Tag Archives: michel

AMA Releases New Reimbursable CPT Code Relevant to Chiropractic During Pandemic

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Here is some new information from our insurance expert Lisa.

Th AMA just released CPT Code 99072 which is relevant to chiros for the reimbursement for cleaning supplies, hand sanitizers, wipes, sprays. ect.

To read the article of the recent release please click here CPT Assistant Guide Coronavirus Sept 2020

What we know:

99072 is a special services billing code, used for additional supplies, materials, and clinical staff time over and above those usually included in an office visit or service.  The code captures practice expenses during a Public Health Emergency such as:

  • Checking patients for symptoms upon arrival
  • Time involved in applying/removing PPE
  • Performing additional cleaning of exam rooms, equipment, supplies
  • Three surgical masks
  • Cleaning supplies such as hand sanitizers, disinfecting wipes, sprays, cleansers.

FAQ

Q:  What is the reimbursement for this code?

A:  Reimbursement information is not available at this time.  We will continue monitoring future communications regarding reimbursement.

Q:  When is this effective?

A:  Immediately.

Q:  How much should I charge?

A:  This all depends on what you paid for the supplies, what you pay your staff per hour, and taking into account how much time you spend on the additional activities.  Our estimated calculation comes out to around $4-$5 per billing encounter, but this is an example estimate.

Again, we will post more information relevant to chiros as it becomes available.

Questions in the meantime?  Email Lisa at lisa@pmaworks.com.

Sincerely,

Your Allies and Advocates at PM&A

Do You Want More New Patients? Use a Checklist! Here is How.

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Around the year 2000, I published the Marketing Manager System. It was initially a series of binders (3) to help chiropractors with their marketing. I received many compliments and positive reviews from both doctors and staff on how it helped them. Palmer Chiropractic College ordered a few hundred of the binders.

A couple of years later, I converted it into a software program and sold it as a CD package you could install on your computer. After a couple of years, I had to shelve the product. I was not set up to stay current with the constant changes in both software and the Internet.

Still, the information is sound, and it continues to work. Much of it is on our PM&A Member’s site, and though the graphics are somewhat outdated, the fundamentals still apply.

One of the motivations for publishing the Marketing Manager System was to solve a simple marketing challenge almost every practice we worked with had. In fact, the problem was so simple that it is almost embarrassing to explain.

We would get a call from an office requesting “something” to “get their new patients up.” “Got an ad that is working?” would be a typical request.  And we would often hear this after working out an effective marketing plan that had been working for months at generating more new patients.

“What happened to your new patients? They were doing very well, even increasing,” we would ask. But when we checked if they were still implementing the marketing plan we had worked on, the usual answer was “no.”

We would go over the action steps on the marketing plan with them. “Are you still doing X?”  “Umm, no, guess we forgot about that.”  “Are you still doing Y?” “Oh yea, well, the staff member in charge of that took on another role so she couldn’t do Y anymore.”

You get the idea.  What worked gradually gets abandoned.

So, I came up with the Marketing Checklists. These were a comprehensive list of marketing procedures, several hundred all told. They were a compilation of marketing procedures that we had used or had seen others use effectively. The idea was that by using the Marketing Manager System, the office would put together its own customized marketing checklists using ours as a template and reference.

This brings up the subject of checklists. In 2009, a surgeon named Atul Gawande wrote a book about checklists called The Checklist Manifesto. Here is a relevant section from his book:

“What is needed… is discipline. Discipline is hard — harder than trustworthiness and skill and perhaps even than selflessness.

We are by nature flawed and inconstant creatures. We can’t even keep from snacking between meals.  We are not built for discipline. We are built for novelty and excitement, not for careful attention to detail. Discipline is something we have to work at.

Good checklists, on the other hand are precise. They are efficient, to the point, and easy to use even in the most difficult situations. They do not try to spell out everything–a checklist cannot fly a plane. Instead, they provide reminders of only the most critical and important steps–the ones that even the highly skilled professional using them could miss.

Good checklists are, above all, practical.”

By the way, I cover this in my new book, the Goal Driven Business scheduled to come out in early 2021. I have learned how to make these checklists more practical and, well, Goal Driven!  (I plan to update all of the Marketing Checklists into their new Goal Driven version next year.)

So, from the archives stored away since 2000, enclosed is one of the 13 marketing checklists from the Marketing Manager System. This one is on Patient Referrals.  It lists just a few procedures you can use to help generate more patient referrals. Of course, there are many more, and I recommend you make your own checklist and review it every 3 – 4 months.

And that is the key: keep marketing procedures that are working – working.

To help you do this, list them on a checklist and review the checklist regularly to ensure that they are still occurring. Use the checklist like an assessment. Look at each successful marketing action and ask: “Did this get done all the time, some of the time, or oops! Hardly at all.” Make sure all marketing duties are assigned. Then, where needed, improve them.

Stay Goal Driven and help your patients do the same!

Ed

Download the The Marketing Checklist on Patient Referrals.

Momentary Affluence — or Is the Tide Turning for True Health?

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Over the last few months, we have noticed that offices have continued to grow – some even breaking their previous records!

Why is this?

I have heard from doctors and office managers that patients may be hesitant to visit medical offices and prefer seeing chiropractors, acupuncturists, and other health-oriented offices instead. Are they just afraid of the COVID at medical centers, or are they truly seeking to improve their health and immune systems?

What have you heard?

I am going to guess that your practice is filling back up as well.  What should you do to augment your growth, sustain it, and even increase it?

RETENTION AND REFERRALS

You want to think about retention and then generating more referrals – from patients and from community members. Consider the following:

  1. First, don’t take this growth for granted. Each patient is unique and special and important. Provide world-class service and deliver world-class outcomes. In the end, this will ALWAYS be your #1 marketing tool.
  2. Educate. I can’t stress this enough. Please… Inform While You Perform. Factual information is one of the reasons patients see you. You are independent. Your strings are not pulled by Merck, Pfizer, or WHO. You can refer patients to information on your services, on Vitamin D, Zinc, and yes, Quercetin. They can trust you for the unedited and unspun truth about health.
  3. Communicate. Newsletters, workshops via Zoom, or in the office, outdoor events (staying in compliance with local ordinances – as you see fit!) – keep the conversation going. Maintain and improve the relationship with your patients.
  4. Capacity. Do you need another provider? Another team member? Don’t overextend yourself, but also, don’t stand in the way of your growth.
  5. Partner with other providers and businesses. Medical doctors are discovering that health solutions they have for COVID are being suppressed. The braver ones are speaking up. Doctors of all kinds, now more than ever, can share the same goal and help each other overcome similar challenges. Businesses as well, want practical solutions for their employees.
  6. Make a List. Make a list of patient retention and referral generation procedures that have worked for you and review them often. In upcoming newsletters, we will brush off some lists from our old Marketing Manager Systemsm that has hundreds of marketing procedures. You know many of them, but it always helps to be reminded!

You can also take your marketing a step further…

IT’S NOT WHAT YOU SELL, IT IS WHAT YOU STAND FOR

As a more aggressive approach, you may want to be more vocal in promoting better health in all its aspects, from what we eat, breathe, to the kind of health care we seek.  In this regard you could take on the role of Health Rebel, or even Health Outlaw!

Your unique selling principle (USP) should include your noble purposes that sets you apart from comparable alternatives.  Consumers are looking for businesses that take responsibility for social and environmental issues. And, according to several studies*, this is especially true for the younger generation – Generation X – those born in the 1990s. Speaking out for better health in your community and against toxic pollutants, for example, is not only a noble purpose but – if genuine, has practical marketing benefits.

There really are two sides in our health culture – one for optimal natural health of the planet and of our bodies, and the other as advertised by corporations.

Your community is bombarded with thousands of advertising messages each day, many of them promoting drugs and COVID hysteria fears.  Advertising is a form of population control, which is an advanced science, and which may be used increasingly to motivate your community to consume more vaccines, including for COVID.  Yale University, as reported by Mercola, is testing advertising messages to shame, embarrass, anger, and otherwise motivate people to take the vaccines.

And the campaign has already started. According to USA today, it is patriotic to get vaccinated.

And it is not just the push for vaccines. Corporate medicine has been discrediting natural health remedies, including chiropractic, nutritional supplements, and certain medical practices such as chelation for years.  And outside of health care, we can see advertisements for the cancer-causing Roundup (with glyphosate), “foods” with toxic ingredients (e.g. aspartame), and the suppression of information about mercury, hexavalent chromium (as in the movie Erin Brockovich), and other toxins currently in our drinking water.

This is really your time. This is a contest for health independence from corporate tyrants that have set up laws to escape liability for their actions.  But those of you in the chiropractic profession are used to the fray. Now, you are not alone. Other doctors are also experiencing suppression and personal and professional retaliation and are joining the fight.

The sales of organic food and supplements continue to increase. And based upon your practice returning to pre-COVID levels, the tide just may be shifting towards true health.

But only with all of our help.

Helping you to help more people,

 

Ed Petty, and all of us at Petty, Michel, and Associates

Tent Poster – Castles in the Air – Walden

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“I learned this, at least, by my experiment: that if one advances confidently in the direction of his dreams, and endeavors to live the life which he has imagined, he will meet with a success unexpected in common hours.  … If you have built castles in the air, your work need not be lost; that is where they should be. Now put the foundations under them.”         

Henry David Thoreau Walden

For a printable version of this tent poster click: Castles in the Air-Walden

New ABN Form Released – Effective 8/31/2020

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The Centers for Medicare and Medicaid Services(CMS) recently released a new ABN Form.

The ABN, Form CMS-R-131, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal.  The use of the renewed form with the expiration date of 06/30/2023 will be mandatory on 8/31/2020.  We are including the links to the forms for your convenience and they can also be viewed at the CMS Web-site. 

In addition to the expiration date on the form, there are a few other minor changes.  If you have further questions please feel free to contact Lisa at 920-334-4561.

Take the Middle Road and Educate.

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“In other words, people may be dying for the need of Chiropractic, and yet they will refuse, unless they have been educated to its character and their need of it.”
B.J. Palmer (The Story of Selling Yourself)

I try to visit Facebook at least once a week. When I do, I sometimes see posts by others labeling the behavior of the public as “sheeple.” The term, I guess, refers to people acting obediently like sheep. The context usually includes those who believe that COVID-19 is a scam and view people who wear facemasks and observe CDC rules for quarantining as weak and stupid, and easily manipulated.

There certainly are indications, as well as precedents, that can support this view. The promotion of potential threats to generate fear has often been used to motivate people. Think of all the weapons of mass destruction that we were told Iraq had – which they didn’t have — that justified a 3 trillion-dollar war (estimated, Wikipedia) to the U.S. alone—not counting up to 400,000 killed. Someone made money off that scam.

There are over 100 cataloged types of biases, and we all have our own odd fears and weird ideas. Included with this is our basic “I-am-right” mechanism that makes others wrong and emboldens our ego.

Recently, I was talking to someone on their speakerphone while they drove in their car. They were wearing a mask and their voice was slightly muffled. I thought to myself that it was odd to talk to someone who was wearing a mask while in their car. Then, I was reminded that the person I was talking with has unselfishly devoted his entire life to taking care of his severely health-compromised daughter.

We all have our own stories and fight our own battles – with the best knowledge we have.

Another method to control people is to dissuade them from education and from learning to think critically and question authority.

So, I invite you to consider this as your #1 duty as a doctor – and as support staff — to educate your patients and community. Doctor, after all, means teacher.

People do not know what you know.

Perhaps they don’t want to know, are too tired, or seem too lazy to make an effort to learn. Maybe they have already made up their mind, and their view reinforces their own identity. But don’t give up on people — they are part of your family. They are your brothers and sisters.

Use newsletters, social media (even Facebook!), webinars, and especially Table Talk.

Educate because you care for people. Market your services from an attitude of compassion.

We are not sheep. We just don’t know. And regardless of what we say, privately, we look to you and your integrity — for your wisdom, your help, and your friendship.

Ed

The Story of Selling Yourself by B.J. Palmer

Keep putting your business THERE

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A tree withstands storms but continues with its systems.

Just a note here about procedures:

Keep the structure of your business – its policies and procedures — in place. As much as you can, stick to your usual routines.

Certainly, you want to integrate needed changes to prevent the spreading of the virus. And obviously, for many of you, patient volume has changed, so you may have to adjust your work hours and staff hours.

You do need to be flexible. Improvise — where needed, adapt, and overcome! (Paraphrase of Marine slogan!)

But do not let the virus be the tail that wags the dog!

Keep the recalls going. Keep the billing going. Hold staff meetings, if only by Zoom. Rally the team! Review numbers and SET GOALS. Give staff study assignments. If anything, increase your patient communication 5 times – or more.

Strengthen your network.

I bring this up as I have seen a few offices start to slack off on their procedures, and while this is understandable in many situations, it can be a slippery slope. This can set a precedent for neglecting other procedures. This is what leads to office anarchy and what I call “Procedural Atrophy.”

Procedural Atrophy is the gradual dropping out of procedures. For example, you used to call every new patient after their first adjustment and send out birthday cards. Then, you became so busy that you “didn’t have time” to do the calls or to makes sure the staff sent out birthday cards. Two years later, you wonder what happened to all your patients.

We are NOT victims. We will respond positively and use this opportunity to strengthen our resolve and our health network.

Hold true to time tested procedures during unusual conditions.

Stability breeds confidence. Your patients are looking to you to be the rock that they can count on.

Management’s job is to hold the structure of the organization in place. (And then improve upon it.) It may have to be abbreviated, economy of time, effort and money come into play, but … do the usual. Set your goals and stick to your successful procedures to reach them.

Do this, and after this storm passes — your business will be busier than ever.

Working now for the future,

Ed

Time to See the World and Your Future Anew

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See the Word AnewI have been in touch with most of you and, for the most part, you all are doing relatively well during these days of COVID-19. Of course, the keyword here is… relatively.

Whatta time, eh? Historic, that is for sure. It will change our society and our world as nothing has since, perhaps, WW 2.

The Lighthouse in the Storm

Your role, right now, is so very important. Perhaps more than you know.  Your patients have fears, questions, and doubts. Their parents could contract COVID, perhaps they could. They are out of work or soon will be, and there is the apprehension that all of this is a government plot towards totalitarianism.

With all the communication regarding our current situation, you have to remain as a calm source for sound, researched data that provides comfort and solutions. You will have to be a lighthouse in this storm.

YOU are independent. You do not work for a drug company, and you are not beholding to a boss that works for a hospital or a government agency. Therefore, when patients come to you with worries and questions, they trust that what you tell them is unadulterated, unbiased, and accurate information.

And even more, they hope that you genuinely care.

Time to See the World Anew

In some sense, the world is experiencing a big “Time Out.”

Perhaps we can all take this time to become closer to our families and friends. My daughter is cooking more, my son is homeschooling his kids, and I am practicing guitar tunes from my old 1960’s book of folk songs!

I notice on my walks and runs that here, in Milwaukee, the air is fresher, cleaner, and the sky is bluer. Less smog from our southern neighbors and nearby freeways and overhead airplanes. The difference is striking and one can only imagine what we have been breathing in all this time!

It is spring, you have a family and friends, and you have your own self. COVID-19 doesn’t change this.

Good to Great: Redesign your NEW Business.

But what I am most looking forward to is the NEW.

Right now, you have a unique opportunity, during this temporary slump, to reimagine and redesign your business.

You’ve had a good, perhaps a very good business before. But as Jim Collins explains in his book, Good to Great, good can be the enemy of great.

The Good is now the Old, and we have this moment to review our goals and engineer better pathways to them.  Now, you can create the Great!  This will be your new version of your business based upon all you have learned as a professional and as a business owner or stakeholder. This new version can be your best creation ever.

Over the next few months, we will be discussing this, and I and all of us at PM&A, look forward to helping you and your team create the business of your dreams.

Looking forward to the future,

Ed

PS Happy Earth Day!

Thank You, Essentials

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Petty Michel and Associates Thank the Essentials

(image from the movie Troy, with Brad Pitt playing Achilles, a Greek warrior. Reddit)

You and your team may not recognize this, and the word hero is overused, but in our book, this is what you are. Heroes.

Caught up with dealing with the urgencies of the times, you and your team may overlook the crucial and significant role you all play in raising the level of physical and emotional health of your community.

Without you, people in acute pain might tax critical and urgent care resources. Without you, patients on corrective or maintenance care might fall back into acute care.

You help alleviate our pain and improve our health – including our immune system.  You calm our concerns with your well-informed insight and give us action steps to improve our health.

Health, as we know, is dependent upon mechanical, chemical, and emotional factors. Besides your adjustments and therapy, you provide education – and reassurance that this pandemic will pass.

I hear about it every day. You risk your health to help others, both physically and mentally.

Let your team know the vital role that they are playing.

Years from now, when asked what they did during 2020 Pandemic, they will be able to say that they were Essential Health Care Workers — and didn’t flinch.

And we just wanted to tell you – very sincerely – THANKS!

From all of us at Petty Michel and Associates.

Fight the Nocebo Effect

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Knowledge is your lighthouse.

I am sure that all of you are trying to stay up with unfolding events regarding the virus and the governmental recommendations – and enforcement — to deal with it.

We are, as well.

I am sending this email out to encourage you to watch an informative video by Del Bigtree, who reviews the facts and numbers of the virus pandemic. It is a bit long, so I am sending this out this weekend in case you have more time to watch it.

I have also included an article by Bruce Lipton. Dr. Lipton is a cellular biologist who taught medical students at the University of WI medical college and often speaks at chiropractic seminars.

Plus, an article that states 99% of those who died from the virus had other illnesses.

(Links below.)

We must watch out for the GENERALITY of the virus. For example: “COVID-19 could kill us all!” “Who says?” “They do.” “Who is “they.””  “The authorities.”  “Who are the authorities?” “Those who are in charge.” You have to break it down and be as logical as you can.

I recommend that you review these sources, add to it what you are learning, and using your best judgment, continue educating your team members and patients/members/clients! 

Be the lighthouse in your community.

Education and knowledge displace fear and uncertainty.

Let’s eradicate what Dr. Lipton calls the “nocebo” effect — the opposite of a placebo.

And let’s continue our fight to help people get healthier!

Keep educating,

Ed

By the way, no one is saying you must close your office.  Even in California where San Francisco has a “Shelter in Place” or strict quarantine.  For example, the California Chiropractic Board of Examiners, on their website,  states:

  1. Should My Practice Remain Open?
    The Board does not have authority to close businesses or practices solely as a result of COVID-19.

YOUR SERVICES ARE VITAL!

The Exec. Director of the Kansas Chiropractic Association, in a letter to their state Governor (March 20, 2020), stated:

“We understand that with the severity of the current pandemic hospital emergency rooms may soon be filled with patients complaining of pulmonary symptoms. We offer our services in diagnosis and treatment of musculoskeletal complaints presenting to emergency rooms. Many Doctors of Chiropractic have arranged to be a referral point for their local emergency rooms on these conditions.

“We are prepared to see these patients in our offices that are already taking every precaution available to prevent the transmission of COVID-19.”

 

REFERENCES

Del Bigtree   Coronavirus Quarantine  March 19

Bruce Lipton Cornonvrus 2019-Covid-19 UPDATE

Bloomberg News March 18, 2020   99% of those who Died From Virus Had Other Illness, Italy Says

Use Your Voice!

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Using your voice to help others.

(Painting by Norman Rockwell, 1943)

When you engage in work that taps your talent and fuels your passion  –  that rises out of a great need in the world that you feel drawn by conscience to meet  –  therein lies your voice, your calling, your soul’s code. (Stephen Covey)

 

For many of your patients, it may be difficult to tell how far to take precautions regarding COVID-19. Who can your patients turn to for a frank conversation and useful information?

Somewhere there is a middle ground between stockpiling hand wipes, toilet paper, and hiding in your bedroom and showing up at the gun show for a family barbecue and square dance. People are looking for reasonable answers without feeling that they are fearfully overreacting, or pridefully underacting.

You have to be that middle ground – and you can be. You do not have a boss that is beholding to Merck, or a company whose board members belong to the AMA. You are independent.

Use your voice and be a source of reason and information. Get in the conversation. You are only beholding to your patients and your community. They know your kids, and you know theirs. You are honest, thoughtful, and know that we are all in this together. You will ask your patients for their best advice on plumbing, cars, taxes, and other life needs. They will seek your advice regarding the best health for themselves and their family. You rely on them, and they rely on you – this year, now, and in the years to come.

Now is not the time to cocoon – not for you. Now is the time to speak up – to stand up.

Keep your practice open, but if not, keep communicating. Aside from seeing your patients in person, you can consider other activities that do not require face to face encounters:

  • Use email and social media to promote health tips.
  • Schedule webinars for health tips.
  • Set up video or phone consultations. 15 minutes, $45 – $100. Send follow-ups and include in patient files. Offer discounts for patients who need it.
  • Staff and doctors call patients for courtesy consultations. See how they are doing. Give them advice. Schedule them for an appointment as needed.
  • Sell supplements at a discount if you can. (Suppliers may be backlogged.)
  • Let us know about other outreach services you are providing!

You are a doctor – an educator, a leader. This applies to your team as well – they, too, are leaders and educators. Your community needs you now more than ever. Years from now, it will remember who was there, who stood up, who helped.

Use your Voice! Download the Poster Here

Always communicating,

Ed

We, too, are here to help.

Has the Coronavirus Affected Your Practice?

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How has the Coronavirus plague been affecting you and your practice…so far?

Most offices I talk to across the country seem to be doing just fine, thank you!

I ran across  an interesting thread on a social media site for chiropractors and as a limited sample survey of how other offices are being affected, most report that they are also doing well.

I want to add a few thoughts from a marketing vantage point that might help. I am sure you are following the clinical aspects of this virus, but I have links below to articles from Bruce Lipton, Ben Lerner, and Joe Mercola that are very informative.

More importantly, a great link from our old buddy, George Carlin just to put things into perspective. So, you might want to save this email just for the links. (Gotta watch Carlin!… WARNING… as usual cursing included!)

So, marketing…

The idea of the Coronavirus is that it could kill you, or at least make you very sick.  Consider these three promotional actions:

Safe Space. Promote your office as a Safe Zone. In your clinic, use plenty of disinfectant around the office. Let the patients see you wipe down tables, doorknobs, pens, clipboards, and have plenty of Purell (or something similar) around for hand wipes. This is to demonstrate that your office is taking all precautions to be a safe, sterile healing facility.

Get Healthier and Stronger. Secondly, promote the healing aspect of your services – how they can improve and bolster the immune system. The virus will have the most impact on the physically weak. Encourage patients to come in and get stronger in your safe space.  (Ben Lerner has a good article about this – link below.)

Communicate and Educate. Use your “table talk” time, and through newsletters and other media, to communicate with your patients. Give them health tips regarding the virus. But also relay positive activities that are going on in your office – an upcoming talk, a community clean-up drive, a patient success or a new team member. This goes for your team as well – educate your staff. People tend to hunker down during a crisis, somewhat out of fear. Standup, standout and maintain your positive presence and leadership – keep communicating.

The viruses may be real and get transmitted from person to person. But ideas can do the same. So spread the word — communicate your office as a worry-free environment where people can become stronger and healthier – safely.

-Ed

From a social media thread:
Chiropractors!! Is the whole coronavirus situation impacting your practice?! Or is it just me?
[March 9, 2020]

I’ve noticed that a lot less people are coming in for care, I’ve especially seen a decrease in overall NPs, is the trend global? related to coronavirus outbreak?? (people being in “survival mode” , or being more careful about their finances)? I’d love to know what you guys have noticed surrounding this issue? Cheers, Kir 2 days ago

ostninja
I’ve noticed a drop this week. I think it’s critical to wipe all surfaces with something that works and have hand sanitizer available. For reality and to create a safe space where they dont have to think about getting it from the table or face rest.
Everybody is concerned. I think it is people limiting their activities, worried about money, worried about the face rest. Let them see you wiping down face rest every time you finish. I’m wondering about sending communication detailing how we are protecting them and ourselves but I’m also wondering how useful overall that would be.

Kiirjava
Interesting… Thanks for sharing 🙂 that communication idea is actually brilliant!
It’s been a slow week so I’ll use this as an excuse lol · 2 days ago

lloydchiro
I’m just as busy as ever, and I’m in San Francisco. I imagine our town will get hit soon.

AshlamAllstar 2 days ago
CCCA here. Only a few one-off scenarios so far. One patient called to pause her treatment plan due to fear of being exposed and one came in with latex gloves, her own lysol wipes and a face mask. Otherwise, practice as usual, if not, a few more questions asking of the doctors’ opinion of the matter.
—-
DrGodzilla22
My practice had grown during since the news cycles started. Well educated patient are referring their friends and families.
—-
DrJayWill · 1 day ago
I’ve had the busiest week I’ve had in a while

All about TELOS and Three Actions to Start the New Year

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Goals: Telos
The Greeks believed that everything had its own innate goal – or Telos. Telos means ultimate aim or purpose of something. The Telos of an acorn is a tree – the purpose of a pencil is to write.

Steven Covey lists Beginning with the End in Mind as an essential habit in leadership and effectiveness.

Now is a good time to review the Telos of your office. What is its innate purpose? There may be a few of them.

Take it a step further – what are the values and standards in which the office must aspire to in order to achieve this mission? For example, “Deliver WOW through service?” (A core value of Zappos).

Reviewing these often and keeping them in mind will assist you and your team to manifest the tangible outcomes of these goals – more people helped and more income collected.

Your Patient’s Goals: Health Never Takes a Holiday
Your patients have made a goal for better health. Don’t’ let them down – help to keep them on their path to a pain free, functionally improved, and healthier life. Here is a desk poster for you to remind patients to keep their appointments over the Holidays. Link

Two Marketing Engines that Help You Reach Your Goals
One aspect of your clinic’s goals should be marketing. Marketing takes many forms, but ultimately it results in more people receiving benefits from your services.

Marketing gimmicks come and go. They work for a while, and then, soon enough, you find that that “hole” is “fished out.” Special promotions and direct marketing avenues need to be pursued. They work and are especially useful for new offices. But they need to be changed often – marketing channels get clogged quickly and the public tires of spam offers.

There are two forms of marketing, however, that will never wear out: extraordinary customer service and outcomes, and your network.

  • Extraordinary Service. Superior service will be THE distinguishing factor that differentiates your business from others. People want to go to the best provider – 5 Star reviews work – for now. But as Internet review systems get hacked – people will look for the best and rely more on word of mouth and endorsements. Simply – be the best at delivering the best.
  • Your Network. Those people who like you form relationships with you and others. Most offices have a network of supporters but are rarely nurtured. These supporters can and should be developed so that you create a network of alliances – people and business who all share your goals for better health are willing to send customers to each other because of their familiarity and trust.

Before the year is out, or just as the New Year begins, consider personally meeting with anyone in and out of your office who has sent you a patient, or supported you in any way. From patients to allied providers to the autobody repair shop down the street, send them a nice and unique gift, or a personal card, or make a phone call thanking them. Tell them you look forward to working with them and seeing them in the New Year. They are part of your network.

Lastly, on a personal note, we want you to know how much we appreciate all the great work you and your team do in helping people improve their lives. If you can, imagine all of us – you, and other offices like you, all of us working diligently as a positive force to make the world a better place.

This is a noble goal – and one we share with you in the New Year. We’ll see you then!

With admiration and respect,

Ed, David, and all of us, at Petty Michel & Associates

Have You Helped A Child Today?

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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

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“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

Tent Poster – In the Arena – Roosevelt

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“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.

Insurance Network Participation and Getting the Best Bangs for Your Buck

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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?

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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:

  1. Deliberate practice.
  2. Coaching and training.
  3. Commitment to being an expert.
  4. Support from family and friends.

 

  1. 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.
  2. 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.”
  3. 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)
  4. 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

Link to a poster on Facebook

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.”

Link to more information.