's Colby in the Chiropractic industry, which you're right. I have a fabulous husband amburgey. That's right.

Sara Amburgey: Care for 27 years. I started in Chiropractic. And in Oklahoma moved to an office and Arizona. I've done. Single doctor practice discipline multi location. So in Oklahoma, we could take x-rays. So I've taken x-rays all the way to cleaning toilets. I've done it all in the chiropractic office. So I'm super grateful to be here and letting my chiropractic life. And where it's brought me all these years.

Dr Michael Perusich: I love it and everybody out there. I can tell you for a fact that Sara is just this incredible wealth of knowledge when it comes to running a chiropractic practice and she's one of the best experts I think in the profession on billing and insurance and all those great things that we as doctors just don't even like to talk about but it's necessary.

Sara Amburgey: That's right. You guys were not made to be Insurance. Gurus. You guys are made to heal people and…

Dr Michael Perusich: No.

Sara Amburgey: you want nothing to do with it, but it's so important.

Dr Michael Perusich: It's so important. I try and trust me. I was not born to read an EOB. That's why we played good people around us. Thank you, Marissa. So anyway,…

Sara Amburgey: That's right.

Dr Michael Perusich: I want to talk about so we hear from a lot of doctors who have for whatever reason and some of them I think kind of see at least sound like valid reasons have stopped to verifying insurance. And I know you and I have had this conversation of How important is it to be verifying patients insurance benefits?

Sara Amburgey: It's everything really and it's a pain on the wall to see let's just admit it. It's not fun.

Dr Michael Perusich: A nice way to put it.

Sara Amburgey: right But it is so necessary. Here's what I think about it is. if we don't do the work up front, we're doing twice three times four times the work on the back end when there's no insurance there and…

Dr Michael Perusich: Mm-hmm

Sara Amburgey: meaning somebody could be

Sara Amburgey: Come in today and have insurance coverage or you saw them two months ago and they had insurance coverage and they don't have it today. And innocently slips their mind to tell my husband changed jobs. And how I lost my job last week, so I don't have coverage anymore. Not to say that you should verify insurance benefits every visit. that's not logical and…

Dr Michael Perusich: right

Sara Amburgey: but I do think especially let's talk about October when Insurance enrollment start happening for so many people start grabbing those new insurance cards at that time find out the effective dates of those new policies and

Dr Michael Perusich: right

Dr Michael Perusich: Okay, hold on right there real quick because you bring up a great point because so many practices wait until January 1st. To start asking about new insurance cards and…

Sara Amburgey: Yes.

Dr Michael Perusich: really you could be 90 days behind at that point.

Sara Amburgey: That's exactly So October is when you guys all know we start seeing the commercials on TV, especially with the Medicare but that's also open enrollment for employers as well. So we see it advertised for insurance.

Dr Michael Perusich: right

Sara Amburgey: Of course, you're gonna have those plans that are plan year versus calendar year. Please gonna be teachers something like that where they going to plan here versus a calendar year so you have to be aware of those as…

Dr Michael Perusich: Yep.

Sara Amburgey: And when you see those commercials start happening, we all know Medicare enrollments happening because they bombard us So you're right there start asking for new insurance cards. Here's the thing the mistake that I see in the office is make Hey Sally, great to see you and had your insurance changed. not the question to ask was there Insurance may not have changed.

00:05:00

Dr Michael Perusich: right

Sara Amburgey: But guess what they got any plan? So if their plan changed their group number could change their ID number could change so there's so many we cannot ask…

Dr Michael Perusich: Yeah.

Sara Amburgey: then through the same thing holds through March. We've got to be asking through insurance cards because guess what going back to Medicare again? Those plans can change they have the opportunity especially if they enrolled in an They had the opportunity to change Advantage Plans one time. And in that process so it's important that we ask him and my typical role of thumb is if we haven't seen a patient in a couple of months. Ask them for a copy their insurance art. Hey, it's great to see you I need to get a copy that insurance card, no big deal. It's not a big deal to them it guess what when they go into their medical office. They give it every single time.

Dr Michael Perusich: every time

Sara Amburgey: Every time Chiropractic is different. And so we just don't create those habits that we probably should and it's super important.

Dr Michael Perusich: Yeah, for sure it at least if they haven't been in a while like you said as a reactivation if they're starting over as a new patient…

Sara Amburgey: Yes.

Dr Michael Perusich: because it's been three years or longer always get that card it that should just be an automatic thing because they do change and…

Sara Amburgey: exactly Exactly,…

Dr Michael Perusich: they change dramatically sometimes.

Sara Amburgey: right, even if they have the same Insurance, it can change dramatically…

Dr Michael Perusich: right

Sara Amburgey: because they've opted for a different plan. And life happens fast things change and that's why I feel like that each office should set up a rule of thumb if we haven't seen the patient in two months if we haven't seen the patient in three months. Get a copy of the insurance card because you don't know. And some of those plans we still have to file on paper very few of them. But if we're not filing daily if we file weekly or for an office that still files and then flee you've given your patient a huge grace period in there. To be treated for free essentially because you're not collecting properly from them…

Dr Michael Perusich: Yeah.

Sara Amburgey: because you don't know their insurance verification.

Dr Michael Perusich: Yeah, which is kind of scary really especially when you talk about your cash flow.

Sara Amburgey: That's exactly right, which is so important. We got to keep the doors open when I help as many people can and…

Dr Michael Perusich: right Right…

Sara Amburgey: keep the doors open.

Dr Michael Perusich: because I'm pretty sure most of us are not supposed to be for-profit businesses.

Sara Amburgey: That's the idea.

Dr Michael Perusich: I love it. So we're gonna take a quick break because we gotta hear word from our sponsors. But when we come back Sara, I want to talk a little bit about some of the additional pitfalls of not verifying insurance and then I want to dive into just a whole building structure and things in our Chiropractic practices and some of the Better habits we could develop so we'll be right back. We're talking about whether or not you should be verifying insurance and all the things that go in with billing insurance. So we'll be right back.

Dr Michael Perusich: All right everybody. Welcome back to the KC carapults podcast brought to you by cath consultants and health Say we're here with Sara today and we're talking about by the way Sara's the expert in all this stuff. Verifying insurance and maybe not all the but a lot of the components of just building to insurance and where we can kind of get in trouble and some of the bad habits that we create. so I want to pick back up on the insurance verification component…

Sara Amburgey: Yeah.

Dr Michael Perusich: because When we don't verify insurance we talked about the fact that you could be letting your patient off for free. I'm not real sure how you even do your good faith estimates and those kind of things if you're doing those but the other side of it is there's one thing that I see a lot of doctors not do and they don't verify

Dr Michael Perusich: Certain codes, they just verify whether or not the patient has Chiropractic benefits. Okay, that's great. But do they cover decompression therapy? How do they cover rehab 97110? How do they cover maintenance care? And we don't ask those questions.

Sara Amburgey: Right all the favorites. I'll add to that extremity, right? Right,…

Dr Michael Perusich: right extremities exactly

Sara Amburgey: do they pay for an extremity adjustment? and what's interesting about that is that you will find in each state it can vary and…

Dr Michael Perusich: Yep.

Sara Amburgey: there's not consistency. So, please don't ask your buddy that you graduated Chiropractic College with it. They cover extremity from Cross Blue Shield in your area…

Dr Michael Perusich: Please don't.

Sara Amburgey: because it won't match just so I'm finds it does.

Dr Michael Perusich: right

Sara Amburgey: Sometimes it doesn't Also important I think Dr. Understand how often can we build a exam? We might in the chiropractic side say okay, we're gonna treat the patient three times a week for four weeks and then we're gonna do a exam. Okay, that's perfect. I think that's great. But insurance is probably not going to cover that. A lot of them. Don't cover it. When you build with a CMT code a lot of them. Don't cover it. If you build it by itself no CMT code and less than 30 days.

00:10:00

Sara Amburgey: So insurance companies a lot of times say nope. You've got to wait till the 31st day to build that enm code. And so you end up in that situation. I would like to say, please appeal if you're doing your CMT and your exam on I shouldn't even say the very first day on the same day. And if you're doing that it's okay, but appeal it don't let them deny that exam because you guys are spending more time with those patients and you are doing things that are outside the scope of an adjustment.

Dr Michael Perusich: And you have to prove medical necessity to be building the insurance.

Sara Amburgey: There you go.

Dr Michael Perusich: And in my opinion at least the only way to really prove medical necessity is that periodic progress To show that the insurance company and if you don't bill it, then they don't know you're doing it and we've seen doctors get audited because they never build a progress exam they did them, but they just didn't build them because the insurance company wasn't going to pay for it. So the insurance company thought there's probably a medical necessity issue here.

Sara Amburgey: That's exactly right and that I'm glad you brought that topic because if you do it, we have to bill it. so we can't not Bill a service…

Dr Michael Perusich: right

Sara Amburgey: and If we perform a service we should bill it. that's yes,…

Dr Michael Perusich: Absolutely.

Sara Amburgey: and I do see offices do that. not because they're trying to do anything wrong. Like you said just it's not gonna be covered.

Dr Michael Perusich: Yeah.

Sara Amburgey: So why take the time to build it but really the opposite is true and really appeals are not that hard and if you don't know where to find there's an appeal form online Google Blue Shield of Florida appeal form. there…

Dr Michael Perusich: right

Sara Amburgey: if you don't have access to one already, they're out there. You've just do a quick Google search to find them. and…

Dr Michael Perusich: right

Sara Amburgey: it's worth it because you're gonna get that money that you deserve and for the services that you're providing to the patient.

Dr Michael Perusich: Right, right, which makes me think about reviewing all the insurance companies policies every year. They're LCD. They don't all call them an LCD, but it's amazing what they tell you in these documents exactly how to document for example

Sara Amburgey: That's exactly right and so many people get scared of insurance companies, but I'm like, it's right there in black and white don't be afraid to find call and…

Dr Michael Perusich: Yeah.

Sara Amburgey: call the insurance company find out where you can find your manual do the provider thing instead of going through all the patient prompts go through the provider prompts and find your manual most of the time they're going to be on the insurance company And so you can find them on the insurance company portals which Kind of comes back around to even Medicare. That's where I see a lot of big mistakes is with Medicare. They don't realize that Medicare Advantage plans are doing a lot better now by marking advantage or replacement or advantage on the card and labeling it on the card, but they're getting better,…

Dr Michael Perusich: That's good.

Sara Amburgey: but many times we'll get a Medicare patient they walk in. They slap down all their cards. then the staff might be may not be familiar. If we check Medicare benefits on your Medicare portal, it is there you guys it will say Medicare Part C. If they're Medicare Part C that red white and blue traditional card, bye-bye.

Sara Amburgey: We don't need it. It's null and…

Dr Michael Perusich: right

Sara Amburgey: void because that Advantage plan. So then we're not billing Medicare or not wasting time to get that rejection and…

Dr Michael Perusich: right

Sara Amburgey: some Advantage Plans need authorization. So it's important to know and are you part of the advantage plan? because you're a provider with does not automatically put you in with United Advantage. So it's important to know what you're part of as well and when we're verifying these insurance benefits and going back and finding out our certain codes covered and we all know with Medicare that's a different code. But going back to what you said originally Doc and in my long-winded answer here is Getting to the specifics of the codes they cover…

Dr Michael Perusich: You're good.

Sara Amburgey: because they will not tell you if they're going to pay for the code, but they will tell you if it's a billable code. And when you're doing your insurance verifications,…

Dr Michael Perusich: Yep.

Sara Amburgey: so all of that is important and for staff. Guys, this is your way that you can go in and say I deserve a raise because look we're collecting all this money. So it's money lost. And we're losing money. We're tossing many out the window. It's so easy to justify to go into your boss and…

00:15:00

Dr Michael Perusich: Yep.

Sara Amburgey: hey, I would love to have a raise. Our collections are up X percent because we've now been verifying insurance benefits and we're collecting more money because of it.

Dr Michael Perusich: Yep, and that is one of the big advantages of doing those verifications is really understanding how the insurance company might pay you. You said, they're not going to tell you if they're gonna pay you. Because that depends on a whole lot of other factors, but at least you find out what's buildable and what's not and…

Sara Amburgey: exactly

Dr Michael Perusich: and that's very important. I want to talk a little bit about Medicare. So in my opinion Medicare is probably the easiest I'm using air quotes if you're listening insurance companies because it's not insurance, but to me, it's one of the easiest To deal with and yet I see so many docs getting it all mixed up and I heard a couple of doctors recently in the last probably 30 days Medicare now has unlimited benefits for Chiropractic Care. wow, where are you getting that? Because that's not true. So.

Dr Michael Perusich: I don't know if it's just we've got a lot of disinformation floating around the profession and too much of talking to your friend across the country. But I want to kind of set the record straight on some of that. So I'm just gonna ask you flat out. You're the expert. Is there unlimited care under Medicare? No.

Sara Amburgey: No, it's like any other insurance company. It's all based on medical necessity where I do think some of the confusion comes in is back in the day.

Dr Michael Perusich: Thank you.

Sara Amburgey: We had a 12 visit limit on Medicare and Medicare did not care if the patient came in three times a week or if they came in one time a month, they could use those 12 visits.

Dr Michael Perusich: Yep.

Sara Amburgey: However, they wanted to and I think sometimes there are some providers that still. Think that or they heard that like you said from their buddy and it's incorrect and it's all based on medical necessity.

Dr Michael Perusich: All based on medical necessity.

Sara Amburgey: Yes. yes,…

Dr Michael Perusich: Yes. Can't say that enough.

Sara Amburgey: and this is where I get in trouble with some doctors when I'm working with them and talking with them is Everything we all know and our heart of hearts that chiropractic is necessary, right? That's…

Dr Michael Perusich: right

Sara Amburgey: where we have to take off our hats and put on our insurance company. Our passion hat has to come off. and…

Dr Michael Perusich: Yep.

Sara Amburgey: we have to be realistic with this is what Medicare is going to consider medically necessary. That's when we're billing that at modifier just because you put that 18 modifier on there for acute treatment does not mean that the visit's going to be covered. This is where people's minds below when we're talking about billing and these kinds of things because 80 doesn't mean it's gonna be paid and…

Dr Michael Perusich: All right.

Sara Amburgey: guess what everybody if you build an at and Medicare denies, you cannot collect from that patient. So it is important for you to understand when to build a ga,…

Dr Michael Perusich: right

Sara Amburgey: as the professional doctor, when the patient has reached their maximum medical improvement. And not I got to keep adjusting them. So they don't get surgery. That's not it. So we've…

Dr Michael Perusich: right

Sara Amburgey: if they're maximum medical improvement their pain level is a level five. And they can only walk out five flights of stairs instead of 10 split. We can't get into that sixth flight of stairs. That's it. So our goal might have been 10 flights of stairs and…

Dr Michael Perusich: That's it.

Sara Amburgey: our goal might have been a pain level 2, but we can't get them Beyond. that's it.

Dr Michael Perusich: Then you're done.

Sara Amburgey: And I will say Doc.

Dr Michael Perusich: Yeah. No,…

Sara Amburgey: I'm sorry to interrupt you. I will say that.

Dr Michael Perusich: you're fine.

Sara Amburgey: and oswestry and neck disability forms are big in Medicare and having the patient fill those out and you do kind of have to think about I've got a positive poly patient as I've always said throughout the years or I'm negative net because negative Nets gonna be pain level of 10 all the time and can't put his pants on where positive poly is going to be a two and can't put her pants on it's

Dr Michael Perusich: I love the names.

Sara Amburgey: So we have to be a little bit realistic in relationship to how they're filling out those forms as well,…

00:20:00

Dr Michael Perusich: yeah, and…

Sara Amburgey: .

Dr Michael Perusich: you actually read my mind because I was gonna bring up outcome assessment tools because Exactly.

Sara Amburgey: Great great minds doc great minds.

Dr Michael Perusich: That's why we're here on the show together.

Sara Amburgey: That's right.

Dr Michael Perusich: That's why we've been friends forever. But those outcome assessment tools. I think to me are one of the greatest. Things since individually wrapped in sliced cheese for the Chiropractic profession because it allows you to document from the patient's point of view. How am I progressing and it creates that disability percentage and when it then go any further You're done. Put an ABN in front of them.

Sara Amburgey: That's right.

Dr Michael Perusich: And I want to talk about the ABN but put an a/bn and from them explain to them the difference in care. You really should explain it up front. So they're not blindsided by it. But that's another story. and if Harris still clinically appropriate great keep going with chiropractic care. That's where our philosophy has to come in. But like you said we have to take that chiropractic passion hat offer just a minute so we know that we're playing the insurance game correctly.

Sara Amburgey: That's exactly right and really that goes back to the insurance verification. And the report of findings and when you're discussing all of the things with Any insurance company is based on medical necessity and really acute care. just because you've been billing Blue Cross for two years with the same diagnosis with the same injury dates does not mean that in three years Blue Cross isn't going to come back and asking for the money back because they will

Dr Michael Perusich: I just had fingernails on the chalkboard when he said that. Yeah, because we hear all the time. they're paying me so everything must be okay. No, they're just waiting…

Sara Amburgey: yes.

Dr Michael Perusich: until the audit department has time to come and take all the money back.

Sara Amburgey: That's exactly right and that's what I mentioned to Providers. All the time audits are not random. They just haven't caught up to yet. I mean the get your house in order now…

Dr Michael Perusich: Yeah. Get your house in order.

Sara Amburgey: because I talked to a provider recently that had a 2016 On his claim form and could not figure out why he wasn't getting paid and I said doc anytime you fill out that claim form. We're painting a picture to the insurance company. And so we've got to be mindful of those box 14 and…

Dr Michael Perusich: Yep.

Sara Amburgey: 15 dates. Based for medical necessity and…

Dr Michael Perusich: Yep.

Sara Amburgey: please don't be the office that changes your box 14 15 every 12 visits because that also sets up a profile be logical if somebody came in on With low back pain and you treated them for six weeks and now they're Improvement and they're where they are and then they come into let's say in another two months. They have the same problem again. But they were gardening or they went surfing or they went snow skiing or they sat in their office chair for several hours and their back flared up. That's a new box 14 15.

Dr Michael Perusich: Yeah, so I have the pleasure of reviewing records for doctors. Sometimes they just want to know if the records are good before they send them in or they're trying to build their EHR system or whatever anytime. I see that happening where the diagnosis date is changed. The immediate thing I go and look for is where's your exam? Proved to me what the new diagnosis is how did you come up with the onset date? What did the patient say about their pain? What are your Orthopedic testing look like, why is there no exam in here. you just change things on the palpation. your palpation didn't actually change it carried over from the last visit. And if it's a Medicare patient, where's your p a r t? So we've got to remember when we changed diagnosis and…

Sara Amburgey: That's right.

Dr Michael Perusich: and you bring up a great point. You can't let it diagnosis get too old and

Dr Michael Perusich: I've always gone by the adage of anything longer than two months could be too old could be. But if you just randomly change the diagnosis you've got to have proof of why you change the diagnosis. What's the rationale behind it?

Sara Amburgey: That's exactly right and that's where I think people's good offices. I see a lot maybe just okay, we're gonna change the diagnosis because they haven't been in two months. So like you said, sometimes that's the case and they could just be coming into for maintenance visit at that two month point. So that's…

Dr Michael Perusich: right

Sara Amburgey: where all of the doctors have to make that professional determination. And is this a new injury if it's a flare up at the same condition, then that's fine. I use myself as an example all the time. I started seeing and a chiropractor in 1983. I entered my low back.

00:25:00

Sara Amburgey: We don't put 1983 on my claim form. So I'm seeing my chiropractor on Friday. I haven't been there probably six months shame on me and That's right shame on me.

Dr Michael Perusich: Shame on you.

Sara Amburgey: But I'm in a flare right now. So on Friday when I go in he'll do it a exam on me and then build the right code with the right modifiers and get me adjusted and justify everything that he's done for me. To reflect a little bit on what you were saying about records and reviewing records. all as providers have received records and cannot make heads or tell them when a patient has transferred to your care. So that's exactly…

Dr Michael Perusich: Yep.

Sara Amburgey: the Auditors feel when they're looking at it. We have to paint a picture to them. So they're understanding exactly what's going on. And that is not to say in your emrs that you're using to go fill in every single blank. That's not the point.

Dr Michael Perusich: right

Sara Amburgey: The point is just to make sure that what you're doing for. The patient is medically necessary. and…

Dr Michael Perusich: Yep.

Sara Amburgey: matches with the insurance verification. So everybody knows what to collect what's covered? What's a billable service what's not billable what you can collect directly from the patient for versus what you can't and tie everything together. It's really simple. It like It's really simple.

Dr Michael Perusich: It is really simple. I know a lot of docs are probably listening to this and going. I can't do all this. number one. Make sure you have your R system set up correctly. Make sure you've got all the macros and everything in there that you need. there are very few systems out there. That won't work at a fast pace as fast as Paces as you need. Unless you don't set them up correctly. I know we spent a great deal of time setting up our system with your help. In fact, making sure that it worked and flowed with our workflows so that we were saying, a hundred and fifty you are not new but 150 patients a day and our notes system kept up with us and we were doing the exams and documenting medical necessity and all those things so you can do it. So if you're out there thinking my gosh, this is gonna kill my practice to do all this extra work. It's not Plus and…

Sara Amburgey: 

Dr Michael Perusich: you mentioned it a little bit ago.

Dr Michael Perusich: Your staff's gonna come to and go. Hey dark because we're checking all the boxes and doing the right things and verifying insurance and all that and we understand what we can bill and how we can build we're collecting more money. And we're doing greater things for patients because of it. So there's really a positive into the rainbow here.

Sara Amburgey: 100% patients want to know two things when they come in. Can you fix me? And how much is it going to cost? That's what they want to know and…

Dr Michael Perusich: Yep.

Sara Amburgey: if we can either mines on that first visit with that insurance verification and what they're going to be responsible for. it done deal patients. Stop coming because they're fearful. I shouldn't say this is the only reason but they're fearful right of…

Dr Michael Perusich: big reason

Sara Amburgey: what it's gonna cost. They don't understand and if you and your staff can't explain it how the heck is the patient's best to understand it.

Dr Michael Perusich: Yeah, the EOB was created by the insurance companies to keep everybody confused and it doesn't great job of it. But if you can be the resource for the patient to help not only understand their EOB, but be able to pinpoint the cost of care pretty darn close every time they're coming they come in you take that fear away and when you take that fear away they relax. And guess what that becomes the patient who will stay pay refer and believe in what you do and they'll send other people into you and they'll never leave you. And I know we talked to a lot of docs who are having trouble with patients dropping out of care and a big part of it is because we're not having this financial conversation up front.

Sara Amburgey: That's exactly right. I see a lot of people that are fearful of finances and talking that and to them but there's no fear when everything is addressed up front. Everybody knows what to expect. and in your Billing System, you should be able to set up allowables in there. So, percentages so if a patient is 80/20 you can collect as close as you can to that personage and of those billable codes and so take the time and talk to your EMR systems out there and get those allowed amounts set up. So you can collect accurately at your front desk. I see that happen with new staff. They're fearful to ask for many because they don't understand what they're supposed to be asking for because they're Billing System.

00:30:00

Sara Amburgey: Set up correctly so they don't even know.

Dr Michael Perusich: Or they're sitting there at the front counter with their calculator trying to figure out what the patient knows because they don't have the allowables and percentages all set up.

Sara Amburgey: That's All right. I've been into many offices where I see sticky notes attached over. this is Cross Blue Shield. I'm gonna grab that sticky note and…

Dr Michael Perusich: My…

Sara Amburgey: this is what you owe.

Dr Michael Perusich: that was our office you were there. That was a long time ago.

Sara Amburgey: I wasn't gonna say anything,

Dr Michael Perusich: And that was funny.

Sara Amburgey: But once you knew you will set it up It was a done deal.

Dr Michael Perusich: Yeah.

Sara Amburgey: It makes it easy to calculate those things. and if you don't know the exact allowable for a particular insurance company Have a plan.

Dr Michael Perusich: exactly

Sara Amburgey: So nobody is petrified to be at the front desk and one of the things I like to say at the front desk. I worked to the front desk. Like I said, Jack of all trades and the Chiropractic Clinic. Working the front desk. One of the things I always like to say is as of today your balance is 2365. As of today your balance is 65 82 Followed up by how would you like to pay right?

Dr Michael Perusich: exactly

Sara Amburgey: That's but always saying as of today, why do we say that because tomorrow I could get an EOB in and they've denied your care and you're gonna owe more money, or they're gonna pay a little differently than what we thought they were going to pay. And so…

Dr Michael Perusich: Yeah.

Sara Amburgey: if we're constantly saying the same things at the front, Desk all the time for constantly saying and how would you like to pay That's a simple question. Your balance is 6582. How would you like to pay? You're not saying I need 65 82 from you,…

Dr Michael Perusich: Yep.

Sara Amburgey: please it's like to pay.

Dr Michael Perusich: right

Sara Amburgey: Time? Can I have part today? We're leaving them an open-ended questions. So those collections can go up.

Dr Michael Perusich: Yeah, that's exactly right great point. If people want to get in touch with you, how can you help them?

Sara Amburgey: That's a trick question because I wear a lot of hats. Thank…

Dr Michael Perusich: I know you do. That's why I posted open ended.

Sara Amburgey: And you can get in touch with me via my cell phone. I'm a wide open book on myself and feel free to reach out to many time. I'm happy to give you my cell phone number and It's ready.

Dr Michael Perusich: Please do.

Sara Amburgey: Are we ready for that? It is 602 690 0509 If you decide that you're going to text me, please let me know who you are because I get a lot of text messages. The other thing I would like to say if you decide to call or text me on that number and if I'm not back to you in two days, please reach out to me. Sometimes my text is so full that I am human and I am going to miss something. There is no doubt.

Dr Michael Perusich: Get messed it's easy.

Sara Amburgey: yes, and so if truly My goal is two days and really same day as my real goal. But if it's two days if it's beyond two days, something's gone on I missed your message. I never received your message, but I'm happy to help with any of those questions that have come up that we've addressed today.

Dr Michael Perusich: Awesome, and I know you do I'm gonna put a Shameless plug in here because it's one of my favorites but you do a lot of work with the clips, which I personally think is a great program. I'm a little biased because we use that in our clinic, but you were telling me they've got a cloud version coming out.

Sara Amburgey: Yeah, we've actually had the cloud version out for three years. Yes. Yeah,…

Dr Michael Perusich: I didn't even know that. That's great. Yeah.

Sara Amburgey: it's been out and it's very affordable. it's super fun and we can offer things in the cloud version that we couldn't in the windows version and one of those things being Insurance verification directly from the software so we couldn't do that in the windows version. So that's one of the fun things we can do with cloud and one of the biggest questions we get when we start talking about cloud is going away. Absolutely not we've got Over 30 years of development in the server version. Why in the world we get rid of a fantastic program that works for so many.

Sara Amburgey: And also there's rural property rule communities out there that don't have great internet still and…

Dr Michael Perusich: Yeah.

Dr Michael Perusich: right

Sara Amburgey: even satellite doesn't work in some of those places.

Dr Michael Perusich: right

Sara Amburgey: And so those people need a software too. So we are not abandoning the server version at all. And so you can reach out to me if you have any questions about either one of those because we can transition any Eclipse client over to cloud and not lose a single bit of data.

00:35:00

Dr Michael Perusich: fantastic fantastic program great company, so Sara thanks for your time today.

Sara Amburgey: Thank you.

Dr Michael Perusich: I really want to get you back on again because there's so many other little nuances and insurance that I want to dig into and I think it'd be fun if we got Marissa on here. We kind of did all three of us on here and just had a little banter about insurance.

Sara Amburgey: Right around table. I love that.

Dr Michael Perusich: Yes, That'd be fun. So hey everybody if you haven't done so yet go check out cats consultants.com. See all the great things that we're doing to help clients and just doctors in general out there. There's some free downloads on there. And as always we appreciate our guests like Sara coming on our show. So all right. Be sure to tune into the Casey Chiropractic chiropoltz podcast every week and make sure you subscribe the buttons down here somewhere and go check out cats consultants.com as well as our other sponsor our health USA. We'll see you guys next time.

Sara Amburgey: Thanks for having me.

Meeting ended after 00:36:04 👋