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Kats Chiropractic Consultants Reviewing Insurance Plans

insurance Oct 04, 2020


Michael Perusich: Hi, I'm Michael Perusich with Kats Consultants, and welcome to this week's video tip. When was the last time you reviewed your billing and collection practices with your staff? How about reviewing EOBs and matching them up with what's being written off? Are you writing off services for which you could be getting paid? One of the places we see a lot of doctors writing off services is when they've performed multiple services on a visit without proper diagnosis code support. This is probably best explained with an example.

Let's say you have a patient for whom you were treating their neck pain and elbow pain. First of all, you need to make sure that your evaluation supports treating those areas, but that's another story. Most importantly, you need to make sure that you have diagnosis codes that match up with these areas of treatment. For instance, in this example, your ICD-10 codes may include an appropriate code for neck pain, cervical segmental dysfunction, elbow pain, and elbow segmental dysfunction. Your billing codes then may include the correct adjustment codes for cervical and extremity adjustments, but sometimes, insurance companies won't pay for two adjustments on the same visit, or so they say.

What they may be wanting you to show is the whole story. That's where code pointing comes in. If you could point your extremity adjustment to your extremity diagnosis, and do the same with your cervical adjustment and cervical diagnosis, you may be able to get paid for both services on the same visit.

Now, obviously, I've made this example very simple, but if you aren't code pointing, you may be potentially writing off services that you don't need to. I'm certain your billing software will allow you to code point, so if you aren't doing that, you'll want to start today. These are just some of the little tips we teach you so you know how to maximize your collections and therefore your profit. I'm pleased to share this with you today. I'm Michael Perusich with Kats Consultants. Thanks for listening.

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