Academy of Chiropractic Personal Injury & Primary Spine Care Program
Quickie Consult 60
As many of you already know through my persistent nagging, I have strongly urged each of you to submit your paperwork for a voluntary audit, to be pro-active in avoiding or surviving a retrospective audit. Regarding retrospective audits, I was interviewed by “The American Chiropractor” on that very subject. The article can be found in the December, 2008 issue. The good news is that as a result of being part of the Lawyers PI Program, you knew these issues months before the rest of the country and have had the opportunity to take action to protect your family and practice. I still urge you to read the interview. I will continue to share these and other issues with you in order to keep you one step ahead of the rest of the profession.
Yesterday, I had a meeting with Dr. Schonfeld, the compliance auditor, who alerted me to a host of very significant issues. I will list them with the understanding that no one is more important than the others:
- Illegible notes: If they can't be read, it is as if they do not exist. Many states consider illegible notes cause for gross misconduct and they can leave you exposed to loss of your license.
- Severely deficient evaluations and re-evaluations that are cryptically written: You need a full evaluation; that is non-negotiable. You can get a template that prompts you to perform a “5” level E &M when clinically indicated.
- Billing for regions not adjusted.
These are just a few of the issues, but the consistent ones in audits. If they are not done or not documented compliantly, it can lead to fraud and abuse issues, with significant money demands from a carrier retrospectively. After reviewing Dr. Schonfeld’s level of audit and recommendations, I am committed more than ever to have every doctor I work with have their charts voluntarily self-audited. I want you to be in full control of what you do and pursue any corrective actions that need to be taken, so that a predatory insurance company does not attempt to extort you, if the action is initiated by them.
I continue to get calls weekly from new doctors across the country who have been contacted by carriers for retrospective reviews. These offices are large, small, multi-disciplinary, single-practitioner, and every other type of practice that exists. My intent is not to be inflammatory or to create fear; it is to give you the least expensive and simplest form of insurance against a predatory carrier.
Take action now. Fax your records to me to review: fax #661-843-1062