I have spent years talking to chiropractors across the country, and one of the biggest dilemmas most of them share, myself included, is determining the clinic’s fee schedule. We are torn between running a profitable business and giving our patients access to affordable healthcare – in many cases diminishing the value of our services and making us the target of unnecessary risk.
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I am always surprised by the amount of misinformation out there when it comes to Medicare and chiropractic care. The truth is that Medicare is not that complicated. The rules are pretty clear-cut on what we can and cannot do. Although they have one of the lowest reimbursement rates, there are still benefits to seeing Medicare patients in your practice. How knowledgeable are you when it comes to seeing Medicare patients?
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The biggest hurdle in advancing a practice comes from a failure to effectively implement change. I have spent hours talking to doctors who are at their wits’ end over their teams’ resistance to progress in the practice. Change can be difficult, but if handled with full commitment and swiftly, it can set a new standard of expectation for your entire team and pave the way for future growth.
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Office billing and collections can create ill feelings between a practice and its patients. It can also be a point of contention for staff and doctors alike. Advances in technology have made life more convenient for us, our families, and our patients. Yet, we continue to use antiquated, confusing, and inconvenient methods for collecting payments from our patients.
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When I started out in practice, the biggest risk I faced was a potential malpractice suit. Now 32 years later, the biggest threat to my practice is an audit. Often, audits are triggered by patients who are not unhappy with your clinical care, but your billing or collection practices. Recoupment is BIG business.
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Hopefully, you have a compliance program established in your office. A compliance manual collecting dust at the front desk is NOT a compliance program, in case you were wondering. Practices without compliance programs in place that treat Medicare, Medicaid or other federally insured patients are more likely to miss errors and potentially violate rules and regulations. The good news is that you don’t have to be the one to implement the program. In fact, many consultants recommend that you designate a trusted employee to act as the compliance officer for your practice.
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More and more providers are feeling the effects of high deductible health plans when it comes to reimbursement and patient collections. Although the Affordable Care Act has lowered uninsured rates in the U.S. from 15.7% in 2009 to 9.1% in 2015[1], the number of patients delaying needed healthcare continues to rise as more of the cost-sharing has shifted from government and third-party payers back to the patient.
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Setting a reasonable fee schedule is key to the financial success of your practice. It should be simple to understand by patients and compliant with provider agreements and state and federal regulations.
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