“Once you make a decision, the universe conspires to make it happen”
-Ralph Waldo Emerson
For a printable copy of this tent poster click: Make a Decision – Universe Conspires -Emerson
Tent Poster – Always Do Your Best – Mandino
“Always do your best.
What you plant now, you will harvest later.”
-Og Mandino
For a printable copy of this tent poster click: Always Do Your Best – Mandino
Tent Poster – Strive and Persevere – Dalai Lama
“To remain indifferent to the challenges we face is indefensible. If the goal is noble, whether or not it is realized within our lifetime is largely irrelevant. What we must do therefore is to strive and persevere and never give up.”
Tenzin Gyatso, 14th Dalai Lama
(Beyond Religion: Ethics for a Whole World)
For a printable copy of this tent poster email services@pmaworks.com
Have You Helped A Child Today?
Reply
It’s a beautiful fall day here in Southeastern Wisconsin. Clear blue skies, the leaves are changing, and the temps are comfortably cool.
I wanted to take a few minutes of your time to introduce myself and let you know about an upcoming opportunity for you to make a difference in a child’s life both locally and globally.
My name is Linda Skiles, some of you already know me and some may not. I have been involved in chiropractic for the past 34 years in some way or another and a patient for most of my life. I began as a chiropractic assistant, graduating to an office manager, and now serve as the client services coordinator for Petty, Michel, and Associates, working with offices across the nation to promote PMA’s 3 Goals(sm)of methodology:
- Greater Profit
- Better Service
- Higher Purpose
I am passionate about chiropractic and passionate about making our world a better place. Each and every day, I strive to find a way to live with a Higher Purpose. With that said, I’d like to invite you to help support my most recent mission.
Ed Petty and Dave Michel along with the Chiropractic Society of Wisconsin(CSW) have graciously given me the opportunity to collaborate with Wisconsin United for Freedom and Chiro Kid’s Day to host a “Kid’s Korner” at the CSW’s Fall Summit, October 18th-20th at the Wilderness Canyon Lodge Convention Center in the Wisconsin Dells.
The whole idea was born when I made the commitment to sell 600+ ornaments for the Khutsala Artisans of Project Canaan. A large task but achievable with your help.
Project Canaan is Heart for Africa’s 2,500-acre large-scale land development project being used to bring HOPE to the tiny Kingdom of Eswatini (formerly Swaziland) by focusing on four key areas: Hunger, Orphans, Poverty, and Education. It will provide training and employment, while supporting orphans and vulnerable children on the property and across the nation.
In 2013 my twenty-nine year old son, searching for a higher purpose in life, found Project Canaan and served as a volunteer missionary for one year as the bulldozer operator. I had the opportunity to visit while he was there and joined the Swazis in making jewelry. I continue to support their efforts through selling their beautiful beaded ornaments. 60% of the sales support the Khutsala Artisans’ daily living needs and 40% is donated to a local charity of my choice. Proceeds from the sales at the CSW Fall Summit will go to Oklahaven Children’s Chiropractic Center in Oklahoma City, OK.
In addition, I recently published my third book entitled, Nettie’s Fountain Pen – Another’s Days Writings. $5.00 from the sale of each of these books will go to Chiro Kid’s Day and Wisconsin United for Freedom.
Promoting the wellness of our children locally and globally is the theme of our booth. We will have informational material and resources available that focuses on the health of our children here in the US. I hope you will stop by, see what we all have to offer, and support our efforts.
Our children are our future! Can you help a child today?
If you are unable to attend the CSW Fall Summit but would like to purchase ornaments or books, please email me at linda@pmaworks.com
Sincerely,
Linda Skiles
262-749-0221
Links:
Follow my Journey at Project Canaan – Oct 17th 2013 – Nov 1st, 2013
Oklahaven Children’s Chiropractic Center
Heart for Africa – Project Canaan
Wisconsin United for Freedom
Chiro Kid’s Day
Children’s Health Defense
8 Successful Marketing Attitudes
“Marketing is an inside job,” one business owner told me years ago.
He meant it first starts with your attitude and your drive to reach your goals.
Your mental outlook will determine the effectiveness of all of your marketing activities. The good news is that your attitude is something which you do have control over. Even if you have difficult personal and environmental factors acting against you, you still have a choice on how you decide to act. The way you look at your world is entirely up to you.
Practice marketing is ultimately an “inside-out job,” and though marketing includes “outside-in” activities, such as advertising, its success is dependent upon what is happening on the “inside.” On a scale of 1-5, where “5” is strongest, and “1” is weakest, you should work daily to reach a “5” on each of these eight attitudes.
At a team meeting every few months, you can hand this article out to each team member and have each person grade (1-5) how the office has been operating regarding each attitude. You can also have a team member summarize one particular attitude and describe it to the rest of the team in their own words. These attitudes are your marketing muscles that can drive and maintain your growth. Keep working them and making them stronger.
I have observed these eight attitudes in common with successful providers and business owners. I encourage you to use them yourself.
1. Friendliness and Cheerfulness. When you smile, the whole world smiles with you. And that is what you want: your whole community smiling with you. A positive and cheerful outlook opens the channels of communication between you and your community. It is an unspoken “open invitation” for people to interact with you. The happier you are, and the more positive your outlook is, the easier all other marketing efforts will be. “Laugh, and the world laughs with you; Weep, and you weep alone….” From a Poem by Ella Wheeler (1883)
2. Interested Attitude. Where I have been successful in selling and marketing services, this has always been my secret: be interested in the other person. Don’t fake it. Just start with whatever strikes your curiosity. You will find that having an honest interest in people is one of your best sales and marketing tools. People respond positively to sincere curiosity about them. “Betty, where did you find those blue shoes?” “So Frank, I have always wondered, why do you guys call yourselves the Kiwanis?” You don’t have to be interested in everyone. Be courteous and be professional, of course. But you’ll find that you can find something of interest in most people. Since your interest is genuine and not simulated, the other person can begin to trust you. You are not a phony operating off of a script. Even if your curiosity makes you seem a bit forward, at least you are honest. Behind your interest should be a desire to understand the other person, and this requires empathy. This kind of interest begets communication which lays the foundation for the other person knowing you, liking you, and trusting you.
3. “Get to Know Me” Attitude. You should want the community to know you. You should want them to know that you are an excellent provider and that your business gets results. Don’t assume people know what you do – or even care. Maybe they know you are a provider but think you are retired, or too busy and no longer taking new patients, or too important to talk to them. And let them get to know about you personally– that your dog’s name is Louie and you are not from Canada, even though you are very nice. Be willing to have the whole community know all about you, and believe that once they do, they’ll like you. Don’t hide. We all spend too much time in boxes – our houses, our offices, our cars, and other buildings. Get out of the boxes and be willing to be seen and heard. “It is better to be looked over than overlooked.” (Mae West)
4. “Gratitude Attitude.” This is a term often used by Zig Ziglar, meaning be grateful and appreciative. The “Gratitude Attitude” melts the ice between people. It shows respect and honors those around you, especially patients, prospective patients, your teammates, and of course, your family and friends. People hate to be ignored and too often we take for granted the amazing souls around us each day. Be thankful to be a provider and business owner and that you have an opportunity to help people. Show your gratitude to others. Let them know how you appreciate them. Count your blessings daily. “Gratitude is not only the greatest of virtues but the parent of all the others.” (Marcus Tullius Cicero. 106 BC -43 BC)
5. Service Attitude. Be a missionary on a mission to help. Be a giver. In the office, think ahead of what each patient needs each day and make sure they get it. Outside of the office, realize that people are in trouble, have problems, and want relief, so help them. Many are looking for answers. Offer information, community services, consultations, and be a “do-gooder.” Find out what people want and help them achieve it – through your services or another’s. It has been said that “The hole that you give through — is the hole through which you will receive.”
6. Big Capacity Attitude. “Whatever the mind can conceive and believe, it can achieve.” (Napoleon Hill.) Hold the concept that everyone in your community should receive your services. THINK BIG. Think abundance. Be willing to meet hundreds of new people each day and be open to scores of new patients. The mechanics of paperwork, finances, and procedure will all follow. Don’t let yourself become encumbered mentally by these things now. Get rid of the yellow light in your business and turn them all green. “Think little goals and expect little achievements. Think big goals and win big success.” (David J. Schwartz, The Magic of Thinking Big.)
7. Industriousness Attitude. Your outlook towards moving the business forward has to be a vigorous one. You must be ready to jump into the thick of things any time and get the work done. You will need a “can do, will do” attitude, one that enjoys being productive. It takes much more energy and effort to get and keep a business going than most people think. Marketing is simply physics. If you expend energy into your business and the community, there will be a reciprocal force — in terms of goodwill and new patients – coming back. Like planting seeds in the spring. You harvest what you sow. Don’t blame the politicians if the tomatoes didn’t come in at harvest time this year because you were too lazy to plant them. The more you sow, the more you can reap.
8. Have Faith, Confidence, and Belief. Be forthright and confident about the benefits of your profession, your skills as a provider, and the services your office can bring about. From this knowledge, you can be authoritative in telling your story and scheduling new patients. Know that you can help your patient. Believe and decide that they will win and you will succeed. If you are confident in what you are selling, then others will be too.
Edward Petty
Gratitude – Cicero
“Gratitude (being grateful and showing gratefulness) is not only the greatest of virtues, but the parent of all others.” -Cicero, 106-43 BC Italy
For a printable copy of this tent poster click: Gratitude- Cicero
The Sickest Generation and Back to School Programs
In late summer, many offices sponsor a promotion for children and their health. This is often in the form of a backpack check-up, scoliosis and posture check, or a school supply drive. The idea is to link the new school year with children’s health to better promote clinic services, generate new patients, and of course, improve the health of the kids.
It’s been my experience that these events are usually only marginally effective. Still useful, I feel that the real opportunity is being missed.
You could be getting more families under care. How?
Educate your families and your community on:
1. The results you deliver. How the outcomes you generate with children’s health are extraordinary. Use written and video testimonials and endorsements.
2. What you stand for. Today’s children face more challenges to their health than their parents. In fact, our children today are sicker than earlier generations. Learn about this and make it your anthem, a flag you wave. Stand up for the kids in your community, and you will earn respect and allegiance of parents. Be their guardians in health.
3. Provide special promotions and events. These could be workshops, screenings, or a special day of services with donations going to a local charity.
4. Alliances and Partnerships. It would be a good idea to create alliances with midwives, doulas, biological dentists, acupuncturists, and other professionals who share a similar concern and goal for healthier children. Invite them to participate in your events. Have them contribute a short article in your newsletter – in exchange, you could do the same with them in their newsletters. Create partnerships.
5. Schedule an event every two months, or every month. Never stop.
Your leadership, based upon your awareness of the health crisis facing our youth, is the primary element that will drive the success of your kid’s programs.
Read the following from the ebook, The Sickest Generation and follow the link below to the entire article, and other resources to become even more acquainted with the challenges the next generation of children face.
- American children have never been sicker. Over half (54%) are suffering from one or more chronic illnesses, with the late 1980s and early 1990s viewed as the gateway period that launched the decline.
- Many chronic illnesses have doubled since that time. The “4-A” disorders—autism, attention deficit hyperactivity disorder, asthma and allergies—have experienced meteoric growth, affecting children’s quality of life and contributing to premature mortality. The spike in autism prevalence has been particularly dramatic, with prevalence as high as 3% (one in 34 children) in some regions. Pediatric autoimmune conditions also are on the rise.
- U.S. children are far more likely to die before their first birthday than infants in other wealthy countries and life expectancy is falling, driven largely by rising death rates in adolescents and younger adults. Suicide is the second leading cause of death in teens, half of whom are reported to have at least one mental, emotional or behavioral disorder.
- The proportion of public school children using special education services is skyrocketing, with estimates ranging from 13% to 25% of school populations.
Sincerely,
Ed Petty
Children’s Health Resources
The following are some sources of information regarding the health crisis affecting our children.
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The Children’s Health Defense is a powerful organization that is on the front lines in fighting corporate propaganda promoting harmful drugs for kids. They have many lawyers, including Robert F. Kennedy, Jr., working on exposing false information and corruption regarding children’s health.
eBook Sign-Up—The Sickest Generation
Free eBook: The Sickest Generation: The Facts Behind the Children’s Health Crisis and Why It Needs to End Children are the key to a successful future and a prosperous nation, yet American children have never been sicker with a vast array of chronic illnesses. (Also available in Spanish.)
The Pharmaceutical Industry’s Front Men
By the Children’s Health Defense Team
The Medical Journals’ Sell-Out—Getting Paid to Play
By the Children’s Health Defense Team
Science Library
This database contains hundreds of peer-reviewed, published articles on environmental contaminants that are implicated in the rise of the childhood epidemics we are currently experiencing in the U.S. and other industrialized nations.
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Pathways is a long-standing publication with health articles that is free to members of the International Chiropractic Pediatric Association. Its website has links to many articles, a few of which are below:
Are We Making Our Children Sick?
http://pathwaystofamilywellness.org/Nutrition/are-we-making-our-children-sick.html
Natural Immunity
http://pathwaystofamilywellness.org/Informed-Choice/natural-immunity.html
Ear Infections in Kids: Natural Remedies to Ease Ear Pain and Enhance Function
http://pathwaystofamilywellness.org/Holistic-Healthcare/ear-infections-in-kids-natural-remedies-to-ease-ear-pain-and-enhance-function.html
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There are many books on children’s health, and it is fascinating to search to find them. Commit to buying at least one per month, reading it, reporting on it to a team meeting, and placing it in your Lending Library. Have your team members do the same! Here are three:
Books
A Compromised Generation: The Epidemic of Chronic Illness in America’s Children Paperback – September 16, 2010 by Beth Lambert
The Vaccine-Friendly Plan: Dr. Paul’s Safe and Effective Approach to Immunity and Health-from Pregnancy Through Your Child’s Teen Years Paperback – August 23, 2016 Paul Thomas M.D.
How to Raise a Healthy Child in Spite of Your Doctor: One of America’s Leading Pediatricians Puts Parents Back in Control of Their Children’s Health Mass Market Paperback – May 12, 1987
by Robert S. Mendelsohn MD
Tent Poster – Declaration of Independence, Congress, July 4, 1776
“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” Declaration of Independence, Congress, July 4, 1776
For a printable copy of this tent poster email us.
Tent Poster – In the Arena – Roosevelt
“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better.
The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.” ― Theodore Roosevelt
For a printable copy of this tent poster email us.
Tent Poster – 3 Constants – Covey
“There are three constants in life… change, choice and principles “
-Steven Covey
For a printable copy of this tent poster click: Constants-Covey
Tent Poster – Make The Best – Wooden
“Things work out best for those who make the best of the way things work out.”
― Coach John Wooden
For a printable copy of this tent poster click: Make the Best
Insurance Network Participation and Getting the Best Bangs for Your Buck
Have you ever . . . Wished there was an easy way to make sense of the array of insurance networks out there? Should I be in? Should I opt out? Here’s a guide for you and your staff to follow to help you decide whether pursuing a specific insurance contract, and staying in, is worth your time and investment:
First, determine which companies you are in network with. Do you have a contract? What are your provider obligations? Are you getting reimbursed what the contract’s fee schedule says it will reimburse? Do you have a profile set up with the national Council for Affordable Quality Healthcare (CAQH) universal provider database and is the information current, and reviewed quarterly? There is no charge to create and maintain your profile in this credentialing database.
Second, make sure you know if you are currently enrolled in Medicare and if you are a participating or non-participating provider. Are you also currently enrolled as a provider in your state’s Medicaid program?
Third, audit your patient demographic. Run a report in your practice management software. What percentage of your reimbursement is coming from insurance? What percentage is coming directly from patients? Which payers are you mainly seeing patients from? Are you finding that patients are requesting you be in network with a certain company? Who are the main employers in your area insured with? Are you enrolled as a provider with the Veteran’s Administration in your area?
Fourth, develop a spreadsheet called “Insurance Networks” to help you and your insurance department keep the information organized and up to date.
Once you have a grasp on the above, you’re ready to determine if you need to pursue network participation with additional companies. Treating this like a sales or business venture, you’ll want to have insurance companies coming to you and requesting you be in their network. Remember, it is to their benefit and their obligation to keep their paying policyholders happy. Patients should feel free to call their insurer requesting you be on their plan. Patients have done this, and outcomes have been successful. Why? Because the worst phone call an insurance company can receive is from an upset policyholder who can’t afford to see their favorite doctor who is helping them (that’s you!) because the doctor is not on the plan.
Things to consider prior to enrolling in a plan include:
- What is the reimbursement rate?
- What percentage of the approved charges are taken out for contract discounts?
- Is there a fee to join?
- What are your provider obligations?
- Do they want you to participate in their workers compensation, PI programs? (In our experience, opting in to the WC and PI products means no steerage to you, and cut reimbursements).
- Are there pre-authorizations required prior to care? Is there a visit limit?
- What is the initial credentialing and re-credentialing process?
Now, you are on all the plans that are making your pocketbook and your patient happy. What do you need to do to maintain your in-network status? You will need to notify a payer with updated clinic information anytime there is a change in information you submitted at enrollment. This includes phone number change, address change, adding a new provider to the office.
You will also need to make sure you are tracking re-credentialing timeframes for each insurance company. Typically, the recredentialing process for commercial payers is every three years but since your enrollments with each payer fall on different dates, your re-credentialing due dates will vary. Your Medicare re-credentialing is every five years. Re-validation with Medicaid programs is typically every three to five years, depending on your state’s standards. For example, it is every three years in WI and every five years in MI. Many of the larger commercial payers such as Blue Cross, Humana, United Healthcare/Optum Physical Health, use CAQH to approve your re-credentialing. Those who do not will send a written communication via mail or email letting you know your recredentialing is coming due and will include the applications and instructions. Make sure to track these dates in your insurance spreadsheet.
We’ve just touched the surface of network plans and credentialing. Email me for assistance with how these processes work for your practice. You may reach me at lisa@pmaworks.com
Happy Credentialing!
Lisa
“Increasing your collections through better billing and documentation”
The Best That Ever Was?
Just imagine… imagine that you have SO many patients that you need to move to a larger office to accommodate them all.
A few years later, once again, you are seeing more patients than your office can hold, so you build the office of your dreams – a custom designed 19,000 square foot clinic. And the patients keep coming, so you bring on other doctors. Some days, you and the doctors see 600 visits.
Since patients travel to see you from all over the world, you build a motel next to your office. You also set up a limousine service from the nearby airport to your office.
Could you do this?
Clarence Gonstead did. Here, in Wisconsin, from the 1920s to the early 1970s
What made him so successful?
He was an expert. He was a master at his art. He was committed and focused on his craft and his outcomes.
A founder of a chiropractic college would later say that Dr. Gonstead was not a “commercial chiropractor.” He didn’t focus on management or marketing – just chiropractic. (As a management consultant, I can only wonder how expansive his operation would have grown had he had managers as dedicated and competent as he was!)
He was focused on results and said: “Our future will be our results.”
According to people who have studied exceptional performance, there are definite ingredients needed to become an expert, all of which are available to you. And by the way, “natural talent” is not one of them. Let’s look at each one:
- Deliberate practice.
- Coaching and training.
- Commitment to being an expert.
- Support from family and friends.
- Deliberate Practice. Knowledge is fine, but it is skills that are needed. Skills are acquired through a specific type of practice, which Anders Ericcson calls “Deliberate Practice.” This is not just going through the motions of hitting a golf ball, for example, if you are a golfer. It is going beyond your comfort zone and making mistakes and learning better methods.
- Coaching and Mentoring. Ericsson points to Tiger Woods for an example of the importance of coaches and mentors. Tiger’s father, Earl, an avid golfer himself, was a teacher of young boys and had a passion for sports. He started training Tiger at an “unthinkably early age.”
- Commitment. It is obvious but often overlooked, that to be an expert, you must want to be one. Deliberate practice and study require work and is not comfortable. Tiger used to train 13 hours a day, according to one of his coaches, Hank Hanley. (Golf Digest)
- Support from Family and Friends. Support can bolster individual efforts to succeed. Tiger’s dad was Tiger’s champion, as was Brett Favre’s dad, Irv, the famous football quarterback. Parents, spouses, and friends can play a major part in helping to bring about expertise in others.
It doesn’t matter what method of adjusting you use, or if you are a dentist or a chef or a cello player. It does matter if you are an expert. Achieving a high level of skill is not always fun or easy, but the rewards are worth it.
Tiger Woods was recognized as the world’s top-ranked golfer in the first 10 years of the 21st Century. He then fell into a slump with domestic issues and physical injuries. But with continued training, he came back to win his 5th Master title and 15th Major title at the Augusta National Golf Course just last weekend! (By the way, Tiger also praises chiropractic for his success!)
I have seen the ads, and I am sure you have as well, on how you can be a laptop chiropractor, travel the world, and make “six figures.”
I love the Internet and laptops and do travel the world and have nothing against being wealthy. But you are a doctor, a provider of service and outcomes, and if what you deliver is not exceptional and extra-ordinary, then the world will pass you buy.
There has been a great “shake-out” occurring in commerce. We have seen it happen with retail – where now the Internet and Walmart dominate. The store on Main Street is shuttered. This will be happening to the service industry as well. Only the very best will survive. Don’t fall for schemes that promise to get rich with easy effort.
What should you do?
You should become the best in the world.
You should work tirelessly, like Tiger Woods and Clarence Gonstead, to become the world class masters.
And as Clarence Gonstead said,
“Practice. Practice. Practice. Never stop.”
Sincerely,
Ed
PS
If you have the time, I encourage those of you who use Dr. Gonstead’s method, and even those who don’t, to come by his clinic in Mount Horeb and listen to some of the stories of those who worked with him directly.
And especially… bring your team.
“My Time with Clarence Gonstead DC”
4 Speakers who Learned and worked with Gonstead
Time and Place
- Friday, April 26th, 6:30 PM (Free!)
- Gonstead Clinic of Chiropractic
- 1505 Bus. Hwy. 18-151 E, Mt. Horeb
- (608) 437-5585
Also, during the weekend, the Gonstead Methodology Institute is sponsoring a “GCSS Knee Chest Extravaganza.”
Tent Poster – Tenacity – Pasteur
“Let me tell you the secret that has led me to my goal. My strength lies solely in my tenacity.” – Louis Pasteur
For a printable copy of this tent poster click the link: Tenacity – Pasteur
Tent Poster – Work Play – Toynbee
“The supreme accomplishment is to blur the line between work and play.” -Arnold Toynbee
For a printable version of this tent poster visit: Work Play – Toynbee
Trizetto Moving to the Cloud
I wanted to pass along the following communication from Trizetto to help you with a smooth transition.
Please share it with your insurance and billing team so they can plan accordingly. Remember, claims will not go, and EOBs will not be accessible during the time-frame of 11:59 p.m. CST on March 14, 2019 until approximately 11:59 p.m. on March 17, 2019.
If you are not a Trizetto/Gateway EDI client, you can disregard the information below.
Sincerely,
Lisa Barnett
“Increasing your collections through better billing and documentation.”
=====================
Important Message from Trizetto Electronic Claims Submitter
RE: Microsoft Azure® Migration
Dear Valued Client,
In order to ensure the most secure, reliable and highest performing platform for our services, TriZetto Provider Solutions, a Cognizant Company, will migrate data from our St. Louis data storage facility to the Cloud-based Microsoft Azure® platform.
Why Are We Migrating?
A cloud-based data center will align data transport security protocols to industry standards while also providing significantly enhanced information security and opportunities for growth. We believe the benefits of this migration far outweigh the costs, and that our clients will benefit greatly from this transition. Benefits include:
- Increased speed
- Consistent, reliable storage capabilities
- Higher levels of security
How Will Your Organization Be Affected?
The transition of data will have a direct impact on our clients. Because of the migration, clients will experience an extended outage starting at 11:59 p.m. CST on March 14, 2019 until approximately 11:59 p.m. on March 17, 2019. During this time all applications will be inactive and no incoming transactions will be accepted for processing.
TPS is working diligently to ensure a seamless transition. We have chosen to put this project into effect over a weekend to minimize impact to our clients. We apologize for any inconvenience this may cause.
If you have any questions or concerns, please reach out to our customer service team at 800-556-2231 or physiciansupport@cognizant.com. Thank you for your patience and support during this time.
-TriZetto Provider Solutions
Goals, Games, and Groundhog Day
It is a New Year and already we are knee-deep in its work.
But it is a NEW YEAR and it is important that you take time out to make new plans and then review them often.
Life Works in Cycles
Each year in Wisconsin, the leaves fall and then the snow falls. But by July the strawberries are ready for the pickin’. Every month, we can see the full moon. Each day, we can see the sunrise – if it is not cloudy.
In human endeavors, we seem to follow this natural rhythm of following cycles. After we finish the 9th grade, we are ready to begin the 10th grade. We are excited to finish when we get out of school for the summer, and then again, eager to start the new grade when we begin again in the fall.
These are all cycles.
What would happen if you stayed in the 9th grade, year after year? How would you feel?
Yet, in our work life we fall into the trap of doing the same thing over and over and over. This is not the first unique and special patient you have ever seen…this patient is a customer just like all the others — just another case. Today is not the first day of the rest of your life, it is just like yesterday which is the same as a long line of days that go on and on. And on…
We get beaten down by the tedium, working endlessly for some forgotten purpose, as if the assembly line we were on never stopped and was always the same.
This is a major cause of stress.
Groundhog Day Syndrome
You can’t do one thing forever, like in the movie “Groundhog Day.” In it, the main character visits a town in Pennsylvania where everyone watches to see if a groundhog can see its shadow. This is traditionally on February 2 (This year, it is on a Saturday.) The only problem is, for this character, the day keeps repeating and repeating, the same each day. It drives the character to suicide, but even that doesn’t work. Finally, he falls in love and wins the girl and has a new life.
Anything in life that begins, it seems, must end. It can start again, but it must end so that a new iteration can be created. It is the cycle of life.
Goals and Games
This is an important factor in what is called Gamification. With the advent of computer games, design elements are added in to make the game fun, challenging, and motivational.
But games are nothing new. Baseball is a game. It has a season and games and innings. It has cycles. Games have been part of human behavior since the beginning. The Olympics started in 776 BCE.
One aspect of games that can be overlooked is the fact that they are just an activity for play. Play is something we do naturally as toddlers. As we grow older, this activity becomes structured into organized sports and games, but at the core is the desire to have fun. To play.
We can lose this sense of play when what we do has no end and no beginning. Persistence is a good quality, but it can lead to an enforced dullness that buries our enthusiasm.
It is important to keep in mind that in business, as in sports, keeping the perspective of play is more effective than bearing down on one’s duties with serious gravity. Practices that incorporate some of the components of a game into their operations are more productive and have a better time.
What are your goals for 2019? For the 1st Quarter? For this month… or for today? Higher numbers? New team members? Community wide outreach program? New training and greater knowledge?
As soon as you make a goal, you start a new cycle and begin a new game. Try to win. But you could lose. Either way, don’t get too serious about it and just be grateful to be able to be in the game.
Set new goals and play. Play — to win. Have fun. Smile a little more!
Health Account Savings Plans: Assisting Your Patients To Stay on Their Treatment Plan
Welcome to your best chiropractic year!
Commercial health insurance carriers such as United Health Care and Anthem BCBS can offer their customers, who are also your patients’ employers, two different health account savings options:
- Health Reimbursement Arrangement
- Health Savings Account
An employer can also directly offer the benefit of their employees signing up for a Flexible Spending Account.
Let’s dig into each one!
What is a Health Reimbursement Account? (HRA)
A Health Reimbursement Account (HRA) is an account that your patient’s employer funds to help the employee pay for covered healthcare services. The patient cannot put monies into an HRA, as the account is owned by the employer. This includes paying for services (chiropractic office visits) that apply to the patient’s deductible. The patient can begin using their HRA on the first day of the plan year. Since the patient’s employer controls the fund, the employer has the ability to make the rules on when and how the patient can use the money. Additionally, there are coinsurance-only HRA plans available, whereby the patient’s employer will pay only coinsurance amounts.
The patient does not have to pay taxes, state or federal, on HRA monies, so it is a tax savings. The HRA cannot earn interest as it is not a personal bank account.
How do you, Doctor, get paid? Once claims are submitted to the insurer, the insurance carrier will pay, as long as the patient has funds in the account. You will typically, but not always, receive two EOBs/remittances for the same DOS. This is usually due to that first charge going to the patient’s PCP and then getting denied and forwarded to the employer. Referrals from the patient’s PCP to your office is not a requirement tied to an HRA.
There is only one account set up for all covered dependents on a plan. The employee does not report the HRA monies to the IRS.
Takeaways:
- Get in good standing with your community’s businesses and industries so chiropractic can stay included on their coverage and benefits, and you can get those referrals!
- Billing Tip: Make sure you are posting to the most recent, newest remittance.
Health Savings Account (HSA)
A Health Savings Account is a savings plan set aside for taxpayers who enroll themselves in a high-deductible health plan. They can be offered by your patient’s employer as an employee benefit, or the patient may elect to sign up independently. The benefit here is that the funds are not subject to tax liability upon deposits. Moreover, if there are monies left in an HSA, they can roll over into the next year. When your patient’s health plan offers this type of plan, they are provided with a debit or credit card to make their eligible health service purchases. Both the patient and their employer can contribute to the fund. The patient must report this account to the IRS when they do their taxes.
Takeaway:
Health Savings Accounts are not owned by the patient’s employer. All taxpayers with high-deductible health plans are eligible and must report this account to the IRS when doing taxes.
Employer-based Flexible Spending Accounts (FSA)
An Flexible Spending Account is a special account the patient puts money into to pay for certain out-of-pocket expenses such as medical related, dependency related, and a limited dental and vision plan. This arrangement also has a tax-free benefit. The list of all eligible expenses can be found on the IRS website at: https://www.irs.gov/newsroom/irs-plan-now-to-use-health-flexible-spending-arrangements-in-2019
The employer owns this account.
A frequently asked question I get is, does an FSA cover massage?
Answer: Yes, it does with the ordering physician (chiropractors included) writing a note of necessity for the massage therapy.
When there are monies left over in the account at the end of the year, the employer has two options they can offer their employees:
- The patient can set aside the monies and use it up to two-and-a-half months into the new year, or
- The employer can allow the employee to carry over up to $500 from one year to the next.
Takeaway:
There are several eligible out of pocket expenses that an FSA will cover. Click on the IRS link for more information: https://www.irs.gov/newsroom/irs-plan-now-to-use-health-flexible-spending-arrangements-in-2019
SUMMARY
If your patients struggle to keep their appointments due to financial concerns ask them if they have one of these savings accounts that might be able to supplement payment of their care and keep them on their treatment plan.
Oh, one further heads-up to our profession just finding its way down the pipeline . . . you may have or will be receiving a letter from a TriWest Family Alliance group out of Arizona promoting their billing services on behalf of VA offices. This letter is being distributed nationwide. Please note we have researched this, and credentialing and contracting with this group is optional. If you already have a contract with your VA, you may continue treating VA patients as usual. There is no change in their referral of patients to you, or the preauthorization process.
If you have any further questions, don’t hesitate to reach out to either myself or Dave.
Please feel free to forward this article to your insurance department.
Adios for now!
Lisa
“Increasing your collections through better billing and documentation.”
Tent Poster – A Good Conscience – Franklin
“A Good Conscience is a continual Christmas.”
For a printable version of this tent poster email us.