Automate Your Care Plans for Chiropractic Patients

Read the transcript:

Jason: Hello and welcome. My name is Jason Barnes and I’m really excited to be here with you today. The subject that we’re talking about is near and dear to my heart and it’s something that has helped hundreds, literally hundreds of providers that I’ve worked with, and in thousands of clinicians simplified a way that they describe how they’re going to implement their plan of care with their patients. So today, we’re gonna talk about that problem, why it’s important, why it’s difficult to solve, and finally, what are our approaches to it so that we can hopefully make your like a little bit easier, too. So let’s get started.

And as we do get started today, we’re going to go through this step by step making a difference in the way that you actually look at this problem. So, what is it exactly? You got patients that come in, that don’t have standardized care. It’s not like you can set everybody up with the same exact problem. The diagnosis and the evaluation that you arrive at is going to dictate what this program is gonna look like. So some patients are going to have a hundred visits, some patients only 36 visits, but you’re gonna have to be able to explain how you’re gonna charge for those visits, especially if those patients come in with insurance, gonna switch over to cash, whether or not you’re gonna offer discounts to some, and you want to do so compliantly. Maybe even somebody’s got a coupon for a couple of free visits and you have to be able to put that in there.

You have to be able to discuss the patient responsibility upfront and make sure this patient not only understands how you’re gonna treat them to get them better but what their out-of-pocket cost is going to look like so that they can make an informed decision right up to the front. And when you resell that patient time and time again you are able to reference that conversation that you had.

So, those discounts that we talked about can lead to enormous compliance problems and you, unless you’re gonna standardized those patient payments across visits and across payers, right, it’s not a good idea to charge one patient who’s got Medicare on one thing and another patient who has Medicare on another thing, that can lead us to some hot water. So we have a system in place that can help with that, then actually scheduling all of those visits. And for a lot of those practices that we talk to who are not just looking to schedule visits with the one doctor but they might want to schedule it with a chiropractor, a PT, a nurse practitioner, a physician assistant, or a massage therapist, how do you make sure all of the appointments get on the right calendars, especially, especially when you’re gonna have those step-down visits where you’re gonna come in three times a week for five weeks, two times a week for five weeks, etc. So we want to reduce that complexity.

By reducing that complexity we’re gonna make it easier for you to explain to your patient exactly what those financial commitments are gonna look like and how you’re gonna implement them, whether or not you’re gonna charge upfront, whether or not you’re going to take money as you go, but we do have to make sure the charges that you put in, even though they can be different from week to week, don’t change the expectation financially for the patient that you’re working with.

So when you have to write off those amounts, you know this system will write off the amounts for you. When you have to adjust those amounts, you know that the system will adjust the right amounts for you. So taking a step further, those long-term plans, they were part of a bunch of things. First of all, you’re gonna track them and you want to make sure that if they go from acute care to maintenance care that, you know, number one, you make insurance changes should you need to, right? Most of the insurance plans out there aren’t gonna pay for maintenance care, they’re only gonna pay for acute care, and we can set that up. We’re gonna have those reminders in place not only for the evals where you can make that decision, but even if it’s during a daily visit or a regular adjustment visit, we notice that the progress has been achieved that you want to.

But, again, if you end up manually trying to adjust those amounts off and change that plan from acute care to maintenance care, it can be messy. If we automate that for you with a click of quite literally a button, where we just move the remainder of the visits on that care plan over to maintenance, we can really change how your practice operates. All right, so, again, what is our approach? So you’re making some pretty outrageous promises here, but I want to actually talk about how we go about doing it.

First of all, our care plans are a financial commitment. We create that agreement when we’re gonna assign a value to a result that you are going to deliver. You know you’ve done it before, you know you’re able to get the patient to where they want to be, but we want to make sure that that care plan that you put together represents very clearly how that patient is going to pay for this, all right? So we’re gonna combine the ability to assign value to a visit, to assign value to an insurance visit or cash visit, to assign value, again, to a free visit at zero, and then have that care plan spit out a number, all right?

Or, you can, by the click of a button, if you’re going to come up with a round number, say $2,000, and you want that divide it over 40 visits you can put the 2,000 in and the system will then automatically write-off the remainder of the charges and adjust the charges down to what they need to be for each visit so that your patient, when they go to pay their bill either at the front desk before or after the treatment or whether or not they’ve got a credit card on file that you’re pulling once a month, it is going to not only reflect the right charges, the right adjustments, but at the end of the day have the patient balance reflect what it’s supposed to. And this includes actually sending claims to insurance.

Scheduling. If you do have multiple specialties, this is probably one of the best tools I’ve seen in the industry for you to go in there and create individual clinician schedules that are going to step down from week to week. It’s a great tool that says “I’m gonna be coming in three times a week at 11 on Tuesdays, 1 p.m. on Wednesdays, and on Fridays I’m gonna come in at 8 a.m.” It will put them on there for the right clinician at the right time and you can even change the appointment types for every 10th visit for your chiropractor, make sure that’s in eval. It does automatically put all the care plan appointments right on the calendar and you don’t have to do anything else. So it’s a tool that people have raved about forever.

But what if you don’t keep track of your care plan? Right now, if you’re doing it manually or if you’re doing it in an automated system like ours how are you gonna make sure that a patient of yours doesn’t get to the end of their care plan, continue to need acute care, by the way, or maybe you have to keep that person going under cash, we want to make sure you’re notified at every step of the care plan where, “Hey, this patient has three to four visits left.” We can configure that for you. And when we do that, not only can you get a notification that goes to you but also the patient, if you’re using any sort of automated check-in. “Hey, you know, this is your last visit that is covered under your care plan. Your doctor is gonna talk to you today about, you know, the next steps to making sure that we have a resign meeting.”

Most of our clinicians want to know before the day that the patient is coming in for the last couple of visits so they can schedule that resign meeting and make sure that those patients’ expectations are managed really, really well, all right?

So the last thing that care plans are really good for, we have offices that exclusively put their patients on care plans. So they know exactly what to expect next month. So if all of your patients are in care plans we have reports that will project what your monthly revenue is going to be. Now, obviously, it doesn’t take into account that you’re an awesome clinician and that new patients will be knocking down your door, so you’ll have to adjust those for the growth that you’re obviously going to experience, but this helps. It usually helps with your financial planning, making sure that your office is gonna cover their needs.

I really hope this was helpful today. I want all of our offices who aren’t using care plans to get on board. It really does help if your client already opened a ticket to your coach or training team. If you’re not, you know, head over to our website, click on something to get an eval scheduled, and let’s show you how this works. Again, my name is Jason Barnes, I’m the Chief Operating Officer over here, and I’m so glad that we were able to talk today.

Kimberly: Thank you, Jason. All right, let’s go into a patient account, and we’re going to go on to the CP for a care plan tab. Here, we’re going to create a care plan for this patient so we’re gonna start off with hitting the New button. All of the required fields are going to be starred with an asterisk to let you know those fields are required. I like to come up with a naming convention so that if I see the name of the care plan I know exactly what that care plan is for.

So let’s start with a “12/36 Wellness 2015” care plan, all right? And then we’re going to select our start date, and let’s just say that this started a little while ago, and it’s going to end at the end of the year. So now we’re going to enter our insurance visits or our medical necessity visits, so I’m going to put the 12 insurance visits here. And then I’m going to have another 24 in the cash portion. Now, because this care plan actually started a while ago, we’re gonna say that a couple of visits have been used already. So let’s just go ahead and say that we’ll go with four visits have been used. Now, to determine if any visits have been used, you actually want to know whether or not any claims have been billed. If the patient has been checked in let’s say for today, but that claim has not yet been billed, you do not need to update this used count.

Care plans get associated with claims at the time the claim is billed. So if that claim is still sitting on your roster waiting to be billed out, it does not to have to be counted in this used count. You just bill out the claim and the care plan will increment the used count automatically for you. All right, so for our dollar per visits column or field for our insurance portion, I’m going to leave that as blank. And what that means is that during the first 12 visits of this care plan, this system is just going to bill out my normal fee schedule and insurance is going to adjudicate and pay whatever they are going to pay and anything that they say is patient responsibility is going to be billed to the patient. I’m not going to do any write-offs.

During the cash portion, I’m actually going to do some write-offs. I’m going to say that based on how much the patient is paying for their care plan, subtracting the amount that they’re going to pay for those estimated amount they’re going to pay for those first 12 visits after insurance is paid. I’m going to say that it’s going to end up being let’s say $18 a visit. What this means in this dollar per visit field is that I’m going to bill out the claim as normal. The system is going to pull the price from the fee schedule. It’s going to be the full price that I usually charge for anyone who’s not on the care plan. And then, because I have this dollar per visit field filled in, it’s going to do an automatic write-off once this claim is in patient’s status and it’s going to adjust it down so that per claim, per visit, at most the patient is responsible for $18.

All right. And then if we haven’t had some free visits for the patient, we can put that into this free visit column. My patient isn’t gonna have any, so I’m gonna leave that as zero because it is a required field. I’m going to say that I expect to get all my…I’m expecting to collect let’s say $200 from insurance and I expect that to be complete, let’s just say by the end of this month. These two fields are optional but if I filled them in, that does mean that if I do not receive this amount by this date we do get a ticket that opens up, so we can look into why we’re needing to add collective much as expected.

I want my transactions to be on the transaction tab so everything is itemized. If the patient happens to want a report or statements, I’m gonna leave that as default. And then I’m going to save my care plan. I also want to add in, just because I can, let me go to view CPTs and, I’m actually going to limit it to just using the adjustment codes that I happen to be using for my care plan. Let’s say it’s going to be 9841 and an S8990. Using this will make it so that any CPT that I bill out, let’s, for example, say a re-exam code or an x-ray code, we’ll bill that out at full price and it won’t be adjusted. Let’s say I took that into account when I figured out my numbers from my care plan. So when the patient gets their re-exam and their activities at the end of their care plan, those get billed out at full price and that will use up the rest of the money that they paid for their care plan.

And this is how you can set up, all right, an example of how you can set up the financial portion of a care plan. So let’s go on to scheduling, go to more, make care plan, and actually, if you go in here and just keep hitting Next, it’ll actually walk you through the different steps. I like doing the care plan financial section first, so that’s why I went into the CP tab. So let’s say that this patient is going to start coming in three times a week at 4:00. And then once…and let’s say they do that for…we’ll do it for those first 12 visits. So we’ll do that for the first four weeks, and then they’re going to go down to twice a week. Let’s just do it at Tuesday and Thursday now. And we’ll do that for the remainder of the time. So that will be another 12 weeks. And then we can have on visit 24, we’re going to have that to be a re-exam appointment.

All right. And I can also select the doctor that is going to be scheduled with this patient. So we’re going to have, let’s say, Dr. Mary. And then I can hit Finish, and these appointments will be created, or I can go to Next, that’s actually going to bring me into a make care plan screen, the financial portion, which I’ve already done. So I’m just gonna hit Next again. Again, that would bring me into the CPTs fields that I showed you under the View button. And if I hit Next, now I’m in the notification portion. So now I can go through and add some notifications for this patient.

So let’s say that on care plan visit 12, I want to let the patient know that their next visit…this was their last insurance portion care plan visit, and their next one is going to be cash. So I’m just going to put in a little note that’s gonna pop up on the schedule. And I want them showing up on the schedule for my front desk to let the patient know, so I’m gonna make sure that stays checked, and I’m going to hit Save. There’s a number of different care plan notifications that you can put into place, how many insurance visits are left, cash, free, how many total. We also have ways to distinguish what type of care plan it is, such as the total visits of the care plan or the name of the care plan. So if you do use a naming convention, those rules might help you break down these alerts or notifications for a large number of patients because…let’s just hit Finish up here.

You can actually go to configuration practice schedule and go to the notifications tab. And here you can set up practice-wide notifications, the ones I was showing you was patient-specific. So if I come in here and select add, has CP name rule, and I put in that name of “12/36 Wellness 2015,” now, any of the patients that I have a set up with the care plan with this name, this alert will apply to. So then I can go ahead and select another rule saying that if the patient has this visit, and they have 12 visits, and it’s the 12th visit, that way if a patient happens to have a different type of care plan, maybe 5 insurance visits or maybe 20, I’m not getting that on the 12th visit popup alert on my schedule, but I also don’t have to set it up individually for each patient. I can do it practice-wide. And then there are a couple of more alerts that will let you know when the care plan is running out of days or if it’s a certain age old. We can also even let you know if the patient has no care plan active at all.

So those are some of the types of rules that you might find very handy when working with patients and care plans. All right, well, thank you for joining us today and I hope to talk to you soon. Bye.