SWAT outsmarts payers to resolve billing issues
Beating the insurance companies at their own game can be extremely frustrating and time-consuming for chiropractors who want to improve the cash flow at their clinics. Even when a provider makes time to deal with the payers instead of treating his patients, he usually lacks the necessary expertise to resolve any issues and often ends up losing massive amounts of profit due to delayed, denied or reduced payments for submitted claims. So, when the going gets tough and a provider finds himself overwhelmed by complex billing issues that keep him from getting paid, Genesis’ SWAT (SPOCs With Attitude and Training) Team steps in to save the day and discover underpayment and delay tactics in massive volumes at the request of the provider’s account manager (a.k.a. SPOC). By analyzing large amounts of data to discover trends for underpayments and delay tactics SWAT puts the combined expertise of over 50 years of billing, practice management, and Vericle experience to use to come up with creative solutions to counteract the payers’ tricks and outsmart them. These solutions are then shared and implemented as concerted effort by multi-specialty teams, including practice managers, billers, account managers, audit and quality assurance managers, systems development, customer support, and the technology team who focus on large-scale problems. The SWAT team is not geographically limited in any way and works effectively to solve chiropractic cash flow issues across multiple states and specialties regardless of any differences. As case in point, SWAT helped a practice collect $5,418 in payments after months of not receiving any money for submitted claims in spite of being re-credentialed as group provider by Medicare. The solution consisted of correcting an incorrectly entered provider’s Group NPI number so that the practice can now enjoy steady income from Medicare. In another example, SWAT helped a practice increase their income from $600 to $15,147 by discovering and correcting inaccurate data that had led to denied claims. These corrections also resulted in steady income from Medicaid and significantly increased profits. Ultimately, Genesis’ billing SWAT team will go to bat for the practice owners against any and all payers who try to avoid paying what they owe for claims.
Are you paying more for your chiropractic billing than it’s worth?
Your chiropractic billing software or billing company may cost you more than it is worth if your collections are consistently low and many of your accounts receivable (AR) are more than 120 days past due. Since your clinic’s profitability greatly depends on speedy and proficient billing performance, the billing fees are actually not as significant as the total amount of collections received in one month when determining the true value/ROI of your billing service/software. Granted, the salary of an in-house billing staff member may cost you less than the fee collected by a chiropractic billing company. But chances are, the billing company can achieve a higher amount in collections each month due to better tools such as sophisticated billing software and a network of employees with more combined professional experience. In other words, you will get what you pay for, but in the end the potential for building your dream practice with greater profits increases when choosing a billing company in spite of higher fees. If you think buying chiropractic billing software to be used by your in-house employee will save you money on billing fees, think again. Ultimately, you will still lack the manpower to fight the payers, just as you will lack the resources to stay on top of technological advancements. Software upgrades don’t come cheap and the insurance companies are notorious for changing codes frequently to throw a wrench in your billing game. Last but certainly not least, the risk of never ever getting the money you are owed for chiropractic claims increases significantly once the AR hit the 120-day mark. You can basically consider these claims to be “dead” charges and start looking for a way to speed up your billing process to prevent this from happening again. Here is how you can compute the true cost of your chiropractic billing fees: Profit = Collections – Billing Performance Loss – Billing Fees Where: Collections: total amount of money received from insurance companies Billing Performance Loss: all claims submitted (AR) that are 120 days past-due Billings fees: money charged for the service Example: Assumptions: Your current fees are 5%. Your current collections are $100,000 Your current AR beyond 120 days is 20 % Potential fees are 8% potential AR beyond 120 days is 10 % –> What is the new performance? How much more money will you have? A) What is the improved collection? Calculate improvement in performance by subtracting new AR percentage past 120 days (10%) from old AR (past 120 days) of 20%: 20%-10%=10% improved collections percentage B) What is the potential collection? Calculate dollar value of potential improved collections by adding 10% (improved collections) to current total of $100,000: $100,000 + $10,000=$110,000 potential collections C) What is the potential profit? Calculate the current profit by subtracting $5,000 for service fees from $100,000 in collections, resulting in $95,000 in current profits: $100,000-$5,000=$95,000 current profit (assume 5% fees) Determine $ amount of new fees by multiplying improved collections of $110,000 by 8-percent fee resulting in the amount of $8,000 for new fees: $110,000 x 0.08 = $8,000 new fee Calculate improved profit by subtracting billing fees in the amount of $8,000 from the improved collections of $110,000, resulting in improved profit of $102,000: $110,000-$8,000=$102,000 improved profit D) How much will the profit increase? Overall bottom line improvement of $102,000 – $95,000 = $7,000 more in spite of the higher fee! Ultimately, the best solution would be to use a chiropractic billing service network that can leverage the network effect of accumulated knowledge and man-power against the payers and get you paid faster.
ChiroFutures adds health plan billing error defense coverage for chiropractors
>The insurance company, ChiroFutures Risk Purchasing Group, now offers Health Plan Billing Error Defense Coverage as part of its Chiropractor’s Malpractice Insurance Program. ChiroFutures Co-Founder Dr. Matthew McCoy said, “We are pleased to provide our clients with this enhanced coverage at no additional charge. We know the special risks chiropractors face in their professional endeavors and we are able to offer insightful risk management advice and tools, as well as insurance products that meet a chiropractor’s specific needs.” In particular, that means chiropractors will be able to get coverage in emerging areas of liability, such as Regulatory Board Defense, Medicare/Medicaid Billing Error Defense, Information Privacy Wrongful Acts, and Peer Review Committee Defense. For more information about the Chiropractic Professional Liability program, please contact Teresa Quale, Sonoran National Insurance Group, at teresa.quale@sonorannational.com or (480) 538-7173.
Genesis Chiropractic Software and Billing Integrates with PostureScreen Mobile
PostureScreen and Genesis Chiropractic Software and Billing, both CBP® Preferred Products, integrate to add mobile phone application dimension to practice management, patient education, and billing. Now with one touch of the screen from the iPhone, iPad, or Android application, the PostureScreen® Mobile report and images are instantly uploaded to the patient account inside Genesis! This integration is available to all Genesis/Billing Precision clients and PostureScreen® clients at no extra charge! Click the image below to request an email with step-by-step instructions. Start using the integration right away. Watch a video of the integration! Dr. Joe Ferrantelli and Dr. Brian Capra Filmed at the Ideal Spine Institute, CBP headquarters in Eagle, Idaho. https://youtu.be/8sIHrzS7Gh Dr. Jason Haas’ Testimonial More information on the integration View the full official press release here: http://www.prweb.com/releases/Chiropractic-Software/Billing-CBP-Posturescreen/prweb10012113.htm
