b'Marketing Free CODING Update ComplianceServicesBy David Kein ANJC Coding & Compliance ConsultantLEGAL NUTRITIONUpdateThe Department of Health and Human Services (HHS) Office of the Inspector General (OIG) has suggested that physician practices should not offer inappropriate inducements to patients, specifically, they should avoid: Soliciting, accepting ANJC News or offering any gift or gratuity of more than nominal value. ANJC Leadership ANJC News! Free consultations, evaluation and management services, X-rays, and other treatment should not be given away for free NUTRITION LEGAL EASE as these services clearly have significant value. The nominal value as defined by the OIG in its December 7, 2016, Policy Statement Regarding Gifts of Nominal Value To Medicare and Medicaid Beneficiaries is $15 per item and $75 annual.As stated above, any financial reduction (including free Practitioners often wonder about whether their marketingREHAB Update services) as a means of inducing the patient to get care may ANJC Scholarships offend statutes designed to prohibit the offer of anything efforts are compliant and legal.I frequently answer questionsmore than of nominal value.Additionally, offering free from providers about different scenarios regarding offersservices to some and not to others could be viewed as fee they wish to extend to potential patients.One scenario insplitting. particular stands out was when I answered a question from a provider who stated: I want to offer health screenings inRecommendations:order to attract new patients to my clinic.I plan on giving out1 CHIRO Assistcertificates that allow potential new patients to visit my officeI t is recommended that practitioners keep their fees the LEGAL Q&A same for everyone and all payers, this will help to avoid for a consultation, examination and X-rays free of charge.Ihaving a duel fee schedule. Executive Directors Update know that I should not bill the insurance for those services,2Do not reduce fees unless for legitimate hardships, legal but should I also refrain from giving those services away for free?Is it best to offer those initial services for a modest3 B 2020 ANJC AWARDSprompt-pay discounts, or network contracts.fee?We are obviously trying to encourage potential newe careful when having promotions.If there is a CPT code (and sometimes skeptical) patients to come in and have theirthat represents the service you are giving away for free problem evaluated without having any financial barriers. then its probably not considered a nominal value.Discounts and free services offered to patients could4 Consider marketing a Free Interview with the DoctorLegislative Update or a Free Consultation and then instruct readers to induce the patient to receive services that otherwise the INSURANCE Update INSURANCE Update patient might not seek.Consequently, a governmental orcontact office for further details.When they call you can other private healthcare plan could become financially liableclearly define that the free consultation is an interview for a measurable portion of the care.chiropractic patient. TECHNIQUE Updatewith the doctor to determine if the patient qualifies as a Because of this, the Health Insurance Portability and Account-ability Act of 1996 (HIPAA) placed significant restrictions onI would also recommend that before you implement providers who wish to market their practices through variousa marketing program for your practice, you consult a financial inducements.These inducements include thehealthcare attorney and/or a compliance expert to review offering of free services, discounted services, and waivers ofmarketing materials and any incentives for potential patients MedicareQ&AMedicare Update you wish to implement.co-insurance and deductible amounts.The restrictions areOUR HEALTHnot just limited to healthcare providers.They apply to [a]ny person (including an organization, agency, or other entity .)David Klein, CPC, CPMA, CHC, is co-founder of PayDCthat . offers . or transfers the inducement. www.paydc.com, a web-based EHR system that focuses on Although the HIPAA restrictions are limited to instancesefficiency, compliance and reimbursement.He is a certified where patients are covered by government healthcareprofessional coder and certified professional medical auditor plans, it has a broader application than just federal and statethrough the American Academy of Professional Coders (AAPC), programs.Many private payers have adopted the same orand is certified in healthcare compliance through the Healthsimilar standards and have established, within their contracts,Care Compliance Board (HCCB).He is the Founder and President prohibitions against this practice of incentives designedof DK Coding & Compliance, Inc. a healthcare consulting firmto induce a patient to seek treatment from a particularthat focuses on audit defense, education, compliance and reim-provider.bursement issues. www.njchiropractors.com I 9'