HIPAA Compliance Services

Call Us at 214-437-7559

Tips for Successfully Verifying Insurance to Increase Chiropractic Coding and Reimbursement

Coding and Reimbursement for Chiropractors

Insurance companies use a variety of tactics to make it more difficult for chiropractors to claim payments, as well as ways to minimize the reimbursements they do authorize. Insurance coding and reimbursement can be one of the biggest headaches for any chiropractic practice.

Coding and Reimbursement Today

If you’ve been in business for awhile, the operating procedures that got your patients’ claims paid in the past may not be enough to protect your income today. Here are a few tips to help you get the insurance benefits that both you and your patients need, expect, and deserve.

  • Use your Insurance Verification Form. Enhancing your standard verification procedures can help ensure there are no unexpected surprises. Some insurance firms now charge separate copays for Extremity Adjustments when they’re performed in the same session with a spinal adjustment; others use the same tactic when physical therapy or massage is used in conjunction with an adjustment. Do double due diligence to ensure you and your patients don’t get stuck holding the bill.
  • Get an actual quote on how much will be paid for scheduled care. These days, everyone who deals with insurance companies knows the phrase “verification is not a guarantee of payment.” But you may still have legal appeal rights if the company actually misrepresents benefits or keeps you from building a reasonable fee schedule. Submit a written request to establish a right to benefit disclosure, and you’re more likely to find the company willing to give you accurate and complete information.
  • Watch for “deductible calculations provisions.” Complex deductible calculation can make it all but impossible to simply determine the amount of your patient’s deductible up front. Take the time to understand what has been calculated and applied toward the deductible to date, so you understand what’s left and which of your services can actually be calculated and applied toward that deductible.
  • Find out whether the insurance carrier is accredited by the Utilization Review Accreditation Commission (URAC). If they’re not, it’s a red flag that they may give you trouble. If they are accredited, they’re required to follow detailed procedures. They’re required to make decisions based on a strict chain of contingencies and must provide certain information upon request.
  • Get the name of who you spoke with while verifying insurance benefits. This can be critical to win an appeal at a later time.
  • Bill physical therapy. Many insurance plans readily pay for therapeutic exercises and preventive care, since it can increase chances that patients will be healthy in the future. Incorporate physical therapy into your patients’ treatment, and you may be more likely to receive equitable and reasonable reimbursements.

Once you’ve got an effective procedure in place for today’s insurance billing atmosphere, you’ll be able to better protect your livelihood. With some planning, coding and reimbursement procedures can be manageable, minor inconveniences.

Don’t lose that hard-won income through unexpected legal problems. Protect your patients and your business. Give us a call or fill out our online form for more information on how to make your Chiropractic office HIPAA compliant or try us at www.hipaacomplianceservices.com

[form contact-us]

HIPAA Compliance: Know the Different Types of HIPAA Forms and Required Audits

HIPAA Forms and HIPAA Compliance

hipaa formsUnderstanding HIPAA forms can mean the difference between proper HIPAA compliance and a $50,000 fine. If you document and maintain HIPAA forms properly, you’ll be able to focus more on the daily aspects of your business.

As a chiropractic practice, you obtain, manage, and transfer patients’ medical information. Since you work with personal health information (PHI), you’re required to comply with the Health Insurance Portability and Accountability Act, or HIPPA.

HIPAA Forms

There are required forms you need to ensure compliance with HIPAA in this area. It is a requirement that templates of these forms be available in your HIPAA compliance manual… even if you believe you will never use some of them. These forms include such things as:

  • Customizable Notice of Privacy Practice: The Notice of Privacy Practice available for  review by your patients if they so request. Your patients must know how you handle their medical records and how their rights are protected by your practice. This is no longer GIVEN to each patient, so know the most current rules!
  • Notice of Privacy Practices Acknowledgement: Each patient must sign an acknowledgement stating that they have been told a privacy document is available to them if they request it. You must keep these forms on file to prove HIPAA compliance in the event of an audit or complaint.
  • Authorization of Release of Health Information: Each patient must authorize who (if anyone) is authorized to receive their health information—including other offices and family or friends. Your form should include a section that’s applicable to minors and an appropriate expiration date.
  • Several other forms are needed for specialized handling of information. You can find a complete list with customizable forms and a training manual at www.hipaacomplianceservices.com

There are also important office forms that are needed for functions outside HIPAA regulations. Some of those forms include;

  • New Patient Authorization: This is a standard “intake” form, which includes a request for insurance information, , assignment of benefits, and your patients’ communication preferences.
  • Statement of Financial Responsibility and Health Plan Coverage: This form creates a record of your patients’ insurance verification and financial responsibility—and should include your policies for missed appointments or instances of non-coverage by the insurance carrier.
  • And many more…

HIPAA Audits

The Department of Health and Human Services (HHS) is charged with making sure all businesses that are “covered entities” and subject to HIPAA are actually in compliance. HHS conducts internal audits to ensure that your business complies with both the letter and the spirit of HIPAA law.

If you’re audited, you’ll need to have your files in order, including all the assessments you’re required to perform periodically for HIPAA compliance. These include:

  • Risk analysis and assessment.
  • Remediation policies in case of security breaches.
  • Personnel policies.
  • Required forms
  • Required audits of ABN forms, clinical file review audits and claims denial review audits.
  • It’s important  you have a separate HIPAA manual to keep all HIPAA forms filed, organized, and accessible so that you can present yourself as a prepared and professional organization if you’re audited. For training relative to these audits, which are misunderstood by nearly every office, you can go to www.hipaacomplianceservices.com.

Don’t Get Buried in HIPAA Forms – Let Us Help You.

Getting your office HIPAA compliant – and then staying that way – can seem all but impossible. But it’s necessary to protect yourself and your hard work from being destroyed by a clerical accident. Give us a call or fill out our online form for more information on how to make your chiropractic office HIPAA compliant!

[form contact-us]

Is Multi-Discipline Healthcare Affecting Your Chiropractic Business?

Chiropractic Business Models and Multi-Discipline Health Care

The “one-stop shopping” craze has hit the chiropractic business world, for better or worse. Chiropractors are choosing to involve themselves with partnerships or businesses that offer multiple medical services under one roof. Medical doctors, physical therapists, and chiropractors, for example, might be found in the same location. However, some major concerns, including HIPAA compliance and business considerations, are keeping many chiropractors from jumping on the “multi-discipline” bandwagon.

Chiropractic Business

The Pitfalls of Multi-Discipline Offices for Chiropractors

The multi-disciplinary model has a wide range of pitfalls for chiropractic businesses. Here are the most common:

  • Sacrifice of the subluxation-based philosophy. Many potential multi-disciplinary partners won’t “go along for the ride” when it comes to understanding and supporting chiropractic care. Make sure you’re compatible with potential partners before you make the plunge.
  • Business structures. It can actually be illegal for, say, a chiropractor to employ a physician or surgeon. A “corporate structure” must be set up to manage those types of situations, according to a chiroeco.com article. Determining the proper legal framework for a multi-discipline organization can be time-consuming and costly.
  • Legal tangles. HIPAA regulations, rules and liability, and even billing can become a complicated mess tied up in a red-tape bow once multiple practitioners are involved across multiple disciplines. Get expert advice on everything from medical testing to coding and billing to HIPAA regulations and compliance before you consider setting up this kind of practice.
  • Loss of professional freedom. If you engage in a partnership with other medical professionals, you lose some of your ability to choose the direction of your practice. In some particularly dangerous multi-discipline setups, questionable “consultants” have convinced chiropractors to involve themselves in operations with an “owner M.D.” who has never even set foot in the practice. Run from any business entity that offers this kind of setup. Every involved member should have a stake and a say in day-to-day operations of the business—and that includes you!

Multi-discipline offices can also offer some advantages. Keeping patients in-house can actually ease the burden when it comes to adhering to HIPAA regulations, and can also improve your profit margins. If you find other specialists, physicians, or therapists who embrace the subluxation philosophy so central to chiropractic care, you may find that you have an unprecedented ability to provide your patients with truly holistic care.

If you’re considering going the multi-discipline route:

  • Consider consolidating instead of diversifying. It might make more sense to band together in a group practice with other chiropractors to improve your profit margins, rather than becoming involved in a multi-discipline organization.
  • Plan. Whether you choose a group chiropractic office or a cross-discipline team, take your time. You’ll need a flawless business plan and full agreement from all parties before you open your doors to ensure success.
  • Consult. Find an experienced lawyer, an experienced CEO, and a HIPAA expert before you finalize any lengthy agreement. Make sure any business consultant you hire has an impeccable record.
  • Keep spotless records. Choose a top-notch software package (or have one custom designed) to help you manage every aspect of the business. Without a well-designed, streamlined organizational system, you’ll find yourself buried under masses of paperwork within the first week.

A multi-discipline practice doesn’t have to be anathema to the chiropractic business—but it can be quite dangerous. Make decisions carefully. If you do decide to try the multi-discipline approach, do so with caution and with the proper guidance.

Give us a call or fill out our online form for more information on how to make your chiropractic office HIPAA compliant! We can help you build a solo, group, or multi-disciplinary practice that follows HIPAA regulations and keeps your chiropractic business interests well protected.

[form contact-us]

Inbound marketing trends for Chiropractors in 2012

Business Coaching in Inbound Marketing for Chiropractors

Inbound marketing has been a growing trend in Internet marketing campaigns in recent years—and successful chiropractors know how to use it. These days, if you want to grow a successful chiropractic business in a competitive market, inbound marketing plans are the best (and most affordable) set of tools for marketing management.

What is Inbound Marketing?

“Inbound marketing” refers to the suite of online tools that can help you build and drive traffic to your website, and then convert leads into revenue-generating customers. Here are a few of the best known types of inbound marketing:

  • Search Engine Optimization (SEO)
  • Infographics
  • White papers and research
  • Blogs and blogging
  • Forums and community posts
  • Social media
  • Question-and-answer sites
  • Podcasting
  • Webinars
  • Online video
  • “Information marketing”
  • “Comment marketing”

This isn’t an exhaustive list. Anything you can do online that drives traffic to your website, or helps you book appointments, can be classified as inbound marketing. And the most beautiful thing about it? Most of these advertising sources are cheap or free if you do them yourself—or can be outsourced for very reasonable rates. We often advise our clients, who want to maximize this area, to get experts to assist them as it is highly specialized marketing.

Here are five ways to take advantage of growing trends in inbound marketing, so you can stand out in the chiropractic industry:

  • Talk to your customers, not atthem or down to them. Today’s potential patients of chiropractors have access to more information than ever. They probably know more about healthcare and maintaining a healthy body than you give them credit for, and many of them will know more about the Internet than you do.
  • Build yourself a niche as an expert, but stay approachable. Internet marketing is all about building community through personality and knowledge. Show your potential clients you know your stuff, and let your personality shine through. They want to know who they’ll be meeting in the office.
  • Good video marketing is a must-have. There are millions of videos on the Internet today, and technology has progressed to the point that it’s fairly easy and inexpensive to produce high-quality videos and “infomercials” for free Internet distribution. Make it good. A video presence lets your personality shine through in ways that no other medium can, and helps clients accustomed to visual stimulation understand what makes your business unique.
  • Don’t underestimate Facebook. About 200 million Americans have a Facebook page; that’s about two out of every three people in the United States. Whether you want to reach a local or national audience, being accessible—and engaged— on Facebook can set you apart from your peers.
  • Build a beautiful and functional website. No matter how effective an inbound marketing strategy is the chances of landing a client are only as good as your website. There are probably multiple chiropractors in your area. Today, it’s affordable and fairly easy to have a sophisticated and beautiful site that represents you well and caters to all your patients’ needs. People love the ease of Internet functionality… so give them what they want.

Build a patient-centered, top-notch practice. Then represent it well on a highly functional, user-friendly site. Then work on your inbound marketing; use Facebook, videos, blogs, and anything else you can think of to build your reputation as an industry leader. Build an approachable persona that’s knowledgeable but friendly, and focused on the best in customer service and patient care. Then, and only then, you’ll have the complete package that can help you succeed in chiropractic practice.

Protect your hard work in growing a successful business – make sure your practice is HIPAA compliant. Since chiropractors collect, manage, and transfer patients’ health information, they’re responsible for protecting patient privacy under HIPAA law.

Give us a call or fill out our online form for more information on how to make your chiropractic office HIPAA compliant.

[form contact-us]

Chiropractic billing and scheduling software: Integrating HIPAA law

HIPAA Law

These days, HIPAA regulations are just a part of running a chiropractic office. But in the day-to-day shuffle of paperwork and office visits, it can be easy to lose track of the details—and difficult to remember just how important it is to stay HIPAA compliant.

Why is HIPAA Law So Important?

HIPAA compliance isn’t voluntary; it’s a legal necessity. The HITECH act of 2009 made HIPAA audits mandatory for chiropractors. In addition, it has become increasingly easy for your patients, your patients’ families, or even their friends to file a complaint with the Department of Health and Human Services (HHS) via the HHS website. Once that complaint is filed, HIPAA will contact you to conduct an audit.

If your records are in order and your practice has taken adequate steps to be compliant with HIPAA regulations, the audit may be little more than an inconvenience. However, if you have not taken documented steps toward being compliant,  you could face fines of a minimum of $50,000 and up to $250,000, as well as potential lawsuits, interruptions to your business operations and losses of reimbursement from third party payers.

HIPAA lawChiropractic Billing and Scheduling Software

The right software package, that meets the new Electonic Medical Records (EMR) requirements, can make your business run so much more smoothly—from scheduling to billing, and even managing insurance claims. But the right software can do more. It can help you manage HIPAA obligations and track your records, so that you can be confident relative to HIPAA compliance.  The right package should let you:

  • Manage a patient’s records, including medical history, current health information, and HIPAA documentation.
  • Maintain an integrated calendar, including patient visitand meetings.
  • Manage billing and insurance needs, including HIPAA releases.
  • Provide quick and easy access to each patient’s documentation as to who is and who is not cleared to access patient records. If an elderly patient’s daughter calls to ask about her mother’s health, you should be able to determine at the touch of a button whether she has clearance to receive such information.

HIPAA law is no joke. If you comply with the letter and the spirit of the law, you’re setting yourself up for success in the chiropractic industry. If, however, you don’t make HIPAA compliance a priority, it’s only a matter of time before that laxity comes back to haunt you.

The government posts the approved software packages that meet the criteria for the new EMR systems requirements. Be careful as some have actually been removed from the list due to not continuing to meet the requirements.

Every office is different and different systems work best for different people. Get at least three demos of different systems before purchasing. There is a proposed rating system, that will feature feedback on different systems from users, that may prove helpful in the near future.

 Fill out our online form for more information on how to make your chiropractic office HIPAA compliant!

[form contact-us]

How to Keep Your Chiropractic Office at its Best: Managing Patient Flow and Staff Morale

The success of any chiropractic office depends on much more than the skill of the chiropractor. In order to keep patients satisfied, they must feel respected, cared for, and valued. They need to feel that their chiropractor’s office is a harmonious and happy place where they can come to heal.

Chiropractic OfficeManaging Patient Flow

“Patient flow” refers to the movement of patients in the office. This includes scheduling appointments, organizing appointments so that all patients can access the therapeutic equipment they need, and keeping patient movements efficient. Here are a few ways to keep patient flow organized and moving comfortably:

  • Plan appointments based on patient needs. Don’t schedule two people who both need muscle stim to have appointments at the same time if you  have only one muscle stim setup. Make sure everyone has equal access to exercise rooms, massage equipment, etc.
  • Complete a work flow via a time and motion study to find bottlenecks.
  • Schedule carefully. Assign a time to a ‘unit’ of care and then determine how many units are needed per service and schedule accordingly. Ex: A standard adjustment may equal one unit (ex. 5 min.) and therefore a new patient visit may need 5 units (25min) on the book. Depending on the office we often recommend to our clients that they book specific pieces of equipment or rooms in the office separately to help manage ‘log jams’ or that they periodically block out a ‘unit’ to give some ‘catch up’ time. The number one reason people fail to get results from chiropractic  is that they do not get the treatment! Set up your schedule to accommodate people so it easy for them to return and experience the outcome you know they can get. This is important on so many levels:
    • Healthier, happier patients will continue to return and refer to your business.
    • Your stress level will be lower, so that you come across to your patients as relaxed, personable, and professional.
    • And you’re less likely to have a patient “bottleneck,” where one long appointment creates a cascade effect—and by the end of the day you’re running an hour behind, rushing through displeased client after displeased client.
  • Manage Information Gathering. Each time your patients come in, you’ll want to make sure their insurance has not changed, and gather some basic information on their current condition. Here’s how to keep it streamlined:
    • Talk to each patient as they check in, collecting basic information so that you don’t have to call them back to the check-in desk.
    • Consider automating the collection of information. Set up a computer terminal (or a printed questionnaire) and ask each patient to answer standardized questions at each check-in.
    • Ask patients to come a few minutes early to allow time for information gathering and to ameliorate scheduling problems if they’re likely to be a few minutes late and /or  have your new patient forms available on line for patients to complete and return in advance Keep your paper work streamlined and review forms at least every six months to eliminate duplication of material or to institute other more efficient approaches.

Managing Staff Morale

Part of building happy patients is building a happy staff. That responsibility falls to the chiropractor and the C.A. but also to each and every staff member. Here are a few tips for building a contented and cohesive staff that encourages satisfied clients:

  • Invest in leadership. Whether it takes the form of weekly meetings, occasional one-on-one chats, or just a strong-but-friendly daily presence, the chiropractor and C.A.need to take a day-to-day role in leading the office staff. Lead by example, not by request. If you want organization and friendliness, make those key components of your daily demeanor in the office.
  • Value happiness.  From the moment a new employee steps into the office, his (or her) superiors should come from the point of view that they are responsible for his professional development. People who are encouraged to succeed, who feel valued and utilized, are more likely to be happy at work.
  • Request (and enforce) professionalism. Most offices need a certain amount of policing. When you ask the best of people, you tend to get it. Request that your employees maintain friendly and professional manners, not falling into habits of being overly familiar or complaining to patients. You’d be surprised how often it happens.

Addressing and improving these issues leads to increased patient confidence and that is THE MOST IMPORTANT determining factor of whether patients follow your recommendations and refer others.

Patients who visit a chiropractic office are quite often ill or in significant pain. Just the thought of coming to a place where the people are kind, thoughtful, concerned, and interested in making each patient feel better can make a big difference to patients’ mindsets and physical outcomes. Caring for your office morale and efficiency can be one of the best methods of improving your patients’ outcomes.

You invest time and energy into building a successful chiropractic practice. Now invest the time to protect it! Fill out our online form for more information on how to make your Chiropractic office HIPAA compliant, and protect your business from fines, fees, and audits.

[form contact-us]

 

HIPAA Training Requirements

Chiropractors count as “covered entities” under HIPAA.  That means you must comply with a mandated annual training schedule to make sure you’re HIPAA compliant, protecting both your patients’ personal health information (PHI) and your own business.

HIPAA training

What is HIPAA?

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 addresses patients’ rights when it comes to the protection of their personal health information.  Patients’ personal health information is now protected by privacy laws, so that “covered entities” can’t release their medical records or other information without the patient’s prior written approval.

HIPAA Training

In order for businesses that keep personal health information to be compliant with HIPAA, employees must receive ongoing training in HIPAA rules, policies, and practices.  The rules must then be followed and policies and practices must be performed as per the training.  As well, any of the required training subjects, that address needed policies or practices not yet in effect, must have a plan to be implemented, followed through, documented and recorded in your HIPAA compliance manual.  This training is part of HIPAA compliance but it’s also a protective mechanism for your business.  If you or your employees don’t understand, and abide by all the details of HIPAA compliance and your chiropractic practice inadvertently violates the law, you may  face any or all of the following: $50,000 fines, lawsuits, audits, costly interruptions to the normal flow of your business, being reported to your Board of Examiners, or being reported to third party payers including PPO’s/MCO’s in which you participate.

How to Comply with HIPAA Training Requirements

Comprehensive HIPAA training can help prevent any of those consequences from occurring.  There are no specifications on how the training must be completed, but there are requirements relative to the topics that must be covered and there is a mandate that training be done (and documented) for ALL staff members annually.

Training methods can and should include:

  • Educational courses: Whether in person or online, make sure the courses you pick cover topics that directly relate to the way you do business.  Choose courses that include hands-on examples of particular situations, so that you and your staff become versed in handling actual compliance situations before you do it “live.” Something that sounds easy on paper can become deceptively difficult once you’re tied up in the red tape of actual compliance management.
  • Computer HIPAA training: Computerized storage and transfer of patient records creates all-new potential hazards when it comes to accidental breaches of patient security.  If you store PHI online, you’ll need to undergo specific HIPAA training designed to help you avoid those instances and ameliorate the damage if they do occur.
  • Ongoing training: The best HIPAA compliance firms won’t simply teach a class or two when you ask, but will help you plan for your training needs and help you implement concerted training efforts over time.  Set up a long-term plan to keep up with HIPAA compliance training, and you’ll be on track to protect your patients, your practice and yourself.
  • Coverage of Every Requirement: There are multiple training requirements necessary for full HIPAA compliance.  Written policies, workforce training, and how to manage complaints–among other things–must be covered in your training. You can read Laura Barten’s article on training requirements for more general overview  information.

Make sure you choose a reputable company that specializes in HIPAA compliance and that has consultants with a long track record, so you know you’re receiving comprehensive training that accounts for all eventualities.  Even with the best you cannot be 100% covered or safe.  Laws and rules are constantly changing.  You need a relationship with advisors who can maximize your protection.  You don’t want to get caught out on a technicality.

Fill out our online form for more information on how to make your chiropractic office HIPAA compliant. We’ll help you from start to finish, so you know you’re covered every single day.

[form contact-us]