\nFrom a Chiropractic Billing Consultant
\n
![\"\"](\"http:\/\/www.pmaworks.com\/main\/uploads\/angie---web-2.gif\")
<\/p>\nAngie\u2019s Angles
\nFrom a Chiropractic Billing Consultant
\n<\/p>\n
For your protection, you should be aware of the Top 10 Red Flags for a billing audit in a chiropractic office. Here they are.<\/p>\n
Since this is the beginning of a new year, I will start with the Top 10 Red Flags for a billing audit (in no particular order):<\/p>\n
1.\u00a0 \u201cPhantom Billing\u201d\u2014Billing for services not rendered.<\/p>\n
2. \u201cDouble Billing\u201d\u2014charging more than once for the same service, e.g., using an individual code again as part of an automated or bundled set of tests.<\/p>\n
3. \u201cClustering\u201d\u2014Using only a few codes on the theory that it will average out.<\/p>\n
4. \u201cUpcoding\u201d\u2014Using a higher reimbursement code than the code reflecting the service rendered; e.g., billing for complex services when only simple services were performed, billing for brand named drugs when generic drugs were provided, listing treatment as having been for a more complicated diagnosis than was actually the case.<\/p>\n
5. \u201cUnbundling\u201d\u2014Using two or more billing codes instead of one inclusive code where
\nregulations require \u201cbundling\u201d of such claims. Submitting multiple bills in order to obtain a higher reimbursement for tests and services that were performed within a specified time period and which should have been submitted as a single bill.<\/p>\n
6. \u201cCode Jamming\u201d\u2014Inserting or \u201cjamming\u201d fake diagnosis codes to get insurance coverage.<\/p>\n
7. Billing for non-covered services<\/p>\n
8. Billing for services that are not reasonable and necessary.<\/p>\n
9. Inappropriate balance billing\u2014billing Medicare beneficiaries for the difference between the total provider charges and the Medicare Part B allowable amount.<\/p>\n
10. Routine waiver of co-payments and billing third-party insurance only.<\/p>\n
The complexity of managing a practice is not a walk in the park. As a Billing Consultant with PM&A, my job is to free doctors from the worries that can accompany running the financial end of a medical practice.\u00a0 I can review and streamline your billing department, train staff, and credential doctors with insurance companies, among other services.<\/p>\n
Questions on how any of these might apply to your office? Contact me<\/a> and I will let you know. Angie\u2019s Angles From a Chiropractic Billing Consultant For your protection, you should be aware of the Top 10 Red Flags for a billing audit in a chiropractic office. Here they are. Since this is the beginning of a new year, … Continue reading
\nNext month \u2013 look for tips on nailing your Financial Consultations!!<\/p>\n","protected":false},"excerpt":{"rendered":"