This is an invitation to get your motor running — and to head out on the Freedom Highway…

We have three webinars this month designed to help you get free from financial and staff stresses, and free to follow your own dreams.

You know…as long as you provide good clinical care, then all you need is effective marketing, a motivated team, and good leadership.  Just three – to be free.

So many of our offices have been surging forward over these last several years and recent months — because they have provided better leadership, team building, and marketing.

Hop on the Freedom Highway with us… and take your patients with you as well. They too want to be free … free of pain and poor health.

**February 9th, Thursday,  at 12:30CT, we start off with a training webinar on management and team development. We will be discussing how to hire the right team member.

How To Hire The Right Team Member

• How do you know if you really need more help?
• How do you promote for another staff member?
• What traits are best for what position?
• What about different personality types?
• Screening and the interview
• The first 30 days

**February 16th, Thursday, 12:30CT, we focus on tools and tips for marketing your services.

• How to make Earth Day your Day
• Powerful internal marketing scripts
• Report of findings trick
• Setting up Community Events (Next Month -Lots more on this subject, including screenings)

The presentation is approximately 30 minutes followed by a 30 minute panel discussion.

**February 23rd, Thursday, 12:30 CT, a special Executive Briefing

just for clinic owners.

• We will show the graphs, report on the personnel, clinical and marketing changes, and tell you what happened and why. An inside look.
• Learn from others mistakes and success.

How to Register

For guests, you may register for all three of these webinars, plus full access to our extensive practice building library for one low introductory fee of $250/mo for all classes.

Guest Registration Form

For all active PMA clients register immediately for these classes at: Active Client Registration.  (Register for each webinar separately. You will automatically receive your special log-in access number where you can participate via computer, or by telephone only.)

If you’d like more information visit our website HERE, or contact Linda via email at Linda@pmaworks.com, or call her at: 888-762-8808  

You can also download a calendar for upcoming webinars: LINK 

Hope to see you at our trainings and briefing.

Ed

INTRODUCTION

For 2012, we will be offering an ongoing program of training and support for chiropractic marketing managers, office managers, and chiropractic doctors as CEO’s.

We are calling this the Practice Freedom Package. Its purpose is to help free the office from financial concerns, day to day managements worries, and give it the freedom to follow its greater purposes.

Each webinar will cover at least 4 practical marketing procedures that are effective in generating more patients.

Who should attend. Designed particularly for chiropractic marketing coordinators and managers, doctors and office managers.

♦♦♦♦♦ Chiropractic Practice Management  Webinar♦♦♦♦♦

When. The 2nd Thursday of each month, 12:30 Central Time.

Description. You will learn fundamental principles of management with specific applications to managing a chiropractic practice and business.

Each webinar will cover at least 3 practical action steps to improve individual and group performance, efficiency, and productivity. Also, tips on working with your doctor and how to provide more support for her or him as a doctor and as the CEO.

Who should attend. Designed for office managers, practice managers, and doctor owners

Description. Using actual case studies for examples, we will see what worked and what didn’t for doctors and their teams.  We will uncover the basic principles of effective leadership and management in case and see how to translate this to your business.

This is training on how to be a prosperous CEO.

Who should attend. This is only for doctors who own their own business.

This is often the most popular part of the program as other professionals really want to hear your stories and ideas. So, hang around and share and get to know your fellow teammates from other areas of the country. (Must be ready to contribute and share a successful procedure.)

Lake Michigan, Milwaukee

Happy New Year! It is now 2012.

It is a New Year – fresh with prospects for new opportunities and adventures.

It will come at us fast, we know that. It will have challenges, though we don’t know what they may be exactly. There will be struggles and successes.

But we are given this opportunity, this chance, this privilege to play this game and to do our best at it. And for this, we are grateful. We can learn from our past and work to make this year exceptional – for ourselves and for all those whom we touch in body and spirit.

This year holds within it a promise for each of us – the promise for prosperity, for helping more people get healthier, and for each of us to spend more time following our own greater purposes.

It also holds a promise for all those who will look to you this year for help.

As the days of this New Year continue to dawn, we wish you success in achieving your goals in chiropractic and in life. We are all in this together – and you can count on us to work with you and to give you our best efforts and knowledge to make this a winning season and a winning year.

NEW MEDICARE ABN FORM – PDF

What is an ABN Form?

“The ABN is a notice given to Medicare beneficiaries to let them know that Medicare is not likely to provide coverage in a specific case. The patient must complete the ABN as described below before providing the items or services that are the subject of the notice.”

What do we need to do with this form?

First, you must put in your clinic name, address and phone number on the form. This is Medicare’s requirement. Have each Medicare patient review the form, check one of the three options, and sign the form. Keep a copy in the patient’s chart for the most current course of treatment.

Why are exams, xrays and therapies noted on the form?

The ABN can be used for both covered, but not medically necessary services (such as a wellness adjustment billed without the –AT modifier) or for non-covered services. Adding non-covered services, such as therapies or exams, helps Medicare patients better understand what will and won’t be paid.

Why is the “Estimated Cost” line left blank?

Because this will vary depending on what you are doing with the patient, whether the patient has a secondary, supplement, or alternative financial agreement with your office. This will be different for different patients. You can either estimate a “per visit” cost or the total cost for care. (per page 4, Form Instructions, ABN).

Please get rid of your older, blank ABN forms. More Questions? Ask Dave!

Our great consultant and coach, Ms. Phyllis Frase, will be speaking at the 5th Annual California Jam, presented by the Dead Chiropractic Society in Costa Mesa California.  Register before January 15th and mention the Promo Code of FRASE for the special discount mentioned in the flier below.

All registration is handled through Cal Jam by calling the number below.

That’s what happened to Dr. Josh Biberdorf, who has a few clinics in that State and also is the president of the South Dakota state chiropractic organization. Here’s a great article: http://rapidcityjournal.com/news/state-board-reprimands-chiropractor-for-billing-practice/article_e3b0eb8e-2f4d-11e1-815e-0019bb2963f4.html.

This is yet another example of State Chiropractic Examining Boards going after local DC’s for practicing their business within their scope of practice. Wisconsin and Minnesota continue to do this.

This begs the question of what the role of the state chiropractic board is. They are created to protect the public – that’s what the State law says. But more and more it seems that the State Boards like to determine what chiropractic is – whether patients, the public or chiropractors agree.

This is bad for patients, bad for the public, bad for chiropractic. No other profession does this to itself.

When, we ask, are chiropractors going to stop going after one another? It seems the biggest crime a chiropractor can commit within his or her own profession is to be successful. If you are, some piss-ant DC is going to report you to the board.

It’s time for the National Board of Chiropractic Examiners to make a clear statement on this and ensure that local Boards are doing what they are supposed to – protect the public. Not protect unhappy chiropractors.

But the New Year is approaching – fast. 2012 only has 12 months and the first one starts in just about two weeks. And then, before you know it, it’s February and you are wondering what you should be doing for marketing and getting the word out about your services.

So as not to be left behind, you should begin the New Year with a strong marketing strategy.

Below are some fast tips to help get you started:

But first… PROJECT X-3. We are finishing adding the final components into our new 2012 program, temporarily called the Project X-3. This is just the working title and we will be announcing the new program soon with all the details. It is designed to help lift you and your practice onto and into a whole new level of prosperity and fulfillment in the New Year.

**Schedule Patients Now. Health Never Takes a Holiday. Poster. If you are active with PM&A, you can also find a customizable version on our Members site, along with other promotions under “monthly promotions.”

**External Referral Sources and Event Locations. Make a list of every location where you participated in a promotional type of event. Include any business or professional that sent you a referral or helped you in some way. Then, make sure you send each a card or a gift, or just stop by and wish them well and that you look forward to continued relationship with them in the New Year.

**Marketing Meeting. Schedule a thorough marketing meeting soon, maybe right after Christmas. Spend a couple of hours making a list of what has worked and what you want to do and then schedule these things over the next several months. One example we recommend is:

**Be an Authority and Educate. People want health care information.  This is proven by the fact that 80% of Internet users search for health information on line, according to PEW Research.  8 out of every 10 people at some time are looking for health information when they go to the Internet. That is significant.

…2 ways to do this is to schedule workshops and health “awareness weeks” for the New Year. People want to know the latest. This gives you an opportunity to teach. Yes, you do have to do your homework and it takes time. But it is time well spent because as you study and prepare, you will find that you will become motivated about your subject. Besides, at least 1/3 of your presentation can be your spinal care class, so this saves you time. These types of community education programs or services not only help you generate direct new patients, but give you an excuse to promote your office and services. Sample Poster Clients can find many more customizable posters and fliers on the Members site under: Marketing Materials/ Community Education.

You can find more ideas about upcoming promotions to start your New Year here. Link

Best wishes for a high volume 2012!

Ed

Thank You Very “Doggone” Much as a matter of fact. Thank you for all you do to care for and help your patients.

You all are part of a great profession that helps millions of people each day. And because of you, chiropractic and the chiropractic way of life has persisted and grown and is now more accepted than ever before.

You are braver than most, work harder than most and genuinely care more for your patients than perhaps other care professionals are allowed to. It could be said that you are the best defense against a drugged zombied society, but it is definitely true that your loving care helps much more than you have been recognized for.

So, just a note to say that we are grateful for all you do.

“THANKS”

Refunds should never be automatically sent out based on a request from an insurance company.  Each request needs to be individually reviewed and processed and the patient’s account should be audited to determine if a refund is actually due and to whom.

Sometimes, a refund is due. Examples may be when an insurance company has double paid dates of service, or when two insurance companies both pay on the same date of service. These are legitimate refunds – ie: you have been paid more than you billed or were due for services rendered. These should be refunded.

Often however, a refund is NOT due and should be disputed. Examples might be when an insurance company or third party does a “post payment review” and determines that the care was not medically necessary, or when insurance pays but later determines that work comp or PI were primary, or when an insurance company decides that the patient did not have a particular benefit or coverage for what they already paid.

Essentially, when you have delivered quality services to a patient that were medically necessary and in the best interest of the patient, and the insurance company pays for those services, you have NOT been overpaid and no refund is due. Even if the insurance company later decides they overpaid or paid in error. These refund requests should always be disputed.

Legally, you are not obligated to repay the insurance company when you have been paid in good faith for services rendered and they paid in error. These should always be disputed.

This will not stop some insurance companies from ‘recouping’ the payment, but you should still attempt to dispute the refund request first. Our experience is that by disputing the refund you will avoid 85% of all refund requests. It is well worth the time and effort to do so.

The exception to the above involves government programs such as Medicare and Medicaid. We generally advise refunding these right away and THEN disputing the request. Remember that you must use the approved Medicare refund form and mailing address (check on line with yur local Medicare carrier for the latest form and address).

Points that can and should be used whenever disputing a refund include these (use any and all reasons that are applicable to each case):

- All services were medically necessary for the health of the patient. Our review indicated that the care was medically necessary; therefore no refund will be issued.

- This request is for a patient no longer active with our office. We have no alternative methods of collecting on these accounts. Because of a supposed error on your part, you are asking us to refund monies to you for services rendered to your insured without a foreseeable ability to collect for said services.

- We called/verified benefits on line with (Insurance Company) on each of these patients prior to the delivery of care and verified coverage for services rendered by our office. Had we been informed, we or the patient could have made a more informed decision regarding the delivery and payment for care.

- It is our understanding that (Insurance Company) has maintained a policy of not reimbursing for services if they are submitted for payment one year or longer after delivery. You are requested a refund for services over two years after their delivery and payment. It would seem that the policy should apply both ways.

- Your letter mentions that 98940 and 97140 are mutually exclusive. This is not the case when they are performed in different regions of the body as defined by the AMA. You also state that manual traction and mechanical traction are mutually exclusive. Again, this is not stated in the AMA CPT codebook and the services were performed by different providers, as our chart records show.

- The time and effort to have our office pull charts and research services from 2009 and 2010 is considerable and cannot be done without prior reimbursement, nor can these records be forwarded to (Insurance Company) without prior consent from the patient.

- We would also like to know if you have informed this patient, in writing, that due to the error on your part, that they are now liable for their medical bill from 2009?

- Our feeling is that the following court cases concluded that the insurance company is responsible for knowing their policy limits prior to paying and therefore must bear the responsibility for their own mistakes.

1. City of Hope National Center vs. Western Life Insurance Company, 92 Daily Journal D.A.R. 10728, Decided July 31, 1992. (In this case the hospital obtained standard assignment of benefits from the patient and submitted claims, which were paid by the carrier. The insurance company later decided the treatment was experimental and requested the money back. The California Court of Appeals stated that if it’s your mistake you have to pay for it.
2. In Federated Mutual Insurance Company vs. Good Samaritan Hospital (Neb. 1974) 214 N.W.2d 493. (The carrier contended that it mistakenly paid claims beyond the policy limits. The court held that the insurance company could not recover the money as it places an undue burden on the providers of service to subject them to retroliability.)
3. Lincoln Nat Life Ins vs. Brown Schools (Ct.App. Tex 1988) 757 S.W. 2d 41 1. (In this case the carrier mistakenly paid claims after its policy had expired. The court denied recovery stating “Here the insurer knew it’s own policy payment provisions, but failed to notify the health care providers as to these provisions and the insurer alone made the mistake of paying beyond its responsibility . . . in the normal course of such business, the hospital has no responsibility to determine if an insurance carrier is properly tending to its business.”)
4. National Ben. Administrators Vs. MMHRC (S.D. Miss. 1990). (Similar case as #3 with same conclusion.)

- Our office made no misrepresentations in filing claims for your insured. We extended valuable services based on preverification of benefits and assignment of payment by the insured. We were not unjustly enriched, and simply had no reason to suspect that any of the payments for services rendered were in error. Refunding the monies at this time would place an undue burden on our office.

As always, send a copy of your letter to the patients involved. The insurance company will send a letter to the patient (if we don’t send them a check) saying that “we are not cooperating and therefore the patient may be responsible”. So, strike first by presenting our side and preparing the patient.

Situation: The insurance company paid twice on one date of service and missed payments on another. They are now requesting repayment on the double payment.

Solution: Send them a letter explaining that the payments were posted to the unpaid dates and no refund will be made.

Situation: The insurance company claims that the work comp carrier is responsible for payment and is asking for all their money back.

Solution: Send them a letter explaining that you will bill the work comp carrier and if and when payment is received, you will refund any duplicate payment.

Situation: The insurance company paid for the first eight visits, then denied the next five and now wants a refund on what they paid.

Solution: Dispute the refund as per the above points and request immediate payment on the five denied visits.

Situation: The insurance company paid for care, but then came back and stated the patient didn’t have an active policy or coverage.

Solution: Dispute the refund as per the above points. It is the insurance company’s job to pay within the limits of their plan; you have been paid for services rendered.

If you have questions, feel free to contact me.

David Michel