Would it surprise you to know that you can supercharge your practice’s success and feel safe and compliant at the same time? It’s not only possible, but when doing so, you are meeting the expectations of your state and government regulations.

And great news! It’s not hard.

Medicare

Ever felt like you’re missing the mark when it comes to documentation and Medicare rules? You’re not alone.

Because as Medicare goes—so goes the nation (and other payers)—it’s critical to know the commonly overlooked nuances and straightforward and actionable solutions to rectify them. It’s not just about compliance—it’s about optimizing your practice’s efficiency and maximizing reimbursements.

Estimates show that over 10,000 people PER DAY age into Medicare coverage, and over 60% of them are currently choosing to participate in Medicare Part C/Advantage programs vs. traditional Part B Medicare.

Never has it been more important to get this right!

Discounting

Offering cash or bookkeeping discounts to patients is an art, and it’s important to paint from the right palette.

It’s critical to strike the perfect balance between attracting patients and staying within the discounting rules…without sacrificing profitability.

• The discount terrain is clearly marked, and it’s even possible to turn it into a revenue-boosting avenue.
• Compliant and consistent cash flow is everyone’s job in the practice, but running afoul of specific rules can hurt.
• It is possible to offer compliant discounts to those who are uninsured, underinsured, or partially insured, like Medicare patients.

It’s also possible to offer help to those patients with financial hardship and to those to whom you want to offer professional courtesy. But doing so requires careful planning and consideration of written policy and procedure.

Third-Party Medical Review Policy (MRP)

Ever wondered why Medical Review Policy comprehension and implementation are non-negotiable?

• It’s literally the “letter of the law” when working with third-party payers, and ignorance of MRP can really cost your practice.
• They usually contain important information, like medical necessity definitions, coding allowances, modifier requirements, and lists of services and products that may be experimental, unproven, and investigational.
• A misstep here could cost the practice if you attempt to bill and are denied, and without proper advance notice, you can’t collect from the patient.

I look forward to being with you in Edison, NJ, on October 19 at the 2023 ANJC Fall Symposium to dive into these topics and leave you with tangible tips and tools to roar back into practice—feeling plenty of certainty and clear direction.

About the Author

Kathy Weidner, better known professionally as Kathy Mills Chang, is a Certified Medical Compliance Specialist (MCS-P), a Certified Professional Compliance Officer (CPCO), and a Certified Chiropractic Professional Coder.

Since 1983, she has provided chiropractors with reimbursement and compliance training, advice, and tools to improve the financial performance of their practices. This year, celebrating serving this profession for 40 years, Kathy leads the largest team of certified specialists under one roof in the profession at KMC University and is known as one of our profession’s foremost experts on Medicare and documentation.

She or any of her team members can be reached at (855) TEAM KMC or info@KMCUniversity.com.