Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 25 G

From the Desk of Dr. Mark Studin
Academy of Chiropractic
Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time.

"Staff Can (pick one) 1. Build My Practice 2. Destroy My Practice

Staff Can (pick one) 1. Make Me a Large Fortune 2. Turn My Large Fortune Into a Small Fortune"

Staffs, you can't live with them, you can't live without them. It is that simple. In many instances, we spend more time with our staffs than our spouses and invariably, we often trust their opinions and judgment as if they cared for us as much as our spouses do. Take it from someone who has been screwed by trusting loving staff for over 30 years...they DON'T.


I acknowledge that there are great staff members. They care about your work, they care about your well being and they care about the patients. However, try not paying them for 2 weeks in a row and see how long they are still members of your staff. You will see...their asses as they are running out the front door saying "Sayonara!!!"


In addition, your staff is a conglomerate group of wonderful, hardworking people who, in general, cannot make it in their own businesses and are forced, due to economics, to place themselves in your office...and yet you rely on them to make your fortune when they can't make ones for themselves. How many of you bypass the process of delegating responsibilities to specific staff members by "abdicating" the decision making process and the creation of systems to office managers, billing people, and front desk people?


Let's play a simple game. Ask your billing/collection staff the following question:How much time does the personal injury carrier have to to pay your fee ?


99% will tell you (and some with authority) that the carrier has 60 days to pay (or some arbitrary number) and that is the end of the conversation. Most will be wrong, but all will have avoided the question. The correct answer is the following:


California W/C Late Pay Laws:


According the Labor Code 4603.2(b) if a billing or a portion thereof is contested denied, or considered incomplete, the physician shall be notified in writing, that the billing is contested, denied or considered incomplete, within 30 working days after receipt.  Any properly documented amount not paid within 45 working days of receipt of claim, the payment shall automatically be increased by 15% penalty


Every state has similar laws for every financial class with the exception of South Carolina. How do I know that? I have researched the laws and know my business.


Why are you abdicating this information for your staff to learn? This isn't their business, it is yours and it is your responsibility to learn the rules of your business, set up systems and have your staff work your systems. Why don't you know the laws in your state? There aren't many. Enforce them with the carriers. The carriers have you profiled and know the weak offices...and...if you are one...they will abuse you with denials and other games and you won't even know it and your staff will not be equipped with solutions because you haven't created a system to overcome the improper denials.


By the way, you deserve to not get paid if you have failed to follow the 6 P's and have not learned how to create a system and compounded the problem by abdicating the responsibility to your staff. Many offices pay me $2500 for 1 day to set these systems up in their offices and teach. First, I teach the doctor and then I teach his/her staff. Those are the smartest because they have realized their staffs cannot bring them to the proverbial "financial promised land." However, armed with this knowledge, you should be able to do this yourself.


As a rule, the members of your staff will do just enough to do their jobs. Your staff gets to do whatever you direct them to do. If you aren't collecting your fees, the first thing to do is look at the percentages of collections in each financial class. If you do not know that statistic, then you are working for your staff because they count your money and compare it to what they are earning. Your staff knows your financial statistics quite well and that is okay if they are handling the finances of the office. But why don't you know? You should be collecting close to 90% for every financial class, including managed care, after the write-offs. If you aren't, you have a problem and you need to figure out what that problem is. If you can't figure it out, call me.


Staff is great and there are exceptions to the above scenario, but it is a rarity. Those doctors who have challenged me and told me that I was way off base about their staffs have allowed me to question their staffs and at the end of the conversations, I can't remember one staff member who knew the law. Some had the correct parameters of payment times, but knowing parameters and quoting law is usually the difference between timely payment and NO payments.


My goal is for you to get paid, not make your staff happy. I don't know what your goal is.

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