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
