Code of Conduct
By Kathleen Casbarro New coding regulations: A major adjustment for chiropractors What will the new ICD-10 codes mean for Ben’s practice? “I’m a lucky man,” said Ben. His wife Carmen had brought an envelope full of family photos to his chiropractic office. The two of them had taken their son Jonathan for a photo shoot in a community park, but the pictures looked as though they had been taken in a pristine forest. “That photographer has skills.” “True, but she also had some great material to work with,” Carmen teased him. “We are a photogenic family,” Ben admitted with a wink. “I want the one with Jonathan on my shoulder for the office. We look so happy!” “That’s because we are happy,” Carmen pointed out. “But you didn’t actually look very happy when I came in. I thought things were going well with the practice.” “They are,” Ben assured her. “But now that I’m getting control over things in the practice and feeling happier at work, I’ve had time to notice an upcoming change in reporting requirements that feels a lot like… hmm… maybe a giant wave coming at me.” Carmen took Ben’s hand. “A trouble shared is a trouble halved. Tell me about it.” “Well, you know we use codes when we file insurance claims. By October 1, 2014, we have to change them all.” “Sounds like some extra work for your staff, but not exactly like a huge wave about to crash over your head.” “It’s kind of hard to know… We don’t know right now which codes for chiropractic will be identified as ‘medically necessary,’ for example, and we know that it won’t just be a question of renaming. We can’t just find all the 724.3 codes and change them to the single new code that will cover it. There are a lot more ICD-10 codes than ICD-9 codes, and there won’t be a one-to-one correspondence. We might need to make some judgement calls about what’s the best new code for a given procedure. If we make the wrong choice, we might not get reimbursed. And that’s just one thing. I don’t really know how many more things there are like that.” “Okay, I can see that you’ll need to be involved in the change. But is it mostly just about learning the new codes?” “I know that the new ICD-10 codes have seven digits instead of five, like the current ICD-9 codes. That could mean all new forms.” Ben frowned. “I guess I just don’t know what’s involved, to tell you the truth. But the government notices have said that it’ll affect scheduling as well as billing, and the way doctors make notes, and — well, pretty much everything we do.” Carmen started putting the photos back into the envelope, leaving out the one Ben had chosen for his office. “It sounds like you don’t have enough information right now,” she said. “I’m not saying don’t worry — it does sound like something to worry about. But it doesn’t sound as though you know the size and shape of the problem yet. It’s like at the pizzeria–” Ben laughed. “Everything reminds you of pizza!” “Okay, that might be true. But when we know we have big parties coming in, that’s very different from just feeling like it’s going to be a busy night. When it comes to this reporting change, you basically don’t know how much pepperoni you need to have on hand.” “Pepperoni sounds good. Let’s grab some lunch and I’ll worry about this stuff later.” “Just don’t leave it too late — October will be here before you know it.” What will the new ICD-10 codes mean for Ben’s practice?
The Roller Coaster of Collections | Where is My Money III
By Charles Pritchard The Ups and Downs of Cash flow Give a Chiropractic Clinic Owner Anxiety Which areas of Ben’s clinic are most difficult to track? The roller coaster of collections drove Ben up the wall. He never knew how many of his claims would get paid each month. Some months the money was pouring in like he had won the lottery, and then the payments would suddenly come to a screeching halt. The worst part was the uncertainty. It made him feel sick to his stomach. He felt like he could not even provide for his family’s basic needs, let alone treat them to the long-planned trip to Disney World. It almost seemed ironic that Ben’s wild ride of unpredictable cash flow prevented his wife, Carmen, and his son, Jonathan, from enjoying the rides at the theme park. Not surprisingly, Ben’s revenue issue was slowly killing his joy of practicing chiropractic. Not to mention how his bad mood put everyone at home on edge, too. “I just don’t get it,” Ben said as he helped himself to leftover lasagne. “Back in January, we were averaging around 325 patient visits per month. Over the summer, my clinic literally exploded with 487 patient visits. The last few months we have been averaging around 436, but strangely enough, our collections don’t match that one bit. Although this month’s number is close to what we got in January, I have no way of predicting what we might receive next month. It could be thousands of dollars less…. or we could hit the proverbial jackpot.” “I wish I could use my rolling pin to turn your collections into smooth pizza dough,” Carmen said, jokingly, while placing pepperoni and cheese on her homemade pizza crust. “Your billing issues remind me of a ball of dough. You can’t make pizza with it unless you flatten it out. And at my pizzeria, for example, I have to offer the kind of pizzas my customers like. Otherwise, no one will come back for more.” Ben chuckled and said, “You compare everything to pizza, honey. At least your customers pay you right away. Imagine waiting for two, three months to receive payment for a pizza!” “Hmmm,” Carmen said, while putting the pizza in the oven. “My suppliers might extend me a little credit, but I’m pretty sure I would have to shut down if I was stretched that thin.” “Well, that’s exactly what I have to deal with,” Ben said. “The insurance companies take their sweet time to pay up and I’m left standing in the rain without an umbrella, so to speak.” After dinner, Carmen gave Jonathan a bath and put him to bed. Ben read him a story to help him fall asleep. Then they sat down in the living room to continue their conversation from earlier that night. “You ever come up with a menu?” Carmen asked, as Ben handed her a glass of wine. “Isn’t that your job?” Ben said, sarcastically. “Do you want me to partner up with you in the pizzeria, or are you just out of ideas?” Carmen punched him in the arm, playfully. “Your menu of services, genius!” “What about it?” “OK, let’s look at it this way… how much do you make each time you see a patient?” “Are we talking about cold, hard cash in my pocket? About 30 bucks per visit. Why?” “When I created my bill of fare, I wasn’t just thinking about the kind of pizzas I like to make,” Carmen said. “I had to consider the cost of ingredients, time for preparing the dough, and the likelihood of people ordering it regularly.” “In other words, I should stick to my most profitable options, right?” “Something like that,” Carmen said. “Based on what I know, your services vary in time and equipment needed. Some of them may not even be in high demand. If you take an honest look at your practice, you can probably find some services that are not worth those 30 dollars– especially when it takes forever to get paid.” “So you think I should cater my clinic that way?” “There you go,” Carmen said with a wink. “On that note, I’m dying for a slice of pecan pie. Can I get you one, too?” Which areas of Ben’s clinic are most difficult to track?
Tracking the Variables | Show Me the Money II
By Michelle Corrigan — Profitability Coach Chiropractic Clinic Owner Must Address Billing and Payment Delays What variables affect how quickly Ben gets paid? Being in the dark about his chiropractic claims payments was seriously bothering Ben. He never knew when he was going to get paid. His chiropractic clinic seemed to be at the mercy of the payers, regardless of how many patients he helped each week. One thing was for sure — he needed to solve his clinic’s cash flow problem rather sooner than later. “Why don’t you talk to a practice management coach?” asked Carmen, Ben’s wife. “A change in your daily workflow might help you with your chiropractic billing issues.”Ben really needed some professional advice, but wasn’t sure whose expertise he could trust. He scheduled a meeting at his clinic after hours with the profitability coach, Steve, who had helped his friend, Tom, improve his practice cash flow. “Is there a way to figure out what I am doing wrong?” Ben asked after he had given Steve a brief overview of his dilemma. “I am not even sure anymore whether or not my current practice workflow is ineffective or harmful. My payments fluctuate although my practice stays busy.” “Just remember, you’re trained in chiropractic, not business management,” Steve said. “So, don’t beat yourself up over this. The truth is, that you depend on insurance companies for a major part of your revenue and they know how to make it complicated. Without a powerful tool, like chiropractic software, it is almost impossible to figure out what is going on.” Ben took a moment to digest Steve’s comment and asked, “So, it’s not entirely my fault then, right? “That’s right,” Steve responded while flashing a supportive smile. “It’s usually a combination of factors. And trust me, you are not the only chiropractor struggling with his billing performance.” “That’s a relief,” Ben said. “What should I do?” Steve took a deep breath and said, “Now, don’t get overwhelmed. But the best way to get to the bottom of this is by tracking and analyzing multiple variables of your billing performance. Time, for example, is definitely an issue. Since your chances of getting paid for a claim decrease by one percent with each passing day, you need to find out how each variable affects your claims process.” “That does sound complicated,” Ben said flatly. “How am I supposed to track all that and help my patients?” “Let’s look at it from a chiropractic perspective,” Steve offered. “Take a man who hurts his back, for example. What can happen if he doesn’t seek treatment immediately?” Ben pondered the scenario for a moment. “Without knowing the nature of his injury, I would assume that it can affect his gait. Once he starts overcompensating it will naturally lead to more problems than he started out with.” “Now apply the same line of thinking to your chiropractic billing issues,” Steve said, excitedly. “This kind of domino effect can cause a new all-time low for your billing performance month after month when an error is not corrected since it ends up affecting multiple claims.” “Oh, now I get it,” Ben said. “So, once I discover which aspects of my workflow cause payment delays or denials, I can make the necessary changes to improve my chiropractic billing performance.” “Precisely,” Steve said. “And then you can build your dream practice.” What variables can affect how quickly Ben gets paid?
Show Me the Money!
By Reuven Lirov Chiropractic Practice Owner Struggles with Cash Flow What can Ben do to correct his cash flow problems?“You ready for lunch?” Ben looked up from the pile of bills on his office desk to see his wife, Carmen, standing in the doorway. “Only if you’re buying,” he said. “That bad, huh?” Carmen replied, closing the door behind her. “I’m a little surprised. On my way in, Pam told me that you’re booked solid.” “Patients aren’t the problem,” Ben said. “Revenue is. Seems like no matter how many adjustments I do, I’m never sure if I’m going to meet expenses that month.” “I thought you had someone who took care of billing,” Carmen said, perching on the edge of the desk. “Isn’t that their job?” Ben laughed, weakly. “That’s how I looked at it. And if it were just a matter of a few patients with payment issues, I’m sure my staff could handle it.” “Then what’s the problem?” “It’s a combination of collecting from insurance companies and then figuring out what the patient owes. Seems like we have to chase after the insurance companies for every dollar we’re due.” “I don’t get it,” Carmen said. “Your staff files the claims. Doesn’t that mean you automatically get paid?” “I thought so,” Ben said. “But I guess that’s why I’m a chiropractor and not an accountant. Come on, I need to get out of here.” Ben wasn’t really in the mood for lunch, but he needed to clear his head. He and Carmen walked to their usual lunch spot and found themselves a booth. As they slid in, Ben’s phone chimed. “What is it?” Carmen asked. “It’s a tweet from Richard,” Ben said, reading the display. “He says, ‘Life is a series of adjustments.’ Hashtag ‘chiropractics.’” “You spoken to him recently? His practice seems to be pretty successful. Maybe he can give you some advice.” “That’s not a bad idea,” Ben said, sliding back out of the booth. “I’m going to give him a call. If the waitress comes, order me a turkey reuben.” It took a couple of days before Ben and Richard could carve out some time. Finally, they got together on Saturday, when Richard was cleaning out his garage. “It drives me crazy,” Ben said. “Cash flow is so inconsistent. Feast or famine, and I never know which. Sometimes the drought lasts for weeks, no matter how many patients I see.” “You’ve got to get down to brass tacks,” Richard said, hanging his hedge trimmer on the pegboard. “Figure out what your best sellers are.” “My what?” “Your moneymakers. Start by checking which CPT codes, POS items sold, referring physicians and employee productivity generates the highest revenue in the shortest time possible.” “I’m guessing my billing department could help me with that,” Ben said as he coiled up an extension cord. “There are no guarantees,” Richard said, “but that’s what works for me. For instance, you want to avoid using the worst CPT code for the best payer. And trust me; once you’ve gotten your system straightened out, you’ll be better equipped to make vital practice decisions.” Should Ben follow Richard’s advice? What can Ben do to correct his cash flow problems?
How This Chiropractor Built His Own Call Center To Bring In Droves Of New Patients On Autopilot!
Dr. Jonathan Hyslop is the Founder and Chief Marketing Executive of NEA’s Call Center. They can help you bring droves of new patients into your office without the hassle of hiring marketing staff and engaging in marketing activities that are expensive, time consuming and ineffective. Like most chiropractors who have been in business for a while, Dr. Jonathan Hyslop has tried everything. From events, fairs, and other time consuming marketing procedures he felt like nothing was working. So he decided to try telemarketing. Finally, he had some great success with something, but the problem was the cost! It was so expensive that it would eat into his R.O.I. until it just almost wasn’t worth it. That’s when Dr. Hyslop took it upon himself to create a sales team and train them on how to bring in chiropractic specific, quality new patients over the phone. This method worked so well for him that he stopped all other marketing strategies, and focused on his personal call center. This method brought in droves of new patients on autopilot for many years with minimal stress on Dr. Hyslop. Today he is making his tried-and-true, chiropractic specific, call center available for a few special chiropractors. He is offering this service at a rate comparable to you hiring two people for $10 an hour. (And you don’t even have to worry about training them, because they are already trained!) To learn more, check out the recent webinar interview we did with Dr. Hyslop by clicking the link below:
Chiropractic Billing Compliance | How to audit-proof your practice
An Audit Proof Practice is what Dr. Ben needs. That was definitely NOT money well spent. Ben felt red-hot anger building up inside him like boiling lava in a volcano right before its eruption. He still had a hard time accepting that Blue Insurance fined him $30,000 for failing the audit and made him refund the payments he had received for all failed claims. He promised himself that he would do whatever it takes to reduce his audit risk from now on. “Given the volume of claims, an automated monitoring system may be the only practical way to detect suspicious conduct or potential flagging for audit,” Ben read out loud from the book Practice Profitability. That made perfect sense to him. He had been racking his brain for ways to implement his friend Tom’s advice of tracking the notorious red flags for insurance companies: unsigned notes, unbilled visits, missed re-exams, and denied claims. An automated monitoring system sounded like a life saver to him. “Does your chiropractic software help you stay compliant?” Ben asked Tom. Tom was a successful chiropractor who had been through several audits, but always seemed to emerge unscathed. “Absolutely,” Tom said. “There are just not enough hours in the day to help my patients and track all potential compliance issues manually.” “But how exactly does it help you?” Ben asked. “I wonder what kind of system would be the right choice for my clinic since I am not exactly a tech whiz.” “Don’t worry,” Tom said. “You just need to find a system with several useful features that are built around your workflow. The idea is to make your life easier, not more complicated.” Ben thought about that for a minute. He had been looking for ways to simplify managing his practice. But the most pressing issue for him right now was staying compliant. “Could it cut down my error rate?” Ben said. “Definitely. Just look for chiropractic software that has automated alerts and built-in claims scrubbing,” Tom said. “Those features will help you fix any mistakes before you submit any claims to the insurance companies.” “So you are saying that your chiropractic software alerts you of compliance issues and helps you manage your entire practice workflow,” Ben said in stunned disbelief. “It sure does,” Tom said “I use the software to assign tasks to my staff with tickets and complete my notes while I’m still with my patients. This makes my life so much easier and saves me so much time. My favorite thing is the Radar on the homepage, which gives me a quick overview of my practice stats so I know what is going on in all areas at all times.” How would you advise Ben? Is there a way to audit-proof his chiropractic clinic?
Chiropractic Software | New Network Members November 2013
Seventy-nine new members across fifty practices joined Genesis Chiropractic Software and Billing Network in November 2013! There is strength in numbers due to the shared knowledge – we call it the “Billing Network Effect,” as the billing performance of each member practice improves in step with the total volume of processed claims with their Genesis Chiropractic Software. Each of these offices uses our chiropractic software to manage their entire practice. Please welcome our new Genesis network members: Iris Meidow of 180 Chiropractic, Beaverton, Oregon Margaret Wagner of Abundant Health Chiropractic, Willowbrook, Illinois Whitney Nava of Advanced Chiropractic, Yuba City, California Chelsea Riddle of Align Family Chiropractic, Salt Lake City, Utah Ryan Varga of Backsmart Wellness Center, Edison, New Jersey Lisa Kronebusch and Melissa Zeches of Back To Health Chiropractic And Wellness, Winona, Minnesota Brandi Messenger of Big Pine Key Chiropractic, Key West, Florida Ellie Hornung of Bold City Chiropractic, Jacksonville, Florida Nick Torrez and Salmad of Cbp Spine Center, Windsor, Colorado Chloe of Chiropractic First, Mukwonago, Wisconsin Jessica Leja and Natalie Tannehill of Chiropractic Wellness Connection Of Florissant, Florissant, Missouri Christine Brett of Chiropractic Works, Oakland, New Jersey Jessica Little of Columbia Family Chiropractic, Columbia, South Carolina Jessica Deleza and Erin Mcknight of Cornerstone Chiropractic, Norman, Oklahoma Theresa York of Dr. Matthew Stuart Green D.C., Oakland, California Christa Leigh Bode of Dr. Fry’s Chiropractic Offices, Port Orchard, Washington Lisa Tejada of Dr. Taras Odulak, New York, New York Carmen Hinote of Elite Wellness & Chiropractic, Tuscaloosa, Alabama Keri Francl and Blaine Rucker of Focused On You Chiropractic, Round Rock, Texas Korey Wiemold of Indy Sports Chiropractic, Carmel, Indiana Renee Richard of James Family Chiropractic, Summerville, South Carolina Maria Fisher of Jubilee Family Chiropractic, Naples, Florida Stephanie Vega of Jurgens Chiropractic, San Diego, California Kaleigh Ohland, Krista Walker, Greg Kulesza, and Bryn Gillow, DC, of Life Is Good Chiropractic, Brodheadsville, Pennsylvania Enid Tillett of Light House Family Chiropractic, St. Charles, Illinois Julie Drakopoulos of Lombard Chiropractic, Lombard, Illinois Theresa Gaspari, Steven O’Dell, Danielle Lafaille, Emily Riegel, and Steven Joseph of Longmont Spine And Physical Medicine, Longmont, Colorado Alexis Strutz of Lyons Health, Green Bay, Wisconsin Alison Cox of Marble City Chiropractic, Knoxville, Tennessee Shannon Reitz of Milwaukee Chiropractic Group, Oconomowoc, Wisconsin Lindsey Mckinley of Natural State Health Center, Little Rock, Arkansas Darrell Crawford Morris of NCV, Shelburne, Vermont Rebecca Warren of New Life Chiropractic, Brentwood, Tennessee Andrea Garcia of North Dallas Chiropractic Center, Dallas, Texas Yvonne of O’Dell Family Chiropractic, Webster, New York Richard Marchetti, Jamie Storey, and Tarron Woon of Optimal Health, Oman, SA Amy Beel and Jaime Adams of Oxford Chiropractic, Oxford, Mississippi Steve Suissa and Jaime Bernard of Paris Chiropractic, Rockville, Maryland Eric Rohe of Patriot Family Chiropractic, Omaha, Nebraska Anais Lopez of Philip Delli Santi, DC, Summit, New Jersey Scott Levin, Ysamin Martinez, Tina Noorishad, Janssen Judge, Stephanie Yim, Marissa Ki, Kelly Milliken, Aaron Oshita, Georgina Khodayari, Dan Mcdonnell and Jason Miller of Posture Works, San Francisco, California Nate of Precise Chiropractic Center, Lake In The Hills, Illinois Maryellen Moore of Proactive Chiropractic, Rockville, Maryland Lee A Thomas and Tristan Dang of Riverside Family Chiropractic, Powell, Ohio Jules Shaver of Sleepco, Rockville, Maryland Ahmed Saleh and Breanne Sylvester of Symmetry Spine And Wellness, Alameda, California Jenna Waters and Kathy Reid of The Health Factory, Knoxville, Tennessee Paul Gasch of Three Rivers Chiropractic, Onalaska, Wisconsin Paulette Matuszewski of Vinciguerra Family Chiropractic, Wilmington, Delaware Justin Sanchez of Vitality Family Chiropractic, College Station, Texas
Chiropractic Billing Compliance | Can you reduce your audit risk?
Ben was forced to put all of his plans on hold. After paying the $30,000-fine to Blue Insurance they would have to cancel their Euro trip for another couple of years. He hated disappointing his wife, Carmen, and their baby boy, Jonathan. It seemed like failing that audit last month would have a ripple effect on his financial situation for a long time. He was still trying to figure out how to return the money he had already received for his failed claims without bringing his practice cash flow to a screeching halt. Although he was concerned about the future of his chiropractic clinic, he held on to the hope that he could emerge from this audit risk nightmare with a better way to stay compliant. He just had to come up with a plan for making his chiropractic billing and documentation audit-proof. “Have you been worried about compliance since you got audited last year?” Ben asked his friend,Tom, whose chiropractic clinic was thriving after last year’s brush with disaster. “I am trying to figure out how I can improve my compliance so that I can avoid another failed audit.” Tom smiled and said:”Yes, of course, but I have learned that we really can’t avoid an audit and the audit risk. So I decided to cut down my error rate to reduce my audit risk. Chiropractors can absolutely not afford to have any unsigned notes, unbilled visits, missed re-exams, or denied claims as number one rule. So you have to find a way to track these meticulously.” “Ok, but it seems impossible to even remember all the different insurance protocols for each patient,” countered Ben. “It is so confusing to keep track of all the requirements, and just when you think you get it, they change everything again.” “That’s true,” Tom admitted. “And many of those so-called compliance experts give advice that is really difficult to implement, not to mention that they all tell you something different.” “So how can we get it right then?” Ben asked. “I can’t gamble with the future of my clinic and need a bulletproof process to stay compliant.” How do you manage your: Unsigned notes Unbilled visits Missed re-exams Claim errors
New Chiropractic World Record – They Adjusted Over 22,000 People in Two Days!
Dr. Peter Morgan is the founder of Mission Life International, a non-profit organization that works to provide humanitarian aid to citizens of impoverished countries through chiropractic mission trips! If you are looking for an opportunity to go on a mission, you will want to talk to Dr. Peter Morgan. He and his team hold the world record for most adjustments in 2 days (over 22,000), and for the most adjustments in 8 days (over 75,000). He is also responsible for the worlds largest chiropractic mission trip with over 38 chiropractors attending, and holds the record for going on the most mission trips of any chiropractor in the history of chiropractic! Dr. Peter Morgan and Mission Life International have a purpose to help the poor, especially in those countries where resources are so terribly limited. A purpose that includes educating people around the world about natural health care. Mission Life International also works to raise funds for charitable organizations, which provide food, clothing and shelter to those in need! They believe they were formed to serve the world, and help all people to expand their hearts and minds. To provide charitable mission trips and community education programs that familiarize people with the benefits of drug-less health care in countries where it is relatively unknown. They work with many organizations, especially chiropractic organizations. They have big plans for the future. Plans that include building schools, orphanages and homes so that people can have a better life. If you are passionate about sharing chiropractic with the world, and you want to get your healing hands on hundreds, if not thousands of people, then going on a mission trip may be be for you. If you would like more information about how to join Dr. Peter Morgan and Mission Life International, check out Dr. Morgan’s webinar interview by clicking the link below:
Can you afford to fail an insurance audit?
It seemed like things might get worse for Ben’s chiropractic clinic before they got better. Sure enough, he received another letter from Blue Insurance. This time they wanted him to pay back the money he had already received for the claims that failed the audit last month in addition to paying a hefty penalty of $30,000. “Why don’t you contact a chiropractic compliance expert,” Carmen suggested. “He might be able to help you figure out this audit fiasco without losing your clinic.” Ben was trying to appear calm as he responded: “I guess it’s worth a shot.” He did not want his wife, Carmen, to know how worried he really was. The truth was, he doubted that anyone could help him make it through this audit-nightmare in one piece. But at the same time he did not want to give up on his dream of having a chiropractic clinic so he could save as many people’s lives as possible. When he met the compliance expert, David, later that week, he did his best to stay composed as David prepared him for the worst case scenario. “You should be aware that Blue Insurance might blacklist you,” David warned. “And once they do that, all the other insurance companies will come after you like a pack of wolves. Then you will have to deal with even more audits and disruptions of your chiropractic billing cycle.” “Something tells me that’s not even the worst outcome,” said Ben. “Unfortunately, it’s not,” David admitted. “You could also lose your license, not to mention the legal fees you would incur if Blue Insurance takes you to court. In case you are convicted for fraud, you could also serve time.” Ben swallowed hard. He started thinking about his patients. Would his patients stay loyal throughout these fraud accusations? It’s not like they would understand how difficult the insurance companies made it for chiropractors to stay compliant with ever-changing regulations for chiropractic billing and documentation. His professional reputation was clearly taking a big hit. Would anyone still think of him as a stand-up guy who was not interested in cutting corners? “Is there any way to minimize the damage from this failed audit so that I don’t lose my entire patient base?” Ben asked. “I can’t blame people for not giving me any referrals until this is over. But I can’t afford to lose my current patients, too.” David sighed. He felt Ben’s pain and wanted to reassure him. But he had to avoid giving him false hope. Ben had to be ready for an uphill battle, no matter how ugly it might get, if he wanted to prevail. Have you ever been audited or do you know anybody who was audited? What was the worst part about it?
