The #1 way insurance companies make their profit
I want to talk to you today about what insurance companies really don’t want you to know. And then I have a checklist. We’re going to go down 10 things. I’m just going to cover one today. And I think, when you understand this one thing, you’ll probably get, and understand, that there’s a lot more to it than you realize. So, what insurance companies don’t want you to know. When I first started chiropractic, first of all, I own Genesis, a software company and chiropractic billing service. Scheduling, documentation, billing. We’re a billing service, I own a billing company. When I started chiropractic and chiropractic practice I had no idea about anything about billing, coding, documentation. Audits were just starting to happen. But I quickly realized what a big need that was. So I started to dig in and I actually went out and found some people outside of the chiropractic profession, in the finance world, in the technology world, in the artificial intelligence world, that’s how I wound up with Genesis as a company. But what I started to realize is that insurance companies are just like every other company. They’re made up of people, process, and technology. They want to turn a profit. But what I did not realize is how they actually make their money. I used to think that it was just simple. They collect a bunch of premiums from patients and they don’t pay insurance claims. That’s of course one way, but there’s actually much more to that. When we’re talking about how they make profit, over 50% of insurance company’s profits are made on what is known in the financial world as the float. Float is interest. Float is interest on money that is not yours. In this case, your money, the chiropractor’s money. So the insurance company is making interest on your money and it’s not their money. When is is not their money? It’s really interesting because in the real world, on Wall Street for example … again, my partners today, in Genesis, are from the financial world, from Wall Street in technology. On Wall Street, every time a transaction happens on Wall Street, by the end of the day everybody has to get paid. All the parties involved in any transaction and on Wall Street, a transaction can be infinitely more complicated than an insurance claim. Diagnoses codes, procedure codes, all that good stuff seems complicated to us, but on Wall Street they’re way more complicated and by law everybody has to be paid by the end of the day and the technology exists to make that happen. So you understand the technology exists today for you to be paid the moment or the moment after you’re finished adjusting the patient. All right so, when you start to realize that insurance companies are actually making more than half of their profit on the interest that should be on your money. The interest on your money. Meaning, after you see the patient, that next moment the money is technically yours. Everything after that is bologna. We’re going to start talking about all this stuff in a little bit more detail and how they actually … First of all, think about these things. How do insurance companies get to rig the system so that they have thirty days, for example, to pay your insurance claim? Why are there diagnosis and procedure codes? Why are there modifiers? Diagnosis code linking? Why is there the ability to deny your claim, medical necessity, documentation? Why does all that stuff exist? So, what I’m going to start to talk to you about over the next few days is all the little details that we take for granted as we think is normal, or they should be there, or it’s for the patient’s benefit, or medical necessities all about the patient, or about the performance of the doctor, or about the results that you get is really a bunch of nonsense actually. Actually the moment that you adjust that patient that money is yours. Insurance companies make more than half their profit on interest on your money. So I’m going to talk to you about, again, over the next few days, the top ways they’ve actually been able to rig the system, put this in place. Then eventually, maybe I’ll get into a little bit more about Genesis and how we’ve actually … helping doctors leverage technology, and automation, artificial intelligence, and processes, and people to actually beat them at their own game. We’re the only company that’s been able to do that with artificial intelligence patented. Not to talk about Genesis, I just want to help you understand how insurance companies, what they’re really up to. It’s a business and it’s their right to run it and the rules are what they are so if we want to change them, we either got to change the rules or we got to learn to learn how to play by the rules and beat them at their own game. Hope for this was a little bit helpful. Again, insurance companies are making more than half their profit on interest on your money sitting in their bank accounts.
What to Look For in a Billing Company – Chapter 11
Chapter 11 What to Look For in a Billing Company As we have seen, Genesis has automated everything with the exception of following up on claims that need a phone call. So the word billing in billing company really does not apply anymore. We are really a follow-up company. For clients who keep things in-house and use Genesis, they really do not have a billing department anymore. They have a follow-up department. What You Do Not Want Sometimes it is easier to think about what you do not want rather than what you do want. We’ve already covered what you do want and why. Here is what you do not want in a billing company: No automation, just lots of experience You do not want a company that does not have automation and just says they have lots of experience or are really great billers. Genesis has been in the business for 14 years and processes millions of claims for practices all over the country. We have many expert certified coders (hundreds, actually) with lots of experience on our team. You might be saying, So what? One biller does not know more than what insurance companies have built into their AI. What happens tomorrow when the insurance company changes tactics? Are billers looking at data across thousands of practices and millions of claims? Are they building new automation and AI to fight back against insurance companies’ tactics? Can one very experienced person follow up on millions of claims? No accountability I used to outsource to a company that would send me lots of reports every month. Guess what? I never had time to look at them. If you cannot see top-down reporting of their work in real time, forget it. How many claims need follow-up today? What is your AR > 120 days? Then drill down into reports from there if you want to or need to. That’s what Genesis offers. Billing companies love to talk about their reports and how they log into your system. No good. No control, no transparency, no accountability. You will wind up not trusting them. They don’t outsource follow-up I know what you’re thinking. I don’t want to speak to someone in India. Of course not. We would never ask a client to do that. With Genesis, you always speak to a resource in the United States. But we do want the insurance company to speak to someone in India (or another country). Why? Because they are doing the same thing. Remember how we said they have unlimited manpower? If we are going to beat them at their own game, we must do the same. Outsourcing your claims follow-up while still giving you transparency is one of our secret weapons. We have hundreds of follow-up resources in other countries driving insurance companies crazy every day. They are managed by resources here in the United States. They are only paid when you get paid. They use another software If they are using another software, then no thank you. I shouldn’t have to explain all the reasons that this is a deal breaker. Your practice management end must be tied to your billing and follow-up if you want real control, transparency, accountability, and a chance to beat insurance companies at their own game. Even if you are using another cloud-based system, it is not enough. That would mean the biller is using the same exact system. But what about Single Point Management? Yes, control and transparency. Low fees and what they mean A billing service should be charging only a percentage of what you collect from the insurance company—not on copays and deductibles. You want them to have all their incentive focused on getting the money you deserve from insurance companies. The average fee for this in chiropractic is between 6% and 10%. The number varies based on what your average collection per claim is. Anything lower is a big red flag. It means they are probably not going to follow up on every single claim and that they will just take the easy money. Since most of them have junk technology, you’ll never really know. The low fee also tells you they are not investing in technology and are most likely using the system you already have and logging in remotely or using some other system. See #4 above. That’s a deal breaker. Some billing services advertise a very low percentage, but then you find out it is a percentage of what you charge. Some of our clients actually want this for some reason, and we do it. However, you’d better make sure you have a way to see everything they have done on any claim and have a way to know they are following up on every single claim that needs it. Some charge a lower percentage but take a percentage of everything you collect, including cash, copays, and deductibles. Watch out for that one. Another pitfall of low fees is that no system (except Genesis) can track underpayments. So while they give you a low percentage, you never really see the income from your underpayments. They just do not have the technology or enough workers to go after that money for you. It could cost you tens of thousands of dollars per year. If you do not keep insurance companies accountable, they will continue to take advantage, and it will only get worse.
What Insurance Companies Don’t Want You To Know Chapter 1
What Insurance Companies Don’t Want You to Know… And… How to Beat Them at Their Own Game The Secret Tactics They Use to Keep More Money Than You Think and Use It to Audit Other Chiropractors Bonus: Going Cash: Myths and Facts Table of Contents About the author From the Author PART 1: What Insurance Companies Don’t Want You To Know Chapter 1 – Insurance Company Strategy – How They Really Make Their Money Chapter 2 – How they rig the system Chapter 3 – Their Tactics and their Rules Chapter 4 – Kicking you while you’re down Chapter 5 – The Fatal Blow – Let’s all go “Cash”! Part 2: How We Can Beat Them at Their Own Game Together Chapter 6 – Leveling the Playing Field Chapter 7 – The Paradigm Shift Chapter 8 – Taking Chiropractic to the next level – The Research – Now We’ve Gotem’ Chapter 9 – Streamlined interface – FAQ Chapter 10 – When should you outsource? Chapter 11 – What to look for in a billing company Chapter 12 – The 3 Biggest Mistakes when choosing software Chapter 13 – What Software Companies Don’t Want You To Know About Your Data Security & Liability 8 Secrets They Keep and the Truth You Need to Know Chapter 14 – Software support pitfalls Contact Genesis Can I see Genesis? Contact the author? I’ve known Dr. Brian Capra for many years and have seen his admirable purpose and passion for the chiropractic profession. His efforts to create a book to give context to chiropractors on the issue of insurance should warrant some notice. I have been critical of the insurance industry for many years and have created programs to help chiropractors end insurance dependency. The goals of 3rd party payers and the goals have chiropractors do not come close to aligning. Take a look at what Dr. Capra has learned about the insurance industry – it will open your eyes.” – Dr. Patrick Gentempo “Having spent the greater part of 16 years in the coding, compliance and insurance world of chiropractic I have seen things come and go. You see people that are so called experts that have made a career on attempting to scare doctors and staff into compliance. You see new software’s come and go that make promises but yet it all leaves a doctor more confused and living in fear. After meeting Dr. Brian Capra I was not sure if he would fall into the same category as others. I took me only a few months to realize he was different. He was not interested in scaring anyone but rather empowering them. Dr. Capra has touched this profession in many different ways but this book is another example of his attempt to create mental freedom for the chiropractor and their team. Dr. Capra and I agree that if we can remove fear, replace it with belief we can get chiropractors back to loving and serving as they were created to do. A must read for all offices!” – Bharon Hoag – One Chiropractic If you are going to play the insurance game in healthcare today, then you’d better play it right. The moment you file a claim, you step into the ring with a heavyweight. You’d better have done your homework. Any misstep can cost you dearly. Even if you consider yourself a “cash practice” or “cash-like,” you are still subject to the rules of the game. Ask any non-participating provider that’s been whacked. Dr. Brian Capra’s What Insurance Companies Don’t Want You to Know is mandatory reading for anyone “in the fight” that’s looking to play within the rules, maximize your returns, and not get hurt. It’s an easy read and a quick study—definitely worth your time. —Dr. Stephen Franson – The Remarkable Practice For almost ten years I have had the opportunity to work side-by-side with Dr. Brian Capra for the benefit of our mutual clients. During this time, we’ve seen clients succeed in practice with a top notch collection percentage, all while giving the doctor balance between the time spent in the system and compliance. —Dr. John Davila – Custom Chiro Solutions Dr. Brian Capra is an innovative leader at the intersection of chiropractic and technology. The EHR/practice management system he and his team have created drives continuous improvement in workflow and efficiency. Brian is an expert at workflow design for chiropractic and other healthcare facilities. He has remarkable insight to help providers address their biggest challenges, be more profitable, and have the vision and foresight to know what the profession, individual practices, and patients will need in the future. In a word, Brian is remarkable. —Dr. Jay Greenstein Since starting with the Genesis AI platform in 2016, I have had more time off in practice (seven weeks) and have had record collection months. I highly recommend the software, only if you want more money and more free time. —Dr. Peter Martone Genesis includes everything your practice needs for efficiency, patient care, and your bottom line. There is simply nothing else like it in today’s EHR market! Because we’ve chosen Genesis for our office, we are confident you should do the same. —Dr. Deed Harrison – CBP
Chiropractic Software Increases Insurance Collections by 10%
Using Genesis Chiropractic Software will Increase your Insurance Collections by 10%. The average new client for Genesis increases their insurance collections from billing by 10%. If your practice isn’t average, then your practice will collect more. The way we do that is by focusing on follow-up and automate everything else. Learn how by understanding every step of the chiropractic insurance billing process from generating the claim to submitting it to following up and finally to payment for services rendered.
Increase Revenue with ClearGage
ClearGage is Integrated into Genesis Chiropractic Software As a Chiropractor you know that insurance collections and patient co-pays make up most of your practice revenue. Surely you’ve experienced the hassle of trying to mention collections to your patients for their co-pays. That conversation is very difficult. Would you like an easier way? What if you could use new tools like a Payment Accellerator, Patient Financing, Online bill pay and ClearCalc. The Patient Financing alone would be a great tool, but ClearGage offers all four and more. Let them have the collections conversation with your patients and then you can concentrate on giving them the best care. These tools have been integrated into your patient accounts, so please put them to good use. Do you think this will reduce the financial burden on your patients? Do you think your patients will buy more of your services with the financing? It will certainly relax the practice owner and their staff with the money collection issue removed from their work days. Happy patients and happy staff makes a practice owner very happy. Watch this Free Webinar to find out more from Jason Barnes, and to see exactly how it works. Enter your information and watch it immediately below. Read the transcript: Christine: I’m Christine Sharon, the marketing manager with ClearGage. We are welcoming you to our webinar, Maximizing Patient Collections. And today, this webinar will be hosted by Chip Hunziker, the CEO of ClearGage, and Jason Barnes, the chief operating officer of Genesis. Welcome, gentlemen. Chip: That’s right. Christine: Chip, I’m going to turn…pardon me. Chip, I’m gonna turn the meeting over to you to begin. Chip: All right. Thank you very much, Christine. Thank you, Jason. We’re very excited about bringing you this presentation and we’re excited about our relationship with Genesis. So, let’s get started. What we’re gonna talk about today is how to maximize patient collections and why you, as a healthcare provider, really need to stop and minimize the leaky bucket around bad debt. We need to be able to collect our patient money cost effectively, we need to be able to offer our patients real financial solutions that’ll help them get the care they need, and help you increase your conversion ratio and your cash flow. Why technology and services, and why ClearGage is are unique to the market. And more importantly, how you could integrate these within practice management systems to make sure that you’re able to deliver the revenue generating machine, the ability to collect from patients and the ability to collect from your payers, all seamlessly on one platform. So, why do we need to adopt a leaky bucket related to our healthcare collections? The reality is healthcare providers are one of the poorest businesses in terms of collecting patient receivables. The retail market has 3.5 % bad debt in healthcare. It’s 25% to 50% when it comes to patient collections. And the fastest growing segment of bad debt is patients with insurance, so it’s very important that we put these solutions in. And it’s no secret, as these patients leave your premises, and walk out the door and then we need to bill and chase them, what this slide shows is the cost of collecting your receivable. So, we know that the cheapest way to collect a paycheck receivable is your patient co-pays. You collect it right at the point of care. Oftentimes, you’re collecting it before you see the patient. Most times, you only have merchant account fees associated with it. So, point of care collections is by far the most cost effective. As that claim ages, as your patients walk out the door, and they receive your product or service and then you bill them 30, 60, 90 days, the cost of collections only grows. So, one of the things that we recommend to all of our clients that every one of you who are healthcare providers should adopt right away is what we call card or account on file. Think about it. Hotels do it, car rental companies do it and now you can. And what we’re saying by card on file is you have the ability to capture your patients’ payment vehicle, either their credit, debit card or even their checking account, keep it in a PCI compliant, which means it’s masked, it’s encrypted so no one can use it for any unauthorized purpose, and you keep it on file. So, when your patients come in and they receive your product or service and they pay your co-pay, should they leave and you bill their insurance company only to find out that there’s a post insurance claim or liability, you can go ahead and automatically run that payment. And what does that do? Well, it transforms the payment cycle from where the patient comes in, they pay their co-pay, they see your doc, you create a claim, you drop the claim, whether you drop it. Hopefully, you’re doing electronic claim submission, but you drop the claim, you then wait for the claim to be adjudicated. Then you find out the patient has a balance, and you send a statement and you send a statement, and all of a sudden, you find out that 60, 90, 120 days has passed and your patients still owe you a balance. Well, with our card on file process, what happens is the patient checks in, they give you their payment card, you store it, they give you the agreement and consent for you to store it, you create the claim in the same manner, you bill in the same manner. But instead of sending them a paper statement informing them that they owe you money, our system would actually send them a text or e-mail, and that text or e-mail would notify them that their payment is going to run. So, we would let them know how much money the patient owes and it would even be able to give them, solely up to
How to Detect CPT Code Underpayments
If insurance companies underpay your practice for certain CPT codes, would you be able to look it up? CPT code Lookup: How would you find that out in your practice management software? Can you look back a year and see what you’ve been paid per CPT code? Our clients tell us that their previous software couldn’t look backwards as they needed it to, so they’re very excited that Genesis Chiropractic software can do that. It’s a tool called the Billing Statistics report and you can configure it to look up just about anything. (Within your own account of course!) Watch this Free Webinar to find out more and to see exactly how it works. Learn how to discover your underpayments and get paid what you deserve. Enter your information and watch it now. Read the transcript: Jason: Good afternoon everyone, it is just one minute past the hour, so we’re just gonna give it a couple of minutes before we get started. Jason Barnes here with Jessica Pancoast, and we’re going to talk today about attracting CPT codes and making sure that you guys are getting paid for visits we are looking to get paid, and so this is a big portion of app, but we’ve got a bunch of people in the web portion we all have and are doing to the audio portion so we’re gonna give this another minute or two. Thanks for your patience and we’ll get started here in a moment. In the meantime, if you have any questions, feel free to type them into the chat. Jessica: If you guys do not see the chat, it should be over on your left-hand side, there is a button up at the top that would say “show chat.” if you don’t see it, then you can turn it on. Jason: All right, perfect. Exactly another minute or two and we’ll get started. Jason: All right, we’re gonna get started. A whole bunch of more people joined, so I’ll go ahead and introduce myself. Jason Barnes, chief operations officer here, and I’m the head of our help desk and training team, and sitting right next to me, Jessica Pancoast. I must announce, Jessica is much tanner than she was a couple of weeks ago, due to some well-deserved vacation and a smile on her face, I think it’s going to be heard by all who are listening today. I know I’m truly enjoying spending time with her. But today we are actually talking about a pretty specific topic, and one would define the problem that we are looking to solve for a couple of our practices here, collections, per activity when it comes to certain doctors or whether or not certain payers, or reimbursing. Today, we’re actually going to start talking about procedure codes, CPT codes, and how we track their reimbursements. So, we’ve got a couple of tools we want to talk about and we’re gonna first head over to our demonstration account here and when you’re looking at collections from a regular base that there’s a lot of different ways of doing it. But I always tell people the radar chart and configuring that is one of your best ways of going about it, so you can see what your total billed is and you’re total collected, but what makes that up and when something’s lower than what you expected, there’s a number of ways to dig in, and sometimes, or all the time, for CPT codes reimbursements can be the difference. Whether or not you offer physical therapy on your office and there’s a sequestration law that you just aren’t aware of that is reducing CPT codes, you’re a network and you’re getting underpaid in a situation where CPT codes is simply being denied, it’s not covered, how do you keep your finger on the pulse of your claim reimbursements at a procedure code level. Today, we’re actually gonna talk about the tools to take a deeper x-ray or look into low collections versus CPT codes and whether or not you’re simply looking at your dashboard, and you see that $27,000 at this point of month is not okay or you head over to your, some of your reports and you wanna look at your month closure reports, and we’ll get to see history or the trends of how much you’re getting paid and keep in mind that I’m very zoomed in here for the sake of presentation, if this doesn’t look how it looks then your strain is totally… it should be expected, is what I’m saying. If you can click on your history tab here and get a history of what you’ve been paid, and what’s been adjusted or refunded. But if you do recognize a problem, where do you go? The first place we’re gonna tell you to go is head over to “Reports,” bill and the analytics and over here I’m gonna leave this entire drop down open is a number of ways of slicing and dicing the financials for your practice. Here, we’re gonna focus on the billings statistics reports, but first I’m gonna open your billing statistics configuration screen. Here is a list of data points that you as a practice owner or as a practice manager can take a look at, but I really want you to understand what each one means. You can create, customize or personalize even reports. Today, we’re gonna be looking at CPT codes and we’re gonna be looking at primary insurance, and you might even wanna be looking at rendering physicians. And so, you can create a report, it means CPT codes, rendering and your pair. You can save this report and it will be added to your list of selections when you actually go to open up your billing statistics report, but the question is, what data am I gonna look at, and why? Today we’re actually gonna dive into what data you actually want to look at. So out of all
Do you reconcile your collections monthly?
When your practice receives payments by cash, credit card or checks, how do you reconcile your practice with your bank account every month? To reconcile your bank account with the collections you receive at your practice is something they teach in business school, but not in Chiropractic School. Co-payments are being taken from your patients every day but checks from insurance companies come in by mail, weeks after the date of service. How do you keep track of everything and everybody? How do you know the money showing in your billing software is actually arriving in your bank account? The Genesis Chiropractic Billing Software can eliminate this memory management with several built-in tools to reconcile your finances. Your Accountant will appreciate these tools because they’re very helpful to number crunchers and bean counters. Learn how with the free webinar that can be viewed right on this page. Read the Transcript: Jason: All right, thanks for joining today, I appreciate it. And looks like we’ve got most of the people that we were waiting for to log back in and actually allow us to get started today. We had a little bit of a technical difficulty. I’m Jason Barnes, and with me is Jessica Pancoast. Today our topic of conversation, we realize is not necessarily the…can I just use the term “the sexiest of topics” when it comes to provider interest, but it’s one of those nuts and bolts that you don’t want to put your car back together and have left over wondering if you actually needed this for the car to operate. Today we’re talking about monthly reconciliation. And this really has two definitions. When we actually post insurance money into the system, or even patient money into the system, and it doesn’t make it to your bank account, I…not to patronize anyone, but that doesn’t do you much good, does it? It can look really, really nice that you’ve got high collections that are represented here in Vericle, but unless they actually translate into funds that you and your practice can use, we realize that all together, this is not useful for you. So today, we’re actually gonna talk about that process that we urge, and would really beg everyone to do, if we could, to actually reconcile what we’re posting in Vericle versus what actually hits your bank account. And there are some nuances, but today we’re gonna highlight those tools that we utilize to do that. And to start, you can see here that I have zoomed in quite a bit on what we call our dashboard. And you can kind of see here I’ll zoom out. In the upper right-hand corner, I’ll zoom back in here that you can see, and I’m overemphasizing this dashboard. This dashboard is what we’d like to think is a tool that every practice owner or office manager could use to see where they’re at, you know, during the month. And if you look at this, that first number in green, the $27,000 number, represents insurance collections month to date. As you look at that number, and then if you were to log in to your bank account website and check that out, you wanna make sure that the discrepancy between the two doesn’t exist, but you also shouldn’t be too surprised if they don’t match. And today, we wanna go over why that is. Why would we expect there to be one number in Vericle, and perhaps another number in your bank account reflection? So today we’re gonna focus on that, and to get us back to basics here, we’re gonna switch over and we’re actually gonna start talking about the two tools that you’re gonna use to get there. Now, you’ll notice that one of these tools is the same as a tool that we recommended last week to actually perform some of your daily or more weekly reconciliation steps, which is your credit cards, your point of sale, anything that you’re entering into the system is gonna have a payment type associated with it, and we’re gonna use this set of tools in order to make sure that something posted in the system is actually in your bank account. So the two reports that we’re going to show you today, probably are…reports is somewhat of a misnomer, in this case, Jess? Jessica: Yeah, reports usually just give you information and that’s it, but [inaudible 00:03:35] you actually do something with. Jason: Yeah, it’s a tool that can report information back to you, but really, it’s only useful if you’re using it as an input and a place to store information that you’ve confirmed is in your bank account, or, conversely, we have posted and isn’t in your bank account. So, the Check and Cash report is one, and the Monthly Invoice is the other. First things first, how do you get to them? Under Reports, you’re gonna head to your Reconciliation dropdown. This Reconciliation dropdown offers a lot of different tools for you to utilize. In this particular case, we are recommending these two tools, the Monthly Invoice right here, and your Check and Cash report, as your two monthly tools to make sure that all the money that’s posted within Vericle is actually in your bank account. Let’s get out of those. So this monthly invoice, you’ll notice here first, going over the nuts and bolts of it, is that you have some options. The first thing is is you can print this. You can refresh it, you know, if there’s a need to, but this other portion is you can actually export this to an Excel file, that Csv, the comma separated value line, if you were to actually access that, will put it in a format that will allow you to copy and paste this easily into Excel and OpenOffice, a LibreOffice, something along those lines. But, you’ll notice here that you have the month collected. Today happens to be April 5 of 2016. You
Do you reconcile your collections daily?
When your practice receives payments by cash, credit card or checks, do you have a way to reconcile your practice with your bank account? Reconciling your bank account with the collections you receive at your practice is something they teach in business school, but not in Chiro School. Co-payments are being taken from your patients every day but checks from insurance companies come in by mail, weeks after the date of service. How do you keep track of everything and everybody? The Genesis Chiropractic Billing Software can eliminate this memory management with several built-in tools to reconcile your finances. Learn how with the free webinar that can be viewed right on this page. Read the Transcript: Jason: All right we’re gonna get started here. We’re just going to type out the message one more time to the people and then we’ll get going. And I’m grateful as always to have Jessica Pancoast, head of our health [inaudible 00:00:12] training team here with me. My name is Jason Barnes, and today we’re actually talking about something relevant to every single practice out there. Each day you’re seeing patients and there are all sorts of things that you wanna track and make sure that it went well, you know, how many patients were checked in versus checked out, how much money was brought in checks, cash or maybe even in patient payments versus insurance payments. You wanna make sure that, you know, there wasn’t something that went really off the rails for that practice…for your practice that day. And today, we’re gonna talk about how to reconcile at the end of the day to make sure you’re tracking all of the things that are important to you, number one. And number two, how to help your staff gain clarity on what their job and what their role is so at the end of the day when they come to report to you or they’re able to leave the practice for the day, they know that they’ve got everything done that they were supposed to. And that clarity really leads to ownership and in our experience where we see that front desk person or the office manager really has an understanding of how that practice is supposed to run, and what’s supposed to happen at the end of the day to make sure that all money was collected and all patients got taken care of, then they typically feel much more vested in the success of the practice. So, that’s the subject matter for today and that’s how we’re gonna go about tackling this. Two, we’re gonna divide this into a couple of different categories and we’re gonna start out with money. Money is just never a bad place to start out with, right? So one of the simpler things that each practice expects to be done every single day is, patients walk through the door, they’re paying copayments, coinsurance, deductibles and deductible season is rapidly coming to an end, but I still see it happening. And all of that money that came through the door, in addition to any paper checks or even electronic trust funds transfer, [inaudible 00:02:21] for the day, how do we make sure that all of the things that get posted in the system in Vericle are actually, you know, getting to the bank account? So we’re going to start out with how to we’re gonna actually reconcile those two things. So just one little recommendation as far as where should they go and what should they look at first if they’re going to try and reconcile how much money came into the practice versus what they’re actually gonna deposit for that day? Jessica: Well, there is a number of different reports in our system. What I usually recommend for reconciling the cash and the paper checks that they got from their patient is actually in the checking cash report. It breaks it down…the cash, of course, is all on together and nothing specifically add in a random code in the check number when they’re adding it on the patient account. But the check in cash report will break it down by each check number, so it’s a lot easier to match it up check number by check number. And that way as something’s entered in the system, they’re able…and can’t find the check they know exactly what check they’re missing and exactly which patient it’s from and vice versa. If they have a check and they can’t find it on that report, they know that that check was not entered. Jason: Oh, perfect. And we’ll show them that in just one second. But I’ve visited a lot of practices, and I’ve been there at the end of the day. I was in Vegas last year with a real high volume practice. You know, they had a couple of inboxes, right? And they had the drawer where they have the checks from the patients and the cash from the patient, you know, they have a credit card machine right then and there. Hopefully, they’re using an integrated credit card solution where they’re able to run that report and see exactly, you know, what number was associated with credit card bookings for that day. But, in the drawer right next to it was backed up all the checks that they received from the insurance company. So, what you’re describing, though, wouldn’t just help them with the cash, right, that they received from patients. They will use that same process for any insurance checks that they got as well, right? Jessica: Yeah, so any insurance check that they got, if they are using one of our billing teams, they’ll send over those BOPs [SP], the team will post them and then they’d be able to match it again on that same exact report. If they are posting those checks themselves, it’s just the same as posting patient payment so they’d be able to verify it right away. Jason: Thanks, nice. All right.
How to Detect Insurance Underpayments
How can you tell if your Chiropractic Practice is being paid in full and on time by insurance companies? How can you tell if there’s an underpayment? Underpayments by Insurance Companies for the services that you render is a constant problem that you need to pay attention to. The Genesis Chiropractic billing software can detect insurance company underpayments and then you’ll know the details you need to address the situation. The elimination of insurance industry underpayments is a challenge because their goal is to not pay for anything until they absolutely have to. Their next tactic is to underpay and hope that you don’t catch on. They also try to delay your payments until you forget about it, and they typically take 120 days to get around to your payments. Our built-in tool will help you to detect and then to fight underpayments. Learn more with the free webinar that can be viewed right on this page. Read the Transcript: Jason: Thank you for everyone who joined us today and we’re gonna get rolling with our topic today. We touched on this topic really a few months ago, but we’re coming back to it, on how to manage collections in your office, very specifically, with measuring collections. There are two ways that we recommend as best practices. I’m not sure there is a third or fourth way to measure collections. Number one is, that all your visits get paid, and number two is, that they get paid the right amount. So today we’re actually focusing on that second portion of, “How do you know if your visits got paid the right amount?” So that will be our topic of discussion and we’re going to make some disclaimers here at the beginning. Is the right amount is specific when it comes to all the insurance companies that you’re in network with, and a little more of the guesstimate, when we’re talking about all of the pairs that are out of network. So we’re gonna go through, to the best of our ability, our options. But if you know a number that you should be getting paid for an insurance company, we’re gonna talk about how you can make sure that we are going to, number one, identify an underpayment. Number two, create workflow that will assign that underpayment to a specific person. And then number three, make sure you can follow up on it and know that you got paid the right amount. So practices are constantly concerned and worried about whether or not their collections are what they’re supposed to be. And it’s a challenge to try and come up with some formula, or algorithm to make sure you got that. So I wanna talk about, first of all, measuring collections. And then, you know, second, whether or not you guys can utilize the tools that we’re talking about to measure your underpayments or potential underpayments. So, collections, when we are talking about a practice and you look at a number in the upper right-hand corner here. And I’ll make it slightly bigger, and now we can use a few of our tools here to help annotate this. You know you’ve got collections… Jessica: Oops, I’m gonna select the color. Jason: You’re looking at, you know, the theory up here of $27,000 that you’re going to get paid, you know, in this month. How do you know that’s the right number? Well, each and every time that you look at that, you have to be saying to yourself, “Could I be getting more?” Every doctor I talk to thinks, or practice owner thinks they could be getting more. If all of your business have been paid and you check out that every single one of your date of service has had a payment posted to it. The next laudable question is, “How do I know that, that got paid the right amount?” Oh, how do I get rid of that? Jessica: Go to top first. Jason: Back to the top, perfect. And, today, we’re gonna bring you over to a couple of other accounts, and we’re gonna show you two reports that will work and help you understand, the first is your billing staff’s report. Your billing statistics report will help you run some trend analysis. And what I’ve done here is I’ve opened up our billing statistics report under billing analytics, billing steps. And the first thing that I’ve done is selected a date range. For this particular report, I selected all the way from January 1st to December 31st of 2015. So looking at the entire calendar year. And there is a lot of useful information that comes in the billing statistics report. Not every single column or piece of information will be something you wanna look at each time. But I’ve selected two metrics to marry together for this particular report. You’ll notice that I’ve sorted this into a month over month range, as I’m doing month of service. So what this means is, all of the dates of service that happened in that particular month. So I don’t care if you billed it out late, you could have billed a January date of service in April, but it would still be counted here for the month of service of January. And then I chose CPT codes, because…any of you providers that are in network with an insurance company, your contractual agreements will be either paid by visit or paid by CPT code. Here we’re focusing on paid by CPT code. And we can see here that you’re going to have a total number of claims of 567, you know, $50,960 billed out. But more importantly, you can see how much is, on average, paid by charge for each one of those months, for the CPT code of 9711O. And you can see here that it’s not a consistent number, month over month. All right? So what courses this fluctuation? Obviously there are balances left
Fortis Payment Systems is Integrated with Genesis.
Use Fortis Payment Systems to process credit card payments in real time online, not with a slow telephone terminal. Fortis Payment Systems is Integrated within Genesis Chiropractic Software. You can charge a patient’s card from within their account and you can charge their card easily from the Point of Sale screen as well. The payments can be tagged separately and they’re automatically posted to the patient’s account. Fortis will handle all of your card charging needs securely and they will handle your PCI Compliance as well. That’s very important. Be sure that you absolutely do not store any patient credit card numbers in your office or you could have a PCI compliance violation. View this webinar to see other features and to see how it works. Learn more with the free webinar that can be viewed right on this page. Read the transcript: Jessica: All right. Well, let’s get started. Again, my name is Jessica Pancoast and I run our training desk and help desk. Today, we are concentrating on third party companies, and today it is Fortis and we have Jonathan McAlees from Fortis to help us out with that. Welcome, Jonathan. Jonathan: Thanks so much for having me. So, we’ll talk a little bit about the integration that we have and I’m not sure, do we have control yet, Jessica? Jessica: I did promote you to a presenter. You should be able to download the… Jonathan: Okay, perfect. Yeah, okay. Here we go. I’ll start sharing my screen. All right, can you see my screen now? Jessica: Yes. Jonathan: Perfect, okay. So, I’ll give you guys a little bit of background into Fortis real quick. So, Fortis is a merchant services company, so we do credit card processing. We specialize in that. We specialize in high-end niche verticals. So, what that means is we aren’t a processing company that is built for everyone. We go into very niche verticals and we specialize in that. And so, one of those verticals that we’re in is obviously the EHR kind of chiropractic, PT, medical background. And so, what we did was we built a specific gateway geared for specifically what you guys are doing. So, what we found was a lot of the stuff that was out there was built for everyone, and it’s built for these web developers and it’s not really built for an office to take payments for their patients. And so, when we met up with Vericle we were able to integrate, and they have this great integration that allows you to take one-time or, you know, store credit cards or bank accounts on file, as well as set up reoccurring payments if you need that. And so, you know, as the market changes and you guys deal with EMV, we wanna make sure that you’re compliant because one of the things that happens is offices don’t realize all the compliance that they’re under. So, lucky you, as an office, not only are you under HIPAA compliance but you are also under PCI compliance by the fact that you take credit card payments. And so, we wanna make sure that you’re compliant and make sure that you’re following the regulations, and we want that to happen on our side, not your side. So, we allow the software to handle all of your PCI compliance for you. One of the things that we see within offices is they do things like they write down credit card numbers. And that’s a big, big no-no in our space. Most offices don’t realize that you can get fined up to $5,000 per credit card that you have written down. So, this is not something you wanna do. It could bankrupt an office if you have a hundred or a couple hundred cards written down and you are breached like that. So, we wanna make sure that you’re compliant, that you’re not doing that, and the other thing is there’s easier ways to do that. So, we’re gonna show you a little bit of that today, how the integration works with Vericle, and how it seamlessly integrates and allows your payments to auto-post back. So, as you can see here, I am right in the Vericle system. I’ve got John Smith, my patient, selected. To access Fortis, all you have to do is click more and then Fortis. You can see we haven’t left Vericle, so we’re still in Vericle but we go right from the patient’s profile in Vericle to their profile within Fortis. Now, from within here, you can do anything you need to on the payment side. So, if you wanna run a one-time transaction, a one-time swipe, you can just click the charge contact button, swipe a card with the little $14 USB swiper from amazon and then your transaction is done. It’s just as if you were running a terminal, except this terminal is now online. Well, we kind of like to say, and we do have terminals and some offices like them, but we don’t often recommend them. Because think of it as a flip phone. A terminal is like a flip phone and this system is like an iPhone. So, you’d really, really be wasting out if the only thing you used on your iPhone feature was making phone calls and text messages. There’s a lot of other things that you can do. Well, that’s kind of similar here. So, we don’t want you just stuck only being able to do one or two things on a terminal. We have a full terminal online. So, you can come in here and swipe payments just like I showed you there. The other thing you can do, and this is really where we start to help save you time and money, is you can store credit cards or bank accounts in our system. We do this all securely, through a system or process called tokenization. If you’re not familiar with tokenization, essentially, what we are
