Academy of Chiropractic Personal Injury & Primary Spine Care Program
Quickie Consult 53
"Make Money & Save Your Ass"
This title is directly on target and for once, not sarcastic. As I have previously shared with you, I am actively working with doctors, nationally, who are either being retrospectively audited, sued or being prosecuted for issues. These issues are always related to billing and documentation. As a result of my exposure to many of these proceedings, I am going to continue to share with you what I see as weaknesses in your offices and tell you how to correct them. The goal is to make your office bullet-proof by simply doing it right the first time, without cutting corners.
One simple method that does not take much time is to cross reference your claims with your SOAP notes prior to submission of the claims. The process is simple. Print a billing report before printing claim forms or transmitting the claims to a billing service. This should have a few vital pieces of information, including the patient’s name, the date of service and the ICD and CPT codes with the charges; nothing more. You take this report, pull every chart and look at the SOAP notes. If the services correlate to the billing and the diagnosis is accurate, you are almost good to go.
The final step is to ensure there is an order for the visit. Has there been an order for the service in an evaluation or was it noted in the previous plan? No orders, no services. This is the easiest step because you are the person responsible for ordering your own care. This is one of the most frequently targeted areas in an action against a doctor. If the process sounds too tedious, it isn’t. I did this every other week in a multi-disciplined office for years, at a volume of over 1500 services. The process took a few hours, but if your charts are organized, it goes quickly. This prevents you from fraud issues (billing for services not performed) and abuse issues (billing for services not clinically indicated). It also will trap numerous services you performed and your staff omitted to bill! I increased my income over 10% by trapping errors not billed found by cross-checking my SOAP notes and seeing what was missed in data-entry.
This is what is called a “Business System,” and will show you what staff members are not functioning at the level you thought they were. I have both re-trained staff and given others the opportunity to work in another field outside my clinic (a polite way of saying they were fired). If your business systems are tight, you will make more money and sleep very well at night!