Kats Chiropractic Consultants Review Insurance Plans part 2
Michael Perusich: Hello, I'm Michael Perusich with Kats Consultants. Can you believe it, we're just a few days away from the fourth quarter of 2020. That means 2021 is just around the corner. While many of us are ready to end the roller coaster ride from this year, for chiropractors, aside from a few weeks, it's really been an awesome year in business. We believe it's going to continue into 2021 provided you do the right things and take the right steps now.
The first thing you need to do is analyze your insurance reimbursement to see how well or how bad your insurance contracts may be paying you. Watch for the reimbursement charts to be posted by the insurance companies for 2021. Medicare has already put out the reimbursement schedule, and unfortunately, the rates have really dropped.
Next, you need to look at your overhead. Where can you make cuts and project where your expenses may increase in the next year, then analyze your profit point. That's the comparison between...
Kats Chiropractic Consultants Reviewing Insurance Plans
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,...
Coffee with Kats Maintenance Care
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Mike: Hi everybody I'm Mike Perusich, Dave Kats and Patrick Hammond with Kats Cnsultants. Thanks for joining us today. I thought something we ought to really talk about is maintenance care, and the fact that maintenance care is typically not covered by insurance especially Medicare. They don't cover it at all. Most of these companies have very specific rules. Let's throw that out on the table.
Dave: One thing with maintenance is doctors think if I quit charging insurance and have the patient pay for maintenance, all my patients, all my maintenance patients are going to quit but I've seen this for 30 years and that is absolutely not true. When you convert somebody from insurance paying to once a month maintenance, they're going to stay with you in 95% of the case.
Mike: I can give you a great example of that and that's my practice. I converted my entire practice from an insurance-based practice to a cash maintenance practice, and now my patients are begging me to come in...
Kats Consultants Video Keeping up with Codes
Dr. David Kats: Hi, this is Dr. Dave Kats and Dr. Michael Perusich with Kats Consultants and we have a tip for you. We've been noticing that some codes aren't being paid too well right now around the United States. The 97140 is kind of falling into the disfavor with insurance companies, and so we had a meeting we said, what should we do? If the procedure needs to be done you need to do it.
What we've done is we've changed a lot of our manual therapy 97140 over to rehab, the 97110. Insurance companies like the 97110 and they'll pay for that pretty much like clockwork in most places. If you have a code that's not being paid for, you need to look at what you can do with that patient that will be paid, so the patient will get more of their care paid for. Especially if it has the same or a better beneficial effect for the patient that is for. There are some other codes that been formed by the wayside.
Dr. Michael Perusich: There are. We are starting to see a little bit of a trend across...
Kats Consultants Video Tip Verifying Insurance
David: Hi, this is Dr. David Kats and Dr. Michael Perusich. Today we have a video tip for you. I'm going to talk to you about verifying insurance. Let me start, and then you finish on this. It's important that you verify insurance on every patient that has insurance if they're going to use the insurance in your office. Now, it used to be in the old days, which means a year or two ago, we called all the insurance companies to verify the insurance coverage, and we'd sit on the line for 15 or 20 minutes waiting for them to come on the line to give you the insurance coverage. Right now the online verification has gotten so good that nearly everybody has switched over to online verification, and if you haven't, probably now is the time to get started.
Michael Perusich: That's absolutely right. You said something very important in there. You don't just verify insurance with new patients, you verify a patient's insurance every year. That's really important, and not just to find out if...
