Which is Better for You: Direct Marketing or Indirect Marketing?

Last week I sent an email with a link to Ode to Joy.

Ode to Joy is from Beethoven’s 4th movement of his 9th symphony, considered one of the top three symphonies ever created.

It was a short 5-minute rendition. It is beautiful and evocative – listen to it again. (Link below.) Plus, its performance was a masterpiece.

But it was actually an ad.

It was a brilliant advertisement for a Spanish Bank. It was promoting Sabadell Bank’s 130th year anniversary in 2012. According to one website, it has had 90 million views since 2012, while another posted in 2015 has received over 18 million views.

That is a lot of exposure. But does it generate new business?

This type of advertising is called brand marketing, or what I call indirect marketing. It is the opposite of direct marketing. Direct marketing, also called direct response marketing, tries to generate an immediate response. Knowing the differences will help you manage your marketing and make it more effective for your particular situation.

Direct Marketing

The goal of direct response marketing is to generate qualified prospects that respond to an offer. When you receive a card in the mail that promotes a free dinner about retirement funds, the company that sent you that mailer hopes you reply and attend the dinner and accompanying talk. At the dinner, a speaker gives a presentation with the hope of scheduling you for a private consultation later that week. When you see an ad on Facebook for a free manual, the advertisers intend that you respond and order their manual. The distinguishing characteristic of direct marketing is numbers – you can quantify the results of your marketing efforts.

Indirect Marketing

The goal for indirect, or brand marketing, is for the name of your business to be well known and well thought of. When you volunteer at the local food bank, co-sponsor a kid’s little league team, or simply provide excellent customer service, these are all examples of indirect marketing. The results of indirect marketing are difficult to identify immediately.

Until you are in Stage 4 in the growth of your business (about 75% or more full capacity), most of your marketing efforts should be direct marketing. Indirect marketing supports direct marketing, but even if your entire town knew about your business and thought highly of it, there is no guarantee that anyone would come to see you as a customer.

Handing out your business card to someone would be an example of indirect, personal brand building. However, handing out your business card with a handwritten note on the back that said something like “N/C screening in May for Joe M. Dr. EP” might be an example of a direct response marketing.

Marketing Mix – Direct, Indirect, and Internal, External

Another factor to consider in managing your marketing is how much should be directed externally – to non-patients and customers and how much should be directed internally to your existing and former patients and customers.

It has been my experience that too few practices are industrious enough with marketing to and communicating with their existing and former patients.

Below is a chart that gives approximate percentages of how to balance your direct and indirect marketing for your practice. I have divided the development of a business arbitrarily into 5 Stages. Figure each Stage to be about 20% your full capacity.

Telling your story and the successes of your services should never end, regardless of how successful you are. Change your marketing strategies depending at what Stage of development your business is in — but keep marketing.

Carpe Posterum (Seize the Future),

Ed
GoalDriven.com

Ode To Joy

Make each day an Ode to Joy!

“Music is … a higher revelation than all Wisdom & Philosophy”
― Ludwig van Beethoven

Takes 5 minutes. This is an inspirational musical event. The link is below.

It is worthy of the best humans have to offer – and akin to what you provide innately to your patients – as doctors, providers, and support professionals.

Match this with all you do in April and you’ll have a great month!

-Ed

 

For more information on how to create a more profitable business that is more fun than what you are doing now, please purchase and then use the book, The Goal Driven Business.

The Missing Role in Your Practice

The cause of almost all relationship difficulties is rooted in conflicting or ambiguous expectations around roles and goals. Stephen Covey

The reason many offices have a difficult time growing has to do with missing roles.

A role is the identity assumed to perform a series of tasks that produce a specified outcome.

In the hundreds of offices that we have visited over the years, the doctors take on essentially two roles: doctor and owner. This works in the beginning for a few years as the practice grows. In time, however, the practice begins to roller coaster. Numbers go up, then they go down, cycling up and down until everyone fatigues and just settles.

There are several causes for the Practice Roller Coaster. There are hidden barriers that hold an office back and sabotage its growth. These are covered in my book, The Goal Driven Business.

One of the barriers has to do with a missing role that most business owners overlook. Can you guess which one that is?

Let’s look at goals: What is the goal of a doctor? “A healthier person,” right?

What is the goal of a business owner? A secure and solvent business. Dividends from ownership.

What is missing? The doctor can achieve their goal by seeing 10 people a week. As a business owner, they can keep their overhead very low – perhaps working out of their home. But is that what you really want – to see 10 people a week out of your house? Overhead is low and you are getting good results. So, what is missing?

The CEO – the chief executive is the missing role. The goal of a CEO is a very profitable business that operates at full capacity providing world class service and delivering extraordinary results.

The CEO is the chief manager, leader, and marketer, which are the three functions that drive the business to its goals.

Sometimes we hear the doctor being referred to as the “boss,” but boss is not a well-defined role. “Boss” is generally recognized as the person who gives orders and makes decisions. However, it is an overlay of an existing role, as in a “bossy” doctor or “bossy” owner. The role of a CEO is much more than this.

Most providers are too busy providing services to do much managing – and besides, they are paid for their services, not their managing or leadership. Doctors are trained to manage patients, not businesses.

Still, this is a role that must be fulfilled as distinct and separate from the owner or provider roles if the business’s full capacity is to be achieved.

Three Functions of the CEO

The role of CEO includes these functions:

  • Leadership: Leadership is all about goals. It defines where you are going and why and helps everyone you work with embrace this knowledge with commitment. Leadership includes your mission, long-range plans, values, and … the insistence upon achieving them.
  • Management: Management deals with how to get to the goals. Management works to ensure that people and procedures are effectively working and improving.
  • Marketing. Marketing includes procedures and projects that help generate new patients/clients and retain them. Marketing is business, and business is marketing.

Once your practice is at least at 50% capacity, a couple of hours spent each week on effective leadership, management, or marketing activities as a CEO is worth 8 hours or more doing anything else. For example, time spent going to a seminar – perhaps 20 hours including the transportation, may increase your numbers for months afterward. A little can go a long way.

Because the role of practice CEO must be very part-time, we have developed the Fast Flow CEO System for the Goal Driven Business. This can take as little as 2 -3 hours per week, depending on the scale of your business. Here are five components of the Fast Flow CEO System:

  1. Get Out to Work On. Regularly take time to get out of the business so that you can work on your business.
  2. The CEO Works for the Business. The business does not work for the CEO. Sure, the business works for the doctors so that they can provide better service to the patients. But that is for the doctor. Sometimes called “servant leadership,” the CEO is the Chief Coach, helping others understand the goals and how to achieve them.
  3. Team Members. The CEO works to create team members who take on a portion of departmental management, marketing, and leadership.
  4. Manager. The CEO creates the role of manager and delegates a team member to assume this as a part-time role. The manager can take on much of the CEO’s daily and weekly duties.
  5. Study. The CEO studies leadership, management, and marketing to improve their skill as a CEO. Leaders are … readers!

Certainly, all this requires some skill and training – and coaching! But just clarifying the role of CEO and its expectations as distinct from the roles of owner and doctor (or “boss”) will significantly improve your chances of breaking out of the Practice Roller Coaster and achieving your goals.

Ed Petty

March 14, 2022

Motivation

No matter how many goals you say you have or how you write them out, unless you have the motivation to achieve them – you won’t.

“Motivation is the driving force behind the energy required to complete a task… a person’s willingness to exert physical or mental effort in order to complete a goal or set aim. (Psychology Dictionary.org)

This is a key element in a Goal Driven Business.

You first need to define your goals – and they must be practical as well as meaningful. But you also need the drive to achieve them. Without the drive, the motivation to get to where you want to go, you are just a poser in the business world.

(Case #345) The doctor and I had discussed a plan to motivate his team and increase production. This was many years ago. Over lunch, we had a team meeting to announce the plan to his other two doctors and about 10 support staff. He announced that if certain goals were met over the next 7 months, everyone could get a trip to Hawaii.

Everyone was shocked. Including me! The doctor and I had discussed a two-month plan for rewards based upon a modest performance improvement – but not Hawaii and not the increase in production he wanted. He came up with this on the spot during our meeting.

But that afternoon, amazingly, the phones lit up. People were calling in for appointments. (Never mind that this was an example of Innate or Quantum Entanglement!) As I recall, they had their best month ever. But unfortunately, they soon realized that the goals were unrealistic, they had little support to achieve them, and the doctor saw that he couldn’t afford it even if they did reach their goals. The practice subsequently went into a long-term slump.

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What is the lesson? Well, there are a few of them, but I want to focus on motivation.

While it may seem like people become motivated because of the “carrot,” or the reward, there are deeper reasons – or principles.

Edward Deci, along with others, put forth a new framework for motivation called Self-Determination Theory. Essentially, it states that we are all driven by intrinsic goals as part of our fundamental nature. Our reward comes from the satisfaction we feel from the achievement more than from any external prize.

These are the three intrinsic goals we all share:

AUTONOMY. We all want to play in our own sandbox! We need to feel in control of our own corner of the world. Just like we don’t like insurance companies intruding into our clinical decisions, staff does not like being micromanaged.

COMPETENCE. We all want to be superheroes! Deep down, the prospect of becoming more skilled, more masterful, and better able to be in control of our environment is a drive we all have.

CONNECTION. We all want to be part of something bigger than ourselves. This manifests in two ways: a) being part of and working with a supportive group or team, and b) working to help bring about something more significant than our paycheck or the accomplishment of our everyday tasks.

The office staff was excited to go to Hawaii, but this was not necessarily because they could lie in the sun. It was because it was a huge goal that gave them a very large sandbox to play in – together – to work for a very large result.

Self-Determination Theory is why games work. In Kevin Werbach book, For the Win, he discusses the subject of Gamification.

“For thousands of years, we’ve created things called games that tap the tremendous psychic power of fun. A well-designed game is a guided missile to the motivational heart of the human psyche. …monetary rewards aren’t even necessary because the game itself is the reward.”

Whether it is a sporting event, video game, or Sheepshead (a popular game of old-time Wisconsinites, so I’ve heard), we love our games. And I think we need them.

But it all goes back to the principles of Self-Determination Theory.

Remember when you started your business? The challenge that lay ahead? The new business card that identified you as the hero to conquer new plateaus?

Those drives are still there and can be rekindled, regardless of prior disappointments.

As Soon as You Make a Goal—You Have Created the Potential for a Game.

Win or lose, IF the principles of Self-Determination Theory are in place, you will be motivated and so will those with whom you work.

Apply these principles to yourself and your team – for the game, for the fun, and for the win!

Seize the Future,

Ed

For more information on how to apply self-Determination Theory, games, and motivating yourself and your team, please purchase the book,
The Goal Driven Business. [Link to sell page]

 

Everything Else: Why The Goal Driven Practice is More Profitable and More Fun

What gets in the way of you growing your business?

What holds you back from your growth? From increased services and profits?

What keeps you from providing better services and improving your marketing results?

The government? Your childhood? Your neighbor’s cat?

One thing that is NOT holding you back is chiropractic or whatever services and skills you provide.

It is everything else.

When you are first growing your business, and let’s say you are barely at 40% of your full capacity, your practice may be performing well. You may have an assistant, but for the most part, you can see patients and generally oversee the operation of your practice. Life is good, and the future is … wide open.

But almost imperceptibly, as you start seeing more and more patients, the tide of administrative demands starts rising.

Eventually, you can look around your desk and see “undones” and “half-dones” and a hundred or so “to-dos” littering your office, smartphone, computer, and brain. You try to keep up, but there seems to be just too much to do.

So, what do you do? There seems to be only one solution – you settle. You settle into a comfort zone just to a point where you can earn enough to pay your bills.

Growth becomes a trap, and after many attempts to reach your goals, you finally settle.

Is there a way out?

Yes. But it has been hidden. And booby-trapped.

But you should know, after years of observation and analysis, what is holding you back is not your lack of effort. It is not chiropractic or your professional services.

The fact is, you can’t really get to where you want to go from where you are now. You can’t get there from here.

You need to make some major Big Shifts. 

To get to your goals, you have to start from a different place and build a newer version of your business. This is your next stage. Stage One is survival and entrepreneurial growth. It is a Personality practice.

Your next version is a fast, more advanced business that will take you to your goals and beyond.

The new version is called a Goal Driven Practice.

To achieve this requires making some significant changes or Big Shifts.

MANAGER OR ADMINISTRATIVE ASSISTANT (BIG SHIFT #7)

One of the solutions to breaking out of the trap and moving closer to your goals is assigning someone on your team to help you with…Everything Else.

This could be a manager or an administrative assistant. In either case, the role would probably only require 5-8 hours per week – at least at first.

One of their goals would be to remove everything from your desk, all your to-dos, all administrative traffic, sort it for you, and then work out with you what should be done with each item.

You would delegate, delay or dump each item.

This would help free you to increase your services as a doctor and give you time to expand the business as the CEO.

You can produce $500 to $1000 in services per hour as a provider if you are unfettered. As the CEO, you can direct your business to produce much more than this per hour. So, why are you spending time drowning in trying to do $20 or even $30 an hour jobs?

Everything Else gums up the works. It slows you down, confuses the staff, and the patients feel the confusion and notice the neglect, however slight.

This is why I came up with the Goal Driven System. It unmucks the gears of your business so that you can freely provide services and not be haunted by the looming demands of hundreds of to-dos.

This is covered in the book, The Goal Driven Business. If you can do this, you will be more productive and have more fun.

This is so valuable that I will be scheduling upcoming Zoominars on this subject for you and your manager. And stay tuned for upcoming programs on manager training, and training and even coaching on the Goal Driven System.

And just, just for fun, (I am smiling) don’t miss this future article:

The 2 Management Consultants from Petaluma California.

Seize the future

Ed

For more information on The Goal Driven System visit Goal Driven

Goal Driven Job Descriptions

playbook goal chart

In a Goal Driven Practice, Goal Driven Job Descriptions are short, fast, and to the point.

And they are used!

They help improve the quality and quantity of services and are motivational.

So, how is this different from other job descriptions?

Most job descriptions are usually a hodge-podge and catchall of unrelated tasks. For example, the front desk job description may include getting supplies, taking x rays, calling attorneys, and scheduling patients. Billing may include marketing and equipment repair.

Staff will do the tasks assigned but end up zigzagging from one function to another, losing focus on what they are doing, and often disengaged in their activities.

In typical job descriptions, the goals are not clearly defined, measured, nor are the expectations stated. Further, employees don’t always see or get recognized for the results of the work detailed on their job descriptions.

Yet another failing of most job descriptions is obvious – they just aren’t used.

Let’s look at how to power up job descriptions so that they are Goal Driven.

Many job descriptions contain the duties of several different roles. A role is an assumed identity. For example, in a restaurant, there are the roles of a server, cashier, dishwasher, and chef, or cook. In a small restaurant, one person may take on a number of these roles, and all these roles would be their job description. Hence the idiom: “chief cook and bottle washer.”

But to be effective, each role needs to be separated, well defined, and organized with the other roles.

In a Goal Driven Practice, job descriptions are broken down into different roles and described in job checklists.

The job checklist begins by clarifying the goals. This includes the mission, the outcomes, what is used to measure performance, and the level of performance expected of that role.

For example, for the role of Patient Accounts, the mission might be something like: “To help the patient pay for all of the services they received in such a way that they will continue to receive services.” The outcome might be a zero balance or “no accounts receivable more than 30 days.” The statistics used to measure this role could be the “percent of collections to adjusted services.” And finally, the expectation might be something like: “All patients very happy with the encounters with Patient Accounts and continuing with their services, with a collections percent of at least 95% of adjusted services average.”

We now list the most important procedures to achieve this goal. The CEO of the office defines WHAT the goals should be – that is leadership. But the manager and those working in patient accounts would work out HOW the goals would be achieved.

Encouraging the team member to define the best procedures to achieve their goals empowers them and gives them autonomy and responsibility for their role. According to Self-Determination Theory, real motivation is intrinsic. It comes from one’s desires and needs rather than external rewards or threats. Edward Deci, in his book Why We Do What We Do, says people “strive for personal causation.” (This is more fully covered in my book, The Goal Driven Business)

If the cook understands that their goal is to make tasty meals that the customers enjoy and for which they will pay, they can be more responsible for how best to achieve that goal.

A team member may have five or more roles, each with a job checklist, as part of their job description. As the doctor and owner, you may have 25! (And if so, that could be a big capacity barrier right there!)

Once the goals are clearly defined … and kept in mind, the rest of the checklist can be easily worked out.

Once per month or more, you or the manager can meet with each team member and do what we call a Coaching Review. This is a fast review of employee performance: at what they are excelling and at what they need to improve. In addition, the job checklist can act as an assessment.

But it is all geared around the goals of their roles. You also ask them what could be added or changed to improve both the quantity and the quality of their outcomes. They can make the changes to the job checklist and make sure you have a copy.

None of this takes a long time to do each month.

Management of your office is not just about getting procedures done. It is about constant improvement in the quantity and quality of their goals.

You may have told your patients something like: “If you do not make time for your wellness, you will be forced to make time for your illness.”

The same applies to managing your business. “If you do not take time to improve your procedures and your people to achieve the goals in their roles, you will be forced to make time to rebuild your practice.”

Steven Covey, in his book The 7 Habits of Highly Effective People put it simply and best:

Begin with the end in mind.

 

Ed

The Goal Driven Front Desk

A dynamic front desk can increase your visits by 20%, maybe more if you have the room. On the other hand, a dysfunctional front desk can constrict the flow of patients and hold your office back.
I have seen instances of both.
There is much more going on and at stake at the front desk than most doctors and staff appreciate.
Ordinarily, you would think that the billing department is the most demanding. There are hundreds of details that need to be learned and followed with excellent discipline. This position requires professionalism and expertise.
But this function is not on the front lines of the constant patient, phone, and doctor interactions and interruptions. Managing patient accounts can be regulated and organized to maintain a calm and comfortable workflow.
Therapy and adjunctive services are often undervalued, but the patient flow is usually smooth, and they are not faced with unexpected patients or phone calls.
It is interesting to note that the front desk has the highest turnover in most offices.
But properly set up and managed, this department can be an engine of growth and stability in your office.
Let’s look at some of the more important attributes of the front desk:
  1. It represents you and your services. It is your ambassador to the world outside your office. The front desk reflects what you stand for and the quality of your services.
  2. It is the first and the last contact – and impression –with anyone in the office.
  3. It can convert inquiries to new patient appointments.
  4. Rapport and relationships. The front desk can provide world-class service to patients, improving patient retention, reviews, and referrals. (The 5 Rs)
  5. Direct marketing. The front desk can directly promote clinic services to patients, hand out coupons, and promote upcoming events to generate patient referrals.
  6. Team member support. The front desk can support the insurance department and all team members to create a positive, upbeat day every day.
  7. Case Management. The front desk can contribute to case management by relaying any comments or observations relative to the patient’s care to the doctors.
  8. Fully Scheduled Day. The front desk fills the appointment book and keeps it full.
Let’s imagine an ideal front desk and put it at a “5” on a 5 Point Scale.

 

5. GOAL DRIVEN FRONT DESK. The appointment book is full. The front desk staff are cheerful, having fun doing their jobs, and genuinely interested in every patient and phone inquiry. They sincerely care for each patient and non-patient. They have a strong intent on helping patients complete their programs by keeping their appointments. They personally and professionally want to achieve the mission of the office and encourage patients to help them accomplish this mission by bringing in family and friends. They also help the rest of the office achieve the office’s mission. They are sending out positive “vibrations” to help more people. They are proactive and Goal Driven.

 

Below this level, we find the front desk that is struggling.

 

2.5 A COPING FRONT DESK– The appointment book is 50-70% full. The front desk is trying, but it is not keeping up, which creates a bottleneck to patient flow. (Subluxated) Even though the staff wants a full appointment book, subconsciously, they don’t want any more work until they catch up.

 

2. A SLOW FRONT DESK. The front desk operates at a “comfortable” 40-50% capacity. The staff is pacing themselves, keeping up with computer tasks, insurance, and following the scripts for phone and patient encounters. However, they are mostly disengaged from the front desk and office goals.

 

1-2. GIVEN UP and BORED. I only describe this because I have seen this condition. The staff is ignored or badgered. In either case, they feel relegated to a 4th class employee. They hide out and pretend to work, essentially having quit and just waiting until something better comes along.

 

You can create a Goal Driven Front Desk. It is not achieved overnight, but once it is established, you’ll be close to a dream practice and a Goal Driven Business. We will cover some tips on how to create a Goal Driven Front Desk in another newsletter.

 

In the meantime, stay Goal Driven,

 

Ed
“Your brain sends out vibrations all the time, and your thoughts affect your life and other people’s. They pick up these thoughts and get changed by them.”
– Bruce Lipton (Biology of Belief)

How to Create a Full Appointment Book with Goal Driven Marketing

busy desk, planning calendar

Happy Valentines Month!

This article is about sharing the love… the love of your services and how they can help people.

And what is the best way to do this? Create a Goal Driven Business.

A Goal Driven Business runs at FULL CAPACITY, or close to it.

That means no more room in the appointment book. It can mean that there is a waiting list to get in to be seen. But how is this achieved?

In a practice, it is a combination of excellent service and clinical results, inspired leadership, sound management, personal integrity, and … marketing.

Let’s take a took at marketing first. What is marketing?

It is a method of helping people get what they innately want through communication. Marketing communication, either through one-to-one contact or through media, communicates and educates in such a way as to point to what an individual wants. It also can inspire them to get it.

Goal Driven marketing is helping people get to their goals!

People want to be free of pain and discomfort, but they do not know about your services or how your services can achieve this. And if they do, they may not trust that you can do it for them.

Every marketing approach you have must help those people who have a particular need or want to find you, and discover how your services can help them, and why they should trust you. This can be accomplished through patient referral programs or events, setting up external alliances, direct response ads in social media, radio, through one-to-one external relationship building, speaking events – all these and more point to how you can help people and that you can be trusted.

Testimonials and reviews top the list, but so do articles, newsletters, and support from opinion leaders. These are all outward types of marketing communications.

What would someone who knows what you know about your services do if they had pains, or lacked mobility, wanted to improve their immune system, and just be healthier? They’d drop by and see you for an adjustment or for some kind of a treatment from your office.

Not everyone wants what you have to offer, and even fewer want it bad enough to do something about it. But there are more than enough people who are looking, right now, to act who could keep your office full – if they just knew about what you could do for them.

Many times, I have heard chiropractors amazed at comments from patients who say, “Headaches? I didn’t know you could help with … headaches!” And the doctor just assumed everyone knew that they fixed headaches!

Don’t assume anything. It is a noisy world, and you and what you do is drowned in the snow storm of competitive messages and personal activities.

You must be industrious in getting your message out. You have to be continuous. And this is where most doctors fail in their marketing.

Marketing fails because it is not systematized,
organized, continuous, and managed.

A Goal Driven Business focuses its marketing three echelons of activity.

  1. Marketing Procedures. Obviously, the different types of marketing communication and marketing procedures need to occur. This is the most evident (and fun) level of marketing – marketing procedures.
  2. Marketing Motivation. But even if you have bookshelves of marketing binders and libraries of marketing books, they will do nothing unless you and your team are motivated to use them. So, this is the second level of marketing.
  3. Marketing Management. The third, and I believe the most essential level of marketing activities, is marketing management.

Your front desk is organized and routine. Your billing is systematized and well managed — or should be. So is your therapy area and your new patient procedures. But in most offices, marketing is not organized! It is hit and miss, now and then. When numbers are down, “Hey, let’s do some marketing.” When numbers are up, we all get “too busy,” and it is neglected.

Most practice marketing is reactive and symptomatic. This causes the PRACTICE ROLLER COASTER.

There are simple methods to effectively manage your marketing systems to help create a full appointment book which we can cover in another newsletter.
But keep in mind two important points in marketing:

  1. Help People Get to Their Goals and Obtain What They Want. You are helping people who already have a perceived need and want to purchase what they are looking for. You simply must help them find it in what you offer and convince them that you are worthy of their trust.
  2. Manage Your Marketing Procedures and Keep them Running. Stay motivated, find the procedures that work best for you, but organize your marketing procedures so that they continue. This will help you avoid the Practice Roller Coaster.

To find out more about how to create a Goal Driven Business and create a full appointment book, buy and read the book the Goal Driven Business. Read about it here.

Happy Valentines Month! Spread the Love!

Ed

 

Are Your “Engines” Driving Your Practice?

A service business needs 5 different engines to become a Goal Driven Business

Five engines drive your business to its goals.

If these are installed and firing at 100%, practicing will be enjoyable and profitable. When these engines are not fully performing, the daily demands of running a business shift to, and fall upon, the owner.

These engines are functions and characteristics of a dynamic team that drive the practice toward its goals.

Many offices that seem to be doing well are driven by heroic owners fighting each day to grow their practices, and not by their engines. But this isn’t easy to sustain. At some point, it becomes too much, and they settle into a comfort zone below their abilities. As a result, their long-term goals remain unfulfilled.

This is the plight and path of the entrepreneur – brave, independent, but too often without a map on how to build a strong business that drives itself.

The five engines that drive a business to its goals are:

  1. Marketing
  2. Leadership
  3. Management
  4. Service
  5. Personal Integrity

I want to begin passing on tips on the marketing engine– what is working now and my best estimation of what will be working in the future. Marketing is vital, for without paying customers, the other engines won’t work and aren’t needed.

But before I do, I want to invite you to look at your business and gauge the health of each of your engines.

You can do this by reviewing how successful you are at achieving each engine’s outcomes (goals) and giving them a grade from one to five (1-5). 5 would be the point where the engine is achieving its goals.

  1. Marketing. Abundant new patients and goodwill with local allied businesses, organizations, and your community. A waiting list practice. (1—5: ___)
  2. Leadership. A business with clearly defined goals that are agreed upon and pursued happily. (1—5: ___)
  3. Management. Expert team members, acting as an expert team, implementing simple but effective procedures. (1—5: ___)
  4. Customer Service. Customers (patients, clients, customers) who are extraordinarily satisfied with the services they receive and their outcomes. (1—5: ___)
  5. Personal Integrity. Each team member is happy because of the positive and and responsible manner in which they manage their personal lives. (1—5: ___)

By grading each engine’s “output,” you can immediately see what needs the most work.

But these engines do not work independently. One affects the other so that there is a synergy created. As one improves, so do the others. The opposite is also true – the more one engine dies down, the more the other ones do as well.

It could be said that everything begins with leadership, and that may be true. But unless you are marketing your services, there will be no one to lead!

So next week, let’s look at a few effective marketing strategies and tactics that will help drive your business to its goals.

And by the way, how to achieve a 5 for all your business engines is described in The Goal Driven Business. If you haven’t read it yet, I encourage you to do so.

A great new February to you all,

Ed

The Cobbler’s Wife Has No Shoes

bare feet in the snow

The Cobbler’s Wife Has No Shoes

And Your Team Members Have No Personal Health Programs

You have heard the old expression, “The cobbler’s wife has no shoes.” Sometimes it is also said: “The cobbler’s children have no shoes.” Either way, the message is that the shoemaker, or cobbler, is often too busy with his work to spend any time making shoes for his wife and children.

The same can apply to your support team when it does not receive the health services you provide your patients.

Too frequently, I have seen employees not given a personal health program that is supervised by the doctors for whom they work and support. While this is an oversight, I feel it is also negligent. And it can be expensive.

Staff who are ill need to take time off to get well. I have heard about this more in the last year with the COVID protocols of quarantining. Employee absences can impair the quality and quantity of daily services to patients and clients. It can also create backlogs and add extra stress to the employees who try to cover for those who are ill.

There are no 100% solutions to prevent employee illness, of course. But perhaps there is more you could be doing. To start, ensure that each team member regularly receives the same services you also provide to your patients.

Then, I have seen many reports that say keeping Vitamin D levels up minimizes the risk of viral infections. Why not get your staff’s vitamin D levels checked if you haven’t already? It is easy to do and inexpensive. I list a source for testing vitamin D that I have used at the end of this article. (1)

Beyond Vitamin D, there are other supplements that can be taken to bolster defenses in winter against viral infections. The FLCCC (Front Line COVID-19 Critical Care Alliance) has a list of supplements they recommend. You can find a link to them at the end of the article.

And speaking of the FLCCC, if you have not been following them, I recommend you do. (Link at the end of the article.)(3) They are a group of medical doctors and other medical professionals that have spoken out on and advocated for other remedies for COVID other than vaccinations. Pierre Kory, who is the President of the FLCCC, once taught at the University of Wisconsin Medical School and worked at St. Luke’s Hospital here in Milwaukee. (4) (He recently spoke at a rally in D.C. this past Sunday. Link to see a clip of his speech at the end of this article.)

But back to your staff and their health.

We all get busy. I get it. Front and center are the urgent and important matters of our practice which we must deal with directly. But some matters are very important that do not seem urgent. For example, taking care of the health of our staff and ourselves is important, but because it does not seem urgent, it often gets put on the back burner.

Working ON the business is important even though it may not be urgent. And working on the business includes working to improve the health and education of your team members that support you and the patients.

So, keep this in mind: for fewer sick days, fewer quarantines (!?!), and fewer service interruptions, see that each team member is seen regularly by you or by one of the doctors at your practice, and ensure that they are on a health program. And help them follow it. This is no guarantee of less sick days, but it can certainly help.

Having a mission to help people become healthier and relieved of pain is a noble goal. But remember that it applies not only to your patients but to your support team, your family, and yourself as well.

In all ways, try to stay true to your goals!

Goal DrivenFaster to a Better Future!

Carpe Posterum (Seize the future.)

Ed

Get the book The Goal Driven Business and apply it. It will help you achieve your goals including better service, more profit, and…more freedom. Be a Health Rebel and grow your practice. Fight Back! The Goal Driven Business

(1) Vitamin D testing
(2) List of supplements recommended by the FLCCC
(3) FLCCC
(4) Pierre Kory, MD, speaking at a rally at Washington DC, Sunday, Jan 23. (Here he is talking last Sunday at a rally in Washington D.C. (Another link to the same clip.)

The Cathedral, Stone Blocks, and Your Goals

stone cathederal

(This is the third in our series on goals.)

The Cathedral, Stone Blocks, and Your Goals

Christopher Wren was one of the greatest English architects. He designed 53 different churches in London before he died in 1723 at the age of 91.*

There is a story about how he walked unrecognized one day among the men who were at work upon the building of St. Paul’s Cathedral — which he had designed. St. Paul’s Cathedral sits on a hill and is one of London’s most famous and recognizable churches.

“What are you doing?” he inquired of one of the workers, and the man replied, “I am cutting a piece of stone and working hard so I can feed my family.”

As he went on, he put the same question to another man, and the man replied, “I am an expert stonemason, and I am building a solid wall.”

He walked a little further, and around the corner, he asked a third man what he was doing. “I am helping Sir Christopher Wren build a beautiful cathedral that will be a place for worship, where people can come to pray, where the poor can come for clothing and food, for the Almighty.”

This is a parable that has some measure of truth, but I have not been able to find any credible verification. But the point of a story such as this is to illustrate an idea or moral.

All three workers had goals. They expressed these to Sir Christopher when asked what they were doing. We can assume that each stone cutter was skilled, worked hard, and did the same work as the others.

One can guess that their goals kept them motivated. But each viewed their goals differently.

The first two workers had immediate tangible objects as goals – a cut stone block and a well-built wall. However, the third stone cutter’s goal was a purpose, a vision of the future he was working to help achieve.

From this, we can look at all goals at two different levels: at a higher level, such as a purpose, and at a tangible level, which is a practical manifestation of the purpose.

In your practice, these two levels of goals might look something like this:

Higher Goal: Our mission is to help as many people as possible in our community become healthier, relieved of discomfort, and better educated so that they continue to improve their health and those around them.

Practical Goal: A person who completed a program of care, whose pain was relieved and is now healthier and incredibly happy with their results and of the service they received and has enrolled in a wellness program.

stone mason building a wall

Practical goals are quantifiable in a set period. For example, how many new patients can we generate, how many visits can we achieve, and how many programs of care can we complete next month?

There must be an equal emphasis on the higher goal, often called a mission, and the tangle goals, often called quotas or objectives.

Too much attention on the mission, and we live in a dreamland and go broke. Too much attention on production quotas, and we eventually feel like we are on an endless assembly line, find no meaning in our work and lose our motivation.

Like the stone cutters, dream about the cathedral but also set a target for how many blocks you will cut and how many walls you will complete next month.

Both echelons of goals should be viewed, reviewed, revived, and recalculated as needed at each team meeting.

Goals are your future – where you want to be. And, where you want your patients and your community to be. So, nourish them both as a mission and as outcomes, and the work to achieve them will come much faster and easier.

Carpe Posterum (Seize the Future),

Ed

*Wikipedia

Why Goals Work and How to Harness Their Power for Greater Prosperity

Goals are the 20%of efforts thatWhy do goals work?

We all know the obvious: they help keep you focused, and as Yogi Berra, the baseball catcher, said, “If you don’t know where you are going, you might wind up somewhere else.”

We have all heard about their importance.  But we may not have heard or understood WHY.

What is the underlying principle behind goals, and why do they work?  What gives them their power? And can you harness it improve your business and its bottom line?

Stick with me and find out…

==   ==   ==   ==   ==

It was one of those September days in the Midwest when the leaves were turning orange, and the wind was blowing.  I was in Chicago – the Windy City – where I attended a seminar downtown at one of its plush hotels.

The program was kind of out of my league – at least then.  The fee for three days was $7,000.  I was only attending the first day, which was $1,000 – still a lot of money.  But I was drawn to the subject, and I was familiar with the person who was putting it on.

There were aggressive young MBA types flying in from around the country and the world.  On the night before, at the hotel where the seminar was to be held, I saw several small groups in lively discussion around laptops – as if they were in the middle of inventing the next Big Thing.  I remember talking to one young man from Singapore and learning about the high-energy atmosphere of entrepreneurship there.

The seminar focused on building, buying, or overhauling a business.  The speaker was a self-made billionaire, a former management consultant, so his teaching fees did not come cheap.  This was not a seminar for dabblers!

The subjects discussed on the first day and, as I learned, on the other two days, were surprisingly uncomplicated.  They discussed the key ingredients to look for when deciding what business to build, buy, or grow.  These few key factors were introduced on the first day of the seminar and then expanded upon the other two days.

But it all started around one principle: the PARETO PRINCIPLE.

Many of you know the Pareto Principle and the Rule of 80/20.  This Principle has been used over the last 50 years by major manufacturing companies to improve the quality of their products.  The concept is easy to state but often difficult for entrepreneurs to apply.  It predicts that roughly 80% of valuable results come from just 20% of efforts.  In some cases, the ratio can even be more extreme so that 10% or even 5% produces 90% or 95% of the results.

Not all efforts are equal: there are the “vital few” efforts and the “useful many” efforts.  Workaholic entrepreneurs can struggle to put this concept into practical use.  We find that delegating a $20 an hour task is risky, so we will spend time organizing a bookshelf or driving to get office supplies ourselves instead of taking care of a potential $1,000 an hour task, or even a $10,000 an hour task.

As a non-business example of the 80/20 Rule, consider all the clothes in your closet.  I bet you wear just 20%, or less, 80% of the time.  Then, consider how you get to work – out of all the choices of roads to take, you use just a few of them.

Look at a winning athletic team.  Just a few players are responsible for 80% of its success.  This does not mean that the other players are not important – just not THAT important.

All efforts are just not equal or average.

How might this apply to your business?  Well, for example, 80% or more of customer dissatisfaction comes from 20% or less of your patients.  On the other hand, 20% or less of your patients account for 80% of your patient referrals.

As the CEO of your business, what are the vital few actions you can take that will produce the most results?  I suggest that defining the business’s goals, ensuring that your team understands them, and keeping these goals alive each week is key.

As Stephen Covey advises: “Begin with the end in mind.”  Goals are simply the end you have in mind.  On the higher end, they would include your mission, vision, and reason for them – your WHY.  They would also include the values you hold as standards of behavior and performance.

These greater goals would be manifested as products or outcomes.  For example, if your mission included helping people have healthy teeth, then a practical manifestation of this goal would be “Jim,” a patient, having his teeth cleaned today.  If your vision were a healthy and pain-free community, the practical outcomes would be 100 patients adjusted today.

As a doctor, what would be the 20% of your actions that account for 80% of your results?  I suggest letting the patient know that you understand their goals and work to help them achieve those goals at each encounter.

As the manager of your business, ensuring each team member knows the goals of their roles and helping them achieve these goals, with good coaching and communication, will produce 80% of their successful efforts.

It all goes back to goals.  

They are the leverage points that direct and amplify all your efforts.

But here is the truth you must understand:

A small amount of time consistently spent defining the goals of, and within, your business — and working out how to achieve them — are the vital few actions that produce most of your excellent outcomes.

Know before you go.

If you and your team routinely define and redefine your goals, both the higher ones and the practical ones, and work out how to better achieve them, you will have a more prosperous and stress-free business.

Get the goals right each day, and all else will follow in your favor.

Working towards a better future,

Ed

If you don’t have it yet, get my book to learn more about how to use goals in your practice. The Goal Driven Business.

***New Training Program***

Also, stay tuned for a new training program we will be offering on the Goal Driven System. It will be limited to just 10 offices and last for 6 months. Its goal is to train the business owner and manager/senior staff member on the Goal Driven System to transform their practice into a Goal Driven Business. A Goal Driven Business is a team of Goal Drivers. That is what this program will teach you to create. (What is a Goal Driven Business? )
If you are interested in taking the training program on the Goal Driven System, for you and 1 team member, please go here to schedule a time to learn more about it. Schedule a meeting with me.

Goal Driven.com
Petty Michel & Associates

Whose Goals: Yours or Theirs?

goals-2022 nurturing your goals to growth

At the beginning of each New Year, it is customary to reflect on the past and look at and set new goals for the New Year.

This can help you have a happier and more prosperous New Year.

Life can get messy and confusing, and like a rookie quarterback facing many onrushing tacklers, even frightening. The solution is to have planned goals already established that you can confidently move forward towards regardless of the circumstances you face.

Here is a vital tip about goals that is often overlooked:

GOALS NEED REGULAR NOURISHMENT.

Weekly, even daily, a fast reflection on where you are going and WHY helps focus and energize your drive towards them. Once established, you need to take time aside weekly, and more so on a monthly and quarterly basis, to rekindle them and mark your progress towards their achievement. Make adjustments and course corrections as needed.

Do this as a scheduled and determined ritual!

Share them as well. There is nothing better than sharing agreed-upon goals with others and working together to make things better. Work with your patients, your team, and your family to achieve shared goals.

And do this or else!

There are good consequences in doing this and not good consequences if omitted. Other powerful interests have different goals for you and your patients. So does plain old inertia.

In this New Year, stay true to your goals, nourish them, and help others do the same.

Ed

For more information on how to do this, please read my book, the Goal Driven Business.

Also, stay tuned for a new training program we will be offering on the Goal Driven System. It will be limited to just 10 offices and last for 6 months. Its goal is to train the business owner and manager/senior staff member on the Goal Driven System to transform their practice into a Goal Driven Business. What is a Goal Driven Business?

“No Surprises Act” effective January 1, 2022

“Wondering about the new federal ruling to end surprise patient billing?

Though this mainly pertains to hospitals and emergency services, chiropractic  providers are impacted as well.  Click here to see  Medicare’s explanation on the ruling. https://www.cms.gov/nosurprises/consumers/understanding-costs-in-advance

For over 35 years, Petty, Michel and Associates has been at the forefront of educating doctors and staff on utilizing financial consultations and worksheets to estimate out a patient’s out-of-pocket financial responsibility for their care.  If you are interested in how you can obtain our Financial Consultations Toolkit,  please contact Lisa at lisa@pmaworks.com.”

Lisa

Faith Demands to Make a Difference

GoalDriven.com - Faster to a Better YearDecember 30, 2021

A year ago, who knew what the next 12 months would be like?

Yet, here we are today.

As the New Year is just before us, again, one can only wonder at what the future holds. Is this the “New Normal?”  How far will it shift in the next twelve months? For you, your patients, and your business?

Whathe goal driven businesstever new realities lie ahead, we are ready to help you and your business. We will be launching a new approach to practice and business building with the theme of Faster to Your Future in January. It is based upon the book the Goal Driven Business.

 

But just before we start the New Year, I wanted to pass along a message of encouragement.

It often amazes me that with all the wars, both “hot” and cold, the greed, the fear, and tyranny, with all of mankind’s utter insanity over the centuries, we are doing as well as we are. Somehow, as Abraham Lincoln predicted in his first inaugural address in 1861, “…the better angels of our nature…” came through and prevailed. Whatever challenges we may have, his were enormous. He was facing a nation divided, secession of the southern states, the policy of human slavery, civil war, and a world of other conflicts.

But in the end, there is something about the Innate Goodness of Life that seems to propel mankind forward towards a better future, however slightly. I think that the more we trust in the Better Angels of our Nature, and in the Goodness of Life itself, the more sure our road will be toward a better year for us all and a happier future.

“I have one life and one chance to make it count for something . . . I’m free to choose what that something is, and the something I’ve chosen is my faith. Now, my faith goes beyond theology and religion and requires considerable work and effort.

My faith demands — this is not optional — my faith demands that I do whatever I can, wherever I am, whenever I can, for as long as I can with whatever I have to try to make a difference.”

― Jimmy Carterjimmy carter supervising

So with this, we look forward to working with you to help make 2022 both prosperous and rewarding.

With admiration from all of us at Petty Michel and Associates,

Ed

Medicare Reimbursement Cuts Delayed in 2022!

On December 10th 2021,  President Biden signed into law a bill to delay reimbursement reductions for physicians. Further, the proposed 2% sequestration reimbursement reduction to physician services as well as to farmers, has been delayed.

Please see the 2022 Wisconsin Chiropractic physician fee schedule below.

For your reference, here are the 2020 and 2021 Wisconsin Chiropractic physician fee schedules:

For over 35 years, Petty, Michel & Associates has been at the forefront of keeping up to date with CMS Medicare & Medicaid Service’s billing and coding standards. Questions? Contact us at 414-332-4511 or email Lisa-lisa@pmaworks.com

Source: https://www.jdsupra.com/legalnews/bill-averting-medicare-sequester-cuts-4029291/

For more details on fees and relative values in your practicing state, refer to your Medicare Administrator Contractor’s (MAC’s) website.

David Michel

Health Never Takes a Holiday

fitness santas
An ounce of prevention is worth a pound of cure. (Benjamin Franklin)

You know this. So do your patients and staff.

But maintaining, and even improving your health must be a priority.

Health IS wealth.

So, encourage your patients to stick to their treatment and health programs through the next couple of months.

Enjoy the season and family and friends. This too is part of health. But the New Year is coming, and an ounce of prevention is worth a pound of cure.

You can use posters, such as those attached, to remind yourself and your patients that… Health Never Takes a Holiday.

Be merry and keep smiling!

Ed

Sample PDF posters:
Poster for Nov/Dec
Poster for any holiday

Customizable posters on Word for active PM&A clients can be found on your PMAmembers site. (You will need your login to enter this site. Please contact Linda@pmaworks.com if you need assistance.)

https://pmamembers.com/december-special-promotions/

Medicare Part B Premium Jumps Dramatically for 2022

stethescope on calculator Kiplinger recently shared information from the Centers for Medicare & Medicaid Services reporting that Medicare Part B premiums will jump dramatically in 2022. An increase of 14.5% or $21.60 from 2021. Deductibles will also show an increase of $30.00 going to $233 in 2022.

The article goes on to say that Medicare Part A will also see an increase in deductibles.

Medicare claims “the increases were due in part to rising health care costs and higher utilization of health care services.”

They further stated, Aduhelm, a prescribed Alzheimers drug was also to blame.

To read the article in it’s entirety visit:
https://www.kiplinger.com/retirement/medicare/603759/medicare-part-b-premium-jumps-dramatically-for-2022

The 2022 Medicare fee schedule has now been released for Wisconsin for 98940-42:

The Problem With Seminars

the problem with seminars

I am all for seminars. Been to many myself. I know I have gotten useful information and, no doubt, have benefited from them.

But, their usefulness is often wasted.

I just talked to a business owner that came back from a seminar he and his doctors and staff attended. He told me that they have started hitting their best-ever weekly numbers. His office manager told me that everyone is excited.

For now.

I have seen it time and time again… go to a seminar, get stoked, come back, numbers go up for a month or so, and then everything returns to how it always was. In essence, the seminar was only a short-term, “acute care” fix that addressed symptoms. Nothing was really improved or corrected.

There is a solution on how to benefit the most from seminars. I discuss it in my book, The Goal Driven Business, from which most of this article is quoted from. The following is a story related to me from a chiropractic staff member a few years back:

“Our office was really slowing down last year. So, the owner decided to take everyone out of town to a weekend business seminar. The speakers discussed new and efficient methods for doing our work. It was entertaining and informative. Plus, we also gained some great marketing ideas. It was a fun seminar, so we were all excited when we returned to work after the weekend.

“On Monday, we agreed to get together at lunch to discuss how to implement what we learned. Some staff members had to take care of urgent matters first, so our lunch meeting started 30 minutes late. Once we finally got together in the break room and started eating, we began a good meeting, but then customers begin arriving for their afternoon appointments. We had to call the meeting to an end without getting through very much of our agenda, but we agreed to continue the meeting the following week. Turns out, we never did meet again about the seminar.

“But we were still pretty motivated from the out of town trip to the seminar and, as I recall, we had one of our best months ever. It’s my job to clean the break room and, after a few months, I noticed that the binders of information we received at the seminar were never opened; so I stored them for future reference. Now it is almost a year later, and everything is pretty much back to the way it was before we went to the seminar. Some of us are a little burned out and I don’t think we ever did implement anything from that seminar.”

Sound familiar?

I bet it does. I have seen it play out almost exactly the same way countless times. Starting, and not following through. No management and marketing system is set up, and no time scheduled to ensure the system is followed, and no lasting improvement is realized.

And I am sure, for most of us, this phenomenon applies to our personal lives as well. For instance, how is your exercise program coming along? Hmm? You’ve set goals to work out more often and eat better, right? To work ON your body, not just in it. Yet, my guess is it’s been pretty hit and miss.

We want to improve, we make improvement goals, but what happens? Why can’t we achieve them? Consistently. Is it that we’re all too busy? Too lazy? There seems to be no solution, so we accept our condition and do our best.

Yet, there IS a solution, and it’ll seem like science fiction—but, it’s actually a science fact.

The Goal Driven System of Business Development covers 20 Big Shifts, or actual office adjustments, that need to be made to reach your goals — and stay there. It takes you out of the Practice Roller Coaster that forces you to finally “settle” and accept a lower level of success because the stress of the ups and downs becomes too much.

Here’s how to get the most out of seminars from The Goal Driven Business.

goals lab goaldriven.comBIG SHIFT #1: Introducing the Goals Lab
You can’t improve your car while you’re speeding down the freeway. You must take it to a mechanic at a garage. Athletes and musicians alike spend time away from their audience to practice their game skills or their music, always improving their performance. Businesses need to do this as well. But where? And when?

 

The answer is you need to create a Goals Lab where you go to work on your business.

Your Goals Lab is a special place, a laboratory, an oasis for change. Here, you can think, study, learn, practice, become inspired, and have conversations. Here is where you go to reset your thinking and improve your actions—and the actions of others in your office as well.

I call it the Goals Lab, but you can give it another title, if you wish. Whatever you call it, this is the first Big Shift you’ll take on your journey to achieving your new goals.

Goals Lab to engineer your best route to your goals, Goalddriven.com

Why do you need a Goals Lab? Because you simply cannot focus on the other Big Shifts when you are in your office, juggling customers, staff, bills, phone calls, emails, vendors, and everything else that consumes your energy and brainpower.

Management companies and consultants may have advised you to work on your business, not just in it. While the idea of working on your business, as opposed to in it, is a clever and useful concept, I have rarely seen it applied consistently or comprehensively. Why? Because real business improvement can be more demanding than meets the eye. It is a separate activity that requires its own distinct time and place, and it has its own rules which must be followed to be effective.

I use the term Goals Lab because it is a virtual location that you visit to improve business performance. As an example, you spend most of your time with your car driving it. But you also take time to take your car to a special place where you let a mechanic work on it.

Not knowing about this place, this Goals Lab, its rules, and how it operates, is a fundamental reason why all your management books, marketing manuals, and practice improvement notes from seminars rarely get implemented.

Your Goals Lab has been mostly hidden from you. It almost has a fourth-dimensional location, which is outside the time and space continuum.”

Why don’t we spend more time on improving the business, not just working in it?

This is the real question, and it is answered in the book, The Goal Driven Business. You can read about it now, or wait for my next article where I explain WHY business improvement is so difficult and what to do about it.

Meanwhile, keep improving.

Ed

Learn more about book and get it here: https://www.GoalDriven.com

the goal driven business by edward petty

Key Updates and Workarounds For the New ICD-10 Codes That Impact Your Office.

icd-10, key updates for 2022Dear Chiropractors and Staff:

Are you having issues with not getting reimbursed due to the new ICD-10 codes and the deleted low back code? Having difficulty getting reimbursed from Humana and BCBS due to precertification requirements and other crazy denial codes?

Please read below where I provide you three key updates to the ICD-10 Codes and some workarounds that are of interest to your revenue cycle.

UPDATES: ICD-10 code Changes relevant to chiropractic

1. Deleted code: M54.5 low back pain.

2. NEW codes to replace the above deleted code include:
• M54.50 Low back pain, unspecified
• M54.51 Vertebrogenic low back pain
• M54.59 Other low back pain

3. Other Chiropractic-Relevant New codes added:
• M45.A0: Non-radiographic axial spondyloarthritis of unspecified sites in spine
• M45.A1 : Non-radiographic axial spondyloarthritis of occipito-atlanto-axial region
• M45.A2 : Non-radiographic axial spondyloarthritis of cervical region
• M45.A3 : Non-radiographic axial spondyloarthritis of cervicothoracic region
• M45.A4 : Non-radiographic axial spondyloarthritis of thoracic region
• M45.A5 : Non-radiographic axial spondyloarthritis of thoracolumbar region
• M45.A6 : Non-radiographic axial spondyloarthritis of lumbar region
• M45.A7 : Non-radiographic axial spondyloarthritis of lumbosacral region
• M45.A8 : Non-radiographic axial spondyloarthritis of sacral and sacrococcygeal region
• M45.AB : Non-radiographic axial spondyloarthritis of multiple sites in spine

NEW Cough codes:
• R05.1:Acute cough
• R05.2: Subacute cough
• R05.3: Chronic cough
• R05.4: Cough syncope
• R05.8: Other specified cough
• R05.9: Cough, unspecified

WORKAROUNDS
If you have claims to send (hopefully only a few) with DOS prior to October 1, with low back pain diagnoses, what should you do to ensure they do not reject by the clearinghouse and payer for adjudication? Your clearinghouse should, by now, be updated to include accepting claims with the old M54.5 code IF the DOS is prior to 10/1/2021. The commercial payer claims adjudication systems should also be updated now to accept claims prior to 10/1/2021 DOS if you billed with the old M54.5 code. Please make sure to get any outstanding claims with DOS prior to 10/1 submitted as soon as possible, if you have not already. If you only have a few claims going to commercial, you also have the option of sending these on paper instead of through your clearinghouse. Do not do both.

State Medicaid programs and Medicare will still require the use of the M99 codes for billing, so continue using those codes for these claims.

HUMANA is requiring pre-authorizations on all chiropractic therapy codes. The latest news is that starting in January, there will now be three entities that will be doing the pre-authorizations. a. Optum, b. Humana itself, or c. A new vendor, Cohere Health. Humana has advised us that the entity will be selected based on the patient’s policy.

When you verify a patient’s benefits you will need to make sure to ask:
if preauthorization on your therapy/rehab codes is required on the member’s policy,
which entity will be preauthorizing/reviewing,
and the process to follow when requesting services requiring preauthorization.

Not getting paid by BCBS, with crazy denial codes? No one at BCBS to help? You’re not alone. Offices across the country are experiencing this. So what can you do at this point? First, do a claims audit on your BCBS claims. Do you have the GP modifier attached? Is preauthorization on therapies required on the patient’s plan using AIM Specialty Health?

Your other option is to ask the patient to call into BCBS and advise that claims are being denied even though they have been billed out correctly. We do have scripting available to help your patients with the communication. Click here and request more information.

Questions? We’re here to help!

Lisa Barnett
PH: 920-459-8500
Email: lisa@pmaworks.com

“Increasing your collections through better billing and documentation”