Adding Chiropractic Manipulative Therapy to Standard Medical Care for Patients With Acute Low Back Pain: Results of a Pragmatic Randomized Comparative Effectiveness Study
Title Adding Chiropractic Manipulative Therapy to Standard Medical Care for Patients With Acute Low Back Pain: Results of a Pragmatic Randomized Comparative Effectiveness Study A ChiroSecure Research Update Abstract To assess changes in pain levels and physical functioning in response to standard medical care (SMC) versus SMC plus chiropractic manipulative therapy (CMT) for the treatment of low back pain (LBP) among 18 to 35-year-old active-duty military personnel. Discussion LBP is common, costly, and a significant cause of long-term sick leave and work loss. Many different interventions are available, but there exists no consensus on the best approach. One intervention often used is manipulative therapy. Current evidence from randomized controlled trials demonstrates that manipulative therapy may be as effective as other conservative treatments of LBP, but its appropriate role in the healthcare delivery system has not been established. Prospective, 2-arm randomized controlled trial pilot study comparing SMC plus CMT with only SMC. The primary outcome measures were changes in back-related pain on the numerical rating scale and physical functioning at 4 weeks on the Roland-Morris Disability Questionnaire and back pain functional scale (BPFS). Mean Roland-Morris Disability Questionnaire scores decreased in both groups during the course of the study, but adjusted mean scores were significantly better in the SMC plus CMT group than in the SMC group at both week 2 ( P < 0.001) and week 4 ( P = 0.004). Mean numerical rating scale pain scores were also significantly better in the group that received CMT. Adjusted mean back pain functional scale scores were significantly higher (improved) in the SMC plus CMT group than in the SMC group at both week 2 ( P < 0.001) and week 4 ( P = 0.004). The results of this trial suggest that CMT in conjunction with SMC offers a significant advantage for decreasing pain and improving physical functioning when compared with only standard care, for men and women between 18 and 35 years of age with acute LBP. Reference Goertz, Christine M., DC, PhD*; Long, Cynthia R., PhD*; Hondras, Maria A., DC, MPH*; Petri, Richard, MD†; Delgado, Roxana, MS‡; Lawrence, Dana J., DC, MMedEd, MA§; Owens, Edward F., MS, DC¶; Meeker, William C., DC, MPH. Spine: April 15, 2013 – Volume 38 – Issue 8 – p 627-634. https://journals.lww.com/spinejournal/Abstract/2013/04150
Genesis Chiropractic Software Marks More Than a Decade of Integration with Cash Practice Software & Training
Genesis Chiropractic Software, the leading provider of technology solutions and chiropractic billing service systems, today marked more than a decade of integration with Cash Practice Software & Training, a solution that increases chiropractors’ cash collections and patient retention. For the past decade chiropractors nationwide have implemented this best-in-class integration that provides real-time synchronization of patients and payments. “For more than a decade, the synergy between Genesis and Cash Practice has provided chiropractors with unparalleled opportunity,” said Brian Capra, DC and President of Genesis Chiropractic Software. “Our best-in-class integration has been proven to save time, increase productivity and patient retention as well as cash collections and substantially increase profits.” Additional benefits for chiropractors include: Saving more than 40 payroll hours per month Both solutions are web-based Single sign-on Auto-posting of payments Delivers more than payment processing with easy access to Care Plans, Wellness Reports and Payment Processing – including gift cards and online payment forms Drip-Education email marketing system & auto-debit system Cash Practice Academy Increased convenience Unique features Cash Practice offers chiropractors include: Payments can be processed within the client record, whether it’s a recurring payment or one-time. A sales receipt can be emailed to the client. If a payment is declined – staff will know instantly with a pop-up on screen. The system will then email a patient directly giving them a button to click on, allowing them to pay online. In the Point of Sale Section, staff have the ability to process a payment. For example, if a nutritional supplement is sold, it will auto-populate with a patient’s information and allow staff to automatically email the patient a receipt as well as pre-fills, Drip-Education campaigns – including educational information, patient reminders and more. “Genesis initially reached out to us for payment processing because Cash Practice offers its clients so much more value than the competition,” said Miles Bodzine, DC and Owner of Cash Practice. About Genesis Chiropractic Software Genesis Chiropractic Software from Billing Precision, LLC was designed by chiropractic business owners with both patient experience and practice profitability in mind. It provides a complete chiropractic practice management system in the cloud that supports every role in a busy chiropractic practice, from the owner and practitioners to the front desk and back office. It automates the vast majority of standard tasks, including patient relationship management, revenue cycle management, compliance and office management. Its exclusive workflow functionality continuously improves productivity, control and predictability, fostering teamwork and time savings, which leads to greater profitability and practice growth. About Cash Practice Software & Training Cash Practice® Systems provides software and training for running a successful cash-based practice. Their suite of cloud-based programs are designed to reduce a doctor’s dependence on insurance and increase their cash collections whether they still accept insurance or not. The four systems include The Wellness Score® for creating report cards for health, the Cash Plan Calculator® for creating compliant payment plans, the Auto-Debit System® for recurring credit card payments and the Drip-Education® Email Marketing System for email marketing. For more information visit https://www.cashpractice.com/ or call 877-343-8950 ext.101.
Maximixed Living Case Study
Working smarter not harder isn’t just a cliche! With this practice honing their skills, helping patients becomes easier when you have one more team member that’s got your back. As a Genesis coach, I have the opportunity to work with ML practices moving from good to great. With Invision Family Chiropractic, I get to be a member of their team. Here is a picture of their visits per month growth that they achieved: WHILE their new patients average per month did this:How is this possible? New patients per month went down and visits per month went UP?! Retaining patients is a skill that requires three things: Excellent communication Amazing results No missed opportunities Not missing opportunities is where Genesis shines! Working with this practice we customized their reminders, alerts, and tracking to make sure they didn’t miss an opportunity to connect with their patients. NO MORE MEMORY MANAGEMENT. We helped automate their reminders and scheduling through SKED, configured their alerts for patients with special circumstances like balances, no future appointments, and more. Now their per patient visit retention looks like: This practice went from averaging 19 visits for patients that committed to care to over 30 visits! I am honored to be a part of the success of Invision Family Chiropractic and was able to share it. I look forward to continued success!
Three Parts of every business – People, Process, and Technology
Hey, everyone. Dr Brian Capra here from Genesis Chiropractic Software. I’ve been getting some questions as I’ve gone through these videos. We’re talking about insurance companies, how they’ve been legally allowed to collude against us, rig the system. I’ve talked about how they use people and process and technology. We went into a little bit of a depth about those things. And as I’m going along here I’m getting some questions about what is people, process and technology? And sometimes, I just kind of flow through some content and forget to stop and go over some of the finer points. So, people, process, technology. Today, I’m going to be talking about people, all right? People in an insurance company are obvious. You have your people that answered the call, you have your auditors, you have your high-level management, your CEOs, et Cetera. And every business is, no matter what business, no matter what size the business is, is always made up three people … Of three things, and that’s people, and process, and technology. So, what we’re going to do is go dive a little bit into people. The number … If I were to do a countdown to number one of the types of people typically in your practice, number one is your customer. Or, any businesses is a customer. In our business, that is our patients. Our patients are our customers. They’re obviously very important. Our whole business exists to give them an amazing experience. Customers, patients in our case, who have great experiences stay longer, get better results in our business. They tend to convert to lifetime patients, and then they refer other people, and in some cases, if your business has such an amazing experience, they’re actually willing to pay you even more than they would a similar type of business that exists down the street. Think of Apple, et Cetera, right? So, the experience has a lot to do with the customer. The customer is number three. The second type of person in your business is obviously your team members. Now in chiropractic, many times, the business owner, you, is also a staff member. You have a job to do. So, the different types of people or roles in your practice, the front desk CA, the check-in and the checkout. You have your billing person, they may do your follow up. They may do insurance benefit verifications. You have somebody at those financials and care plans. Usually, you want to have somebody that does at least some of the marketing, or manages the marketing or the marketing calendar, et Cetera. So, you have your marketing. Usually, you have some type of sales role, and you may have three people in your office, and these roles, one person may have more than one role. But you have sales, whether or not we get that or want to admit that, there is a conversion process. When a patient comes in that has never heard chiropractic before and you’re going to teach them what their problem is, how it’s affecting their life, and what they need to do about it, and have them pay for that. That’s a sales process. So sales is a key component of your business, and somebody on your team, somebody on your staff, has to be responsible for that thing. Okay? Now, we have customers or patients. Staff, which may include you, a practice owner, it may include an office manager, and all the roles we talked about. And the last, and I will say most important, is you. You are the visionary. You’re the business owner and the business manager, really. So, sometimes you get an employee that can manage the business. That’s when doctors really start to be able to run their practice like a real business where the business actually becomes really self-managing, self-sustaining, and you are an owner of a business that that can be transferred to another. Steven Franton likes to say “It’s transferable.” You can sell it and the value of that business wouldn’t change the next day cause it’s literally run by your team, your staff, right? That whole thing is actually run by an entire team. But as the business owner building a great team, the number one reason is to free you up, free your mind up, your thoughts, because you’re a visionary. As an entrepreneur, the number one thing that we do is think, and dream, and think of better ways to do things. So, when you’re adjusting … And this is not to shun this. This is okay if you do this. This is one of your passions. But if you’re adjusting, you’re not thinking about how to scale the business. You’re not thinking how to replicate the business and do it in multiple locations. You’re not thinking of the details of how you can measure different processes in your office and whether or not those processes are successful. So, the reason the middleman exist, the middle woman exists, whatever it may be, is to free you up to be the visionary, to develop better processes. And we’re going talk about process and technology. When you are free, you’re able to dream again, you’re able to experience life, you’re able to take vacations, spend time with your family. You need to be free to be a better parent, be a better partner in your relationship, to have your own peace of mind, and to actually, most importantly, contribute to our community and our world. So, we really need you to understand this, people, so that you can free up. We’re going to talk about process and technology too, and how that ultimately leads to freeing you up to be able to serve even better, be able to serve patients even better, to really expand out. And this profession, we have nowhere near enough chiropractors to serve the amount of people that need what we have to offer. So, I hope
Three Step Management
Everyone, Dr. Brian Capra here from Genesis Chiropractic Software. Tonight we’re going to talk about the three steps to management and this is where your software, your practice management software, ironically fails you. It’s about management at the end of the day. Practice management, air quotes, software that’s on the market these days really, I don’t consider management software because it doesn’t help you manage. It does some really cool stuff. When I started my practice, I used other software to be frank, I used Platinum System. It was cool. It did a lot of great things. It did a lot of automation. It did somethings for me that really helped. If you know my personal story, I encourage you to go listen to that. It really didn’t actually help me manage my business. It made things easier in certain circumstances, there was good reports, but it didn’t help me actually manage my business. As a chiropractor, I think I said this in my last video, it’s really important that we start to really shift from a doctor a business owner, pulling ourselves more and more and more out of the day to day life or being in practice, being an employee in our own practice. As a business owner, as a chiropractor, you have to understand that you really are two things at the same time, which really puts you in a very unique situation. You’re not only a business owner, but you’re an employee in the business. To be an effective manager of business, there are three things that you must do, and this is not chiropractic, this is any business. Give you a little perspective, you probably know by now, I own Genesis Chiropractic Software and Billing Network. We are a chiropractic software, we serve thousands of clients in the cloud, but we also do insurance billing and collections for thousands of providers and users in the cloud. You’ve got to understand that I have learned, I wish I knew what I know now, by building this business over the past 15 years, I wish I knew this when I was in practice because it would have saved me a lot of frustration, number one. It would have freed my time up so I could have been focused on things other than my practice while I was outside of the practice, I wouldn’t have had to be always thinking about all of the processes and procedures my team was supposed to be doing and whether or not they did it and thinking about which patients I haven’t seen in a while. I wish I would have known this 15 years ago plus, because that’s when I was in practice. I had a great practice, 400 plus visits a week. I wasn’t super high buying, but I did corrective care so we had a great practice, huge collections and it was awesome. We did some insurance, some cash. Here’s the thing, there’s three steps. This comes from the experience of building my company over the past 15 years, reading every business book I can get my hands on possibly and now I just want to just give this to you. It’s just three steps. Ultimately at the end of the day there’s only three things you have to do. It’s simple to understand, I’m not saying it’s simple to do. Okay. Number one, quantify. We talked people, process technology. We talked about process specifically. We talked about revenue, retention and compliance and the three types of processes in any business. So, this is quantifying means developing your processes. Step by step by step, clarifying your processes. If you have a new patient, it’s not that you just have a new patient, you have the phone call, you have the script. You have to schedule them. You have every step of what needs to happen in your technology. When they check in, after they’ve checked in, there’s a whole bunch of steps that have to happen after that. The doctor has to do their exam for it, the doctor has to do the recommendations for care. Somebody has to create their financials. Somebody might have to call insurance and verify benefits or maybe there’s no coverage. Then that has to be coordinated, create a financial and that has to be presented to the patient. After the first visit, a lot of times in practices that I know, I know I did this, I would call the patient after the first visit, the phone call. That’s just the new patient. There’s several steps right. Every single daily visit, there’s several steps that have to happen and they have to happen perfectly because like we talked about in people, processes and technology, like we talked about in process where we have revenue and patient retention/patient experience, everything has to happen perfectly. If it doesn’t happen perfectly, you’re affecting the patient relationship. If the relationship doesn’t happen perfectly, you’re affecting the ability of that patient to really understand chiropractics, stay longer, get great results and refer other people. This is, when you think about this stuff, it should be thought about with a sense of urgency. Managing should be in your life blood. It should be part of your core of who you are. It’s not like you want to manage a business. It’s just that you want to manage the patient experience the best you possibly can. Quantify the work, again management three steps. We’re going to talk about quantify. Sorry if this is, I don’t know if this video is kind of backwards, but it’s just the technology, the way it’s working right now. Quantify the work. That means your processes, and not just your processes, but every single step in a process has to be documented perfectly in detail. It has to be, like I said in the last video, it has to be revisited on a regular basis. I’m not saying every week, or even every
Three most common people problems
Hey everyone. Dr Brian Capra here from Genesis Chiropractic Software with another episode. Today I want to talk to you about the three most common types of people problems. And I mean, by people I mean your team, and when I mean problems, the things that cause them or prevent them from performing to their fullest level and serving the function in your office and your business. Number one is a training issue. So we talked about recently, people process technology. We talked about how the technology should, especially with Genesis, would show you by the end of the day how many tasks, or during the day, how many tasks each person in your office would have to perform. And then by the end of the day you’d know what was left, if anything, which there shouldn’t be anything. But what if there was something left over that wasn’t completed before the end of the day? It’s an easy conversation. It’s proactive, you’re proactively managing the patient experience. So now you go on there and you go to your team member and you say, “what happened? There’s 10 of these tasks left over.” And you look at them, let’s say they’re all 10 are no shows. You might be concerned, you might say, “Hey, you know what? Why haven’t you followed up on all these things?” And they may say to you, “well I just started on Tuesday and I don’t know how to do that one thing.” So there you have a training issue and they just need better training, but at least you were proactive about it. All right, so that’s a simple one. Training issue. Second example, the second most common problem is a capacity issue. Capacity is very simple. “There’s 10 things leftover. What happened? How could I help you with these 10 things that are left over?” “Well I did 50 and those are just the 10 that are remaining.” So now we can see that they are just purely out of their capacity to be able to do that amount of work for that simple problem in the practice. So now they go in and you say, okay, we may need more team members, we may need to automate certain things. Maybe if we turned on text reminders and appointment reminders and emails and things like that, maybe that would decrease the need for how many no shows are happening in the practice. Maybe you see a 2000 patients a week and there’s only 10 left at the end of the day, yet you still have a capacity issue. So you can automate in those cases or sometimes you really just need another person. The third type of thing that can happen, pretty simple is a wrong seat, wrong law office type of problem. So in that case, you have a situation where you go to that person and you say, “how come you haven’t called all the no-shows or how come all these re exams didn’t get scheduled today?” Or whatever the case may be, they may say to you, “you know, I really, really hate doing that thing, that type of task, I hate doing it. It’s too confrontational for me. What I’d rather do is call companies and follow up on insurance claims or handle care plans or financials or whatever.” So in that case, you have a great person on your team that wants to work real hard, but they’re just in the wrong seat in your practice, meaning the wrong role in your business. And so you have a good person in the wrong seat. So that’s a wrong seat problem. Now, the wrong practice, wrong business problem. Now you have a real problem. So this should be mitigated by some of your upfront hiring protocols, how you hire people, how you find people, how you find people to apply for your office, your application process. I definitely recommend you work with Chiro Matchmakers if you’re a chiropractic office. It’s a staffing company for Chiropractic offices, they do a lot of profiling, making sure you’re hiring the right person for the role you’re looking for. But if you get somebody in your office that understands the mission of your business, your why behind your business, your core values in your business, and you hire them for a certain role and then they tell you they hate it, it could happen. It does happen. They’re just in the wrong seat or the wrong business, They’re working for the wrong type of business. Now, what’s great about technology with Genesis, since you know right there and then, the day that there’s too many tasks that are left over, and as soon as you confront the person about that, and it’s not confrontational necessarily, but you’re going to approach it in a proactive way and say, “how can I help you with that thing?” And they tell you, “you know what, I hate doing that thing and I never am gonna like it. And I hate this.” Basically, it’ll come up pretty quickly. You’ll figure out, you might shift them into a different role and they don’t perform there either. So then you have the wrong person in the wrong business. So we talked about there’s three types of common issues with staff, with people in your practice, your business. One is training, two is capacity and three, wrong seat or wrong business. So this pretty simple short video I definitely, to prevent, the capacity and the training issues are easy. Even the wrong seat is relatively easy. Preventing hiring the wrong person, that’s a bigger problem. You want to make sure you have really good hiring processes. I definitely recommend you work with Chiro Matchmakers to make sure you get the right person for your business, before you find the right seat for them. Okay. Thanks so much. Have a great weekend. I’ll talk to you soon.
What if your server crashes
Hey everyone, Dr. Brian Capra here from Genesis Chiropractic Software. Today I’m going to talk to you about what you have to do if your server crashes. Of course what I’m referring to is a client server based system. That’s your Platinum, your ChiroTouch. Any other system that’s not in the cloud. Genesis as you know, has been in the cloud for 15 years or so, so we know quite a bit about this or I know quite a bit about this. I actually had a client service system before we started Genesis. This was one of the scariest things that I had to think about as far as the software in my office running. If this thing ever crashed, what would I do? There’s always like a disaster recovery process, right? Yet hopefully you’re backing up your data every single day at least. Hopefully your software company has taught you how to test whether or not that data recovery is actually working. But what you’ll have to do if that server crashes, and when I say crash, not just crashes but is fried, and that that’s going to happen every three to five years. So, when – not if – when that happens, of course you have to buy a new server. The first thing you got to do is find some type of expert; some type of network expert that knows how to work with different components of a network in your office. Contact your expert. You’re going to have to get a new server of cost. You could expect to spend 2,500 to $5,000 on that. Get that server. You’re going to have to configure the database. It’s not like you just get the server and plug it in. You have to configure the database, then you have to load the software, whatever software you’re using on that server. Then you have to network that server to all your other computers in the office and get that network back up and running. Somewhere in there you have to restore the data, and hopefully that data backup worked. Now, this is a stark contrast from other systems like Genesis in the cloud. First of all, we have multiple site, redundant server backups in real time, so it’s not the end of the night or anything like that. It’s actually backing up every second or two as you’re actually using Genesis in the cloud. Everything is backed up, so if your server in your office crashed, if you have a server, you don’t need one for a cloud based system but it would have literally no effect. But if your computer crashed or something like that, still has no effect because you’re literally just accessing all your data every time you log into Genesis. Remember now, with a cloud based system, there’s really no issues with that. We also got to remember with a cloud based system like Genesis, your data is being stored and backed up in real time in a HIPAA compliant data center. As opposed to your data being on a server in your office, which has all kinds of HIPAA compliance risks where somebody can hack that server and get that data and that would be your liability, hundred percent on you. Make sure you have HIPAA compliance insurance. But if you have a cloud based system and you’re outsourcing basically your HIPAA compliance and your data backup, you don’t have that level of exposure. So again, the data and for a cloud based system like Genesis is stored in a HIPAA compliant data center. You can’t even get into the building without a biometric scanning and things like that. The other thing to remember is servers break all the time, right? With Genesis, we have multiple servers running all the time, so if one crashes, the other one kicks in and so on. The users would typically never see a downtime at all if one server just crashed. The other one would just pick up where it left off. But something to remember, in these data centers, they have server experts, technology experts on staff 24/7. So if anything, God forbid, happens, we know. We have people on site. It’s not dependent on somebody at our company 24/7 around the clock. Hopefully what you’re seeing with this, there’s a lot of extra costs associated with a client service system, there’s a lot of extra exposure with the client server system, and there’s a lot more risk just generally of downtime. Because even if your server goes down and you know what to do, it’s going to take you quite some time to get back up and running. Hopefully you can understand the differences between downtime with a client service system and a cloud based system. That’s all I wanted to talk to you about today, so thank you so much and stay tuned for the next video.
How to beat insurance companies at their own game – The “claim” lifecycle
Hey everyone, Dr. Brian Capra here. Tonight we’re going to start getting into how we’re going to beat insurance companies at their own game. So I’m going to quickly review something here, just kind of a little bit more of a schematic. This is my first screen sharing, so hopefully this is working for you right now. What we’re going to do is first of all talk about just overview of what we’ve already spoken about. Number one, insurance companies, we know how they get money, they get premiums from either employers or just patients out there that buy health insurance on the market, right, so they get premiums. Then what happens is the doctor over here, poor doctor on the right hand side over here, submits a claim to the insurance company. The insurance company delays reimbursement. We’re going to go into more depth about this, but we’ve already kind of talked about how the whole process is rigged in this way, where, how do they delay reimbursement? Part of it is just preventing you from getting the claim out to begin with. Forget the fact that they get the claim and deny it and all that stuff, but making complex coding systems and all that is part of the issue. So delays in reimbursement. They collect money. So as soon as they don’t pay you at the time you saw the patient, interest starts accruing on the money that’s yours still sitting in their bank account. So they’re going to collect that money, that interest, that’s called the float. They’re going to put that money, they actually reinvest that, there’s some very complex financial mechanisms that they use, so they’re going to reinvest that. Then they take all of those profits combined, they either keep the profits, they invest in better systems, technology, automation, and also invest in audits. All right. Eventually, hopefully they pay us, but then we have denials and underpayments, et cetera, that we have to deal with. So this is just kind of, I put together a quick overview. What I’m going to start talking to you about right now, we’re going to go into a lot of depth about each one of these steps, is how are we going to beat … What I talked to you last video about was how are we going to use their people, the types of person that they use, or our people? When I say people, our staff, our teams, how are we going to start to reposition those things, use them in a different way, use different types of people, leverage technology, automation, artificial intelligence, and leverage different processes to basically beat them at their own game? We’re going to go over a quick overview and I’ll come back to this and go into more depth that the way you beat them at their own game is on the claim level meaning every single claim you have to beat them at it. All right, so the claim starts when a patient actually checks in the door into your office, and then we see the patient, create a document, and we got submit the claim to insurance. I’m going to get back to cash in a second here so don’t get scared there. The claim is accepted by the insurance company. The AI, I’m going to go in depth about this, artificial intelligence looks for errors, submits it back to the office. We have EOB posting, secondary claim submission, secondary EOB posting, same process to find claims that need followup. The claim is fully processed, now we have a patient balance. If it was a cash patient, we just bypass all those steps and the claim, whether it’s cash or insurance, a claim is a claim. There’s a diagnosis code, there’s procedure codes, there’s the associated fees that go with those procedure codes for, you can have a different payer system even for cash patients. But we wind up with the patient balance and then we have all kinds of automation and technology that we can use to get that patient balance down to zero as fast as possible. So the name of the game is to leverage people, process, and technology to get that timeframe from time of service, the time the patient was seen in your office or checked in, to the time you have a zero balance for that patient. Obviously for insurance, that gets more complicated. So I’m going to go into more depth, little bit step by step in the next video. Stay tuned. Thank you very much. Again, this is Dr. Brian Capra From Genesis Chiropractic Software, and I will see you soon
How to beat insurance companies – people process and tech – automate, focus, measure
Hi everyone, Dr. Brian Capra here from Genesis Chiropractic software. And another video in the series here, I’ve been building on, each one building on the ones before. Last week, last I was on I was talking about how we can use people, process, and technology to beat insurance companies at their own game. Something that we’ve been doing at Genesis for close to 15 years now. So I’ll try to give you kind of a, some of the context here. What we’re going to focus on with people, process, and technology are three things. Automate. Automate everything possible. In order, in doing so, by automating everything possible, and we’ve automated literally using artificial intelligence, automation, aggregating data across thousands of providers, we’ve been able to automate more than, I think it’s 62% to 72% more automation in Genesis than any other system. When we automate, then we can focus. We can focus on the things that actually get you paid. And that doesn’t have to be just insurance, it’s cash as well. Focusing you and your team on just the tasks that get you paid, and I’m going to go a little more in depth about that. And then once we automate and we’re able to focus, then we can measure. We can measure how much work was actually needed to be done, how much work was actually completed, the quality of the work. And then we can also start to measure not just our own performance as an individual practice but also see the trends across the entire profession as far as what insurance companies are doing trend-wise so we can continue to battle, build more automation, more rules, better artificial intelligence, to beat them at their own game. I have a really cool example of how we’re able to actually beat insurance companies at their own game, specifically in New Jersey. So, what am I talking about with automation? I’m going to just start with insurance claims. This is going to expand into way more than that. It’s going to expand into the patient experience, and patient retention. Of course other things that affect your revenue. Let’s talk about insurance. So we’re going to automate everything, right? We’re going to automate benefit verification. We’re going to automate, like we do in Genesis, and maybe I’ll post some videos of some of the documentation, but we’ve now built an even better documentation system that’s been released this year in beta, it’s starting to get to full production right now. Where the documentation is completely automated from the intake form into the exam form into the daily note in every document after that. Where we can take out all the manual steps that you have to do right now. And as well, on your daily notes from visit to visit make it super simple for you to make changes and updates to that. So, benefit verification. Documentation of every single visit. Not only documenting, but the next step in actually collecting insurance is making sure that you create a claim. Well, in a lot of systems, in a lot of technologies out there, it’s kind of two different processes where you create your document, then you create your claim, and hope you don’t get audited later. What we’ve done with Genesis is make the document, create the claim. Meaning that what’s documented in your visit actually generates the claim, the codes, the diagnosis codes, the procedure codes, the modifiers, the time units, the diagnosis linking. All those things so that literally in seconds while you’ve seen a patient you can create, your claim is actually created, and it’s compliant, meaning that it’s actually supported by your document and submitted to the insurance company in real time. Then if for some reason you tweet something or things didn’t work properly, it’s going to go through a huge, huge rules engine where we have millions of validations, or rules, or artificial intelligence rules that are going to scrub that claim. This is not clearing house scrubbing. This is Genesis level scrubbing with millions of rules that we’ve learned, you know, tens of millions of claims over the years. All right? So now we’ve got the claims that maybe need a little bit of tweaking before they go out. Just focusing your team on correcting them if need be. The claim submission, like I just said, is real time. EOB posting is now automated, right? Secondary claims go out automatically, secondary EOBs come in automatically, and post. And then we’re going to talk about probably the most important difference with automation, using automation, to make sure you’re keeping those insurance companies accountable and make them pay the second, the first time, the first minute that you have something that you can legally do to make them pay as soon as possible. Making sure that comes right to you. What do I mean by that? We know, just go back and watch the previous videos, and how they’re legally allowed to create these laws and rules, and that we have 90, I’m sorry, 30 days to pay you and get an EOB back to you. Making sure that they pay on that day. Really we know that they should pay at the time you see the patient, or right after you’re finished seeing the patient, right? But we know the laws aren’t quite that way. So when we get that EOB back, if there’s something that needs to be followed up on, it has to be done that second. I’m going to show you how this applies to the follow up being done the second it’s due. It doesn’t just apply to insurance claims. It applies to every part of the patient life cycle. The no shows, the no future appointments, the care plans. I’m going to talk about that in other videos. But now we have identified the claims. I mean, we, the technology and the artificial intelligence, is actually
Going Cash
Hey, everyone. Dr. Brian Capra from Genesis Chiropractic Software once again. Tonight I am going to talk to you about going cash facts, myths, pretty straightforward, pretty simple, very misunderstood out there in the profession. I understand how we wound up in this situation. Tired of dealing with insurance companies, tired of submitting claims and following up on claims and dealing with having to resubmit claims and submit documentation and all the rigmarole. I understand it 100% why you’d want to quote unquote go cash. Quick quote from Ayn Rand. If you don’t know Atlas Shrugs, read the book, watch the … There’s movies now you can watch. So watch the movie. It’s really cool. “Contradictions do not exist. Whenever you think you are facing contradiction, check your premise. You will find that one of them is wrong.” So I’ve talked to a lot of doctors that thought going cash would kind of keep them safe and make it simple, and they wouldn’t have to document as much. They wouldn’t have to use the coding as much and all that stuff. But now we know that’s just not the truth anymore. State boards are requiring Medicare-level documentation and coding even for cash patients. So it’s not even the insurance companies anymore. This has become a standard of care. You’ve probably heard that kind of terminology before. Standard of care means it’s just required because you’re a doctor and it’s expected of you. So what does that mean? So let’s talk about going cash. Obviously insurance companies ideally never have to pay you, right? So we think by going cash and submitting superbills to pay or giving superbills to patients that we’re kind of playing along with the game. That’s not the game. That’s not what they’re looking to do. They’re going to have to pay the patient anyway, so that’s really not the problem. So there’s really no such thing today, and don’t shoot the messenger, as a cash practice anymore. There was a long time where you can kind of get away with that, but it’s just not the truth anymore. Number one, you have to submit claims to Medicare for Medicare patients. That’s the law. So right off the bat, I know a lot of the cash doctors say you’re cash, and I know you know that you have to submit to Medicare. So you just submit to Medicare and that’s it and everybody else gets a superbill. I understand that scenario there, but again, state boards now require Medicare … So number one reason that cash doesn’t really exist, you have to submit claims to Medicare. Number two, state boards now require Medicare-level documentation and coding even on cash patients. So you have to do it anyway. The only difference is whether or not you have to submit claims, follow up on claims, and so on. The third and probably biggest reason that there is no such thing as a cash practice is even if you give superbills to patients today, insurance companies can still come back and audit your documentation for those claims to support that it was actually done. So what they’re going to do is tell the patient this is denied, ask your doctor for documentation. If you don’t provide that documentation, you’re in trouble. If you do provide that documentation and it doesn’t support that, you could also be in trouble because what are they going to do? They’re going to report you to your state board, which in my opinion is an even bigger problem than an audit. You get audited, worst case, you have to pay a bunch of money back. Obviously there’s legal fees involved. That’s never … it’s not fun. There’s a big distraction. It’s a nightmare. But I would say a bigger problem is actually getting reported to your state board. Why? Because now it’s your license and your livelihood. So the insurance companies have figured out every single possible scenario to tighten the screws. You know, there’s the old Godfather quote, “Just when you thought you were out, they pull you back in.” That’s because there’s really no such thing as a cash practice. Now a little light at the end of the tunnel. The wrong question, what we should not be asking ourselves … I know how we, as this profession and how we think, we just want to save people, we just want to save their lives, we’re just trying to serve people. We just want to adjust. I get it. I’ve been in the same, you know, your shoes. I was the same way, except today the game is just a little bit different. Even if you want to see cash patients, and we work with CHUSA and other companies that do cash discounts, legally doing cash discounts. That’s great. When they are in the cash portion of their care plan. When they’re not and it’s medically necessary, insurance is still in the game. So that means the state board and/or the insurance company is in play. All right, so the wrong question is how do we see patients to avoid documenting and coding requirements? Can’t do it anyway. So that’s the wrong question. The wrong premise, right? Ayn Rand. You’ve got to check your premise. It’s just wrong. You can’t do it. The fact is we can’t do it, so state boards are now requiring it all. The correct question, what we should be asking, how can I see patients regardless of their payer, whether it’s insurance, because at some point in their care, they’re either insurance, they’re allowed to get covered by insurance or they should be covered by insurance or they should not, right? Meaning that they’re not in acute care or not in active care. So how can we see patients regardless of the payer and have systems in place that make it feel like, for the doctor, for you, for your team, like a cash practice as
