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A Failure to Communicate

March 13, 2025

In the old movie, Cool Hand Luke, the Captain said to Luke, “What we’ve got here is failure to communicate.” This has been a major problem with the chiropractic profession since our inception. So many people who’ve never been to a chiropractor have simply no idea what it is that we do and why we do it. In fact, the rest of what I like to refer to as the “Health Care Universe”, which includes other health care providers and payers, has very little understanding of what we do or why we do it. Why not? It’s because of our documentation. How do I put this gently? You see, as a profession, our documentation, um, sucks. I’m a 2nd generation chiropractor and I’ve been treating patients for more than 31 years. I’ve also been reviewing LOTS of records and performing IMEs for quite awhile. If you could see what I see…you might have a better understanding of what I’m talking about. We seem to have little to no standardization of how to perform a history and exam. One patient can go to 10 different chiropractors, and that one patient will likely get 10 different exams, all kinds of different diagnoses and 10 completely different treatment recommendations – some for 2 visits, some for 6 visits and some for a pre-paid package of 53 visits. We’re all over the place, and it makes us, as a profession, look ridiculous. Many chiropractors ask me if they should be sending their patients’ primary care doctor their notes. My answer is always…”NOT IF THEY SUCK.” But, if you document properly, using the “universal” language of healthcare, not language that only chiropractors understand, then, by all means, send the notes. Many chiropractors tend to have a love/hate relationship – hmmm, check that – a hate/despise relationship – with Medicare. What has been our biggest problem with Medicare over the years? Yep – our documentation. Personal Injury? Yeah, the documentation. Blue Cross Blue Shield and other payers? More and more of them are producing guidelines that are putting chiropractors into a full blown panic attack. Why do they keep doing this to us? I suspect it’s because we, as a profession, have done such a poor job of documenting what it is that we do and why we do it. At least that’s a big part of it. So how do we fix it? I can just say “document better,” but that’s too ambiguous. We need to standardize our exams more. We need to address BOTH pain and function, not just pain. Let’s start with the History. Too many chiropractors are taking shortcuts on the history. The standard in the Health Care Universe is the OPQRST method, but we’ve got to ask and document ALL of those letters, and we need to document them for EACH condition that we’ll be treating. We need to understand what the ortho/neuro exam is actually for, and what it’s NOT for. We need to understand how to document the findings of the exam. If I see one more time a chiropractor’s records for a non-radicular patient in which the chiropractor notes Grade 2 muscle weakness, I’m going to spit. We need to wrap our head around using outcome assessments for ALL of our patients. This is not a Medicare thing or a PI thing – it’s a DOCTOR thing. But we need to figure out which outcome assessments are more powerful, take less time and are most cost-effective. We need to accept and embrace some guidelines (I know, a four-letter word, so to speak) that actually HELP us help our patients. The CCGPP Guidelines are an EXCELLENT place to start. We need to know exactly WHEN to re-assess the patient and HOW to determine if our treatment has been effective or not and if we’re justified to continue treating the patient – or not. We need to know exactly when ACTIVE care ends and MAINTENANCE care begins. And, here’s the big one – we need to be able to do ALL of this in the LEAST amount of time, with the LEAST amount of effort (documentation, not the exam or treatment) and, yes, the LEAST amount of cost. Is all of this even possible? You bet it is. But only if we stop failing to communicate. Gregg Friedman, DC, CCSP, FIACA Creator of The Bulletproof Chiro EMR

What Are General Chiropractic Business Costs?

March 10, 2025

Running a chiropractic practice isn’t just about patient care—it’s also about managing the business side efficiently. From billing services to software costs and compliance fees, many chiropractors wonder if they’re overpaying or missing critical expenses in their operations. A recent discussion on Reddit highlighted the question: Am I paying too much for my billing company? The reality is, billing is just one part of the equation—there are multiple costs that chiropractors must consider to maintain a successful and profitable practice. How Much Does It Cost to Open a Chiropractic Office? Starting a chiropractic practice involves several upfront and ongoing expenses. The total cost can vary significantly based on location, equipment needs, and staffing requirements. Some key costs include: Office space rental or purchase – Lease rates vary widely, but expect to pay anywhere from $1,500 to $6,000 per month depending on location and size. Equipment and furnishings – Adjusting tables, diagnostic tools, and office furniture can add up to $20,000 to $50,000 or more. Initial marketing and branding – Website development, local advertising, and signage can cost $5,000 to $15,000 to establish a strong presence. Licensing, credentialing, and insurance – State licensure, malpractice insurance, and credentialing with payers can add another $3,000 to $10,000 in initial costs. These startup expenses are in addition to the ongoing operational costs covered in this post. Careful planning and budgeting are essential to ensure a smooth launch and sustainable growth. Breaking Down the Costs of Running a Chiropractic Practice 1. Billing & Revenue Cycle Management Many chiropractors outsource their billing, with costs ranging anywhere from 5%–10% of collections or a flat monthly fee of $1,000–$3,000. While outsourcing can be more efficient than in-house billing, overpaying for a service that doesn’t maximize reimbursements can hurt your bottom line. With ClinicMind’s Billing Services, you get a comprehensive revenue cycle management solution that ensures claims are processed correctly, reducing denials and improving cash flow. Instead of wondering if you’re overpaying, you can be confident that every claim is being optimized for maximum reimbursement. 2. Practice Management Software & EHR Systems A robust EHR system is essential, but some chiropractors pay $300–$800 per month for outdated or limited software. Others forget to account for the hidden costs of using multiple disconnected platforms, which lead to inefficiencies and increased administrative work. ClinicMind’s All-in-One EHR eliminates the need for multiple platforms by integrating scheduling, documentation, billing, and compliance tracking into one system—saving time and reducing costs. 3. Credentialing & Insurance Payer Contracts If you accept insurance, proper credentialing is critical. Fees for third-party credentialing services range from $150 to $500 per provider per payer, and errors in credentialing can delay payments for months. With ClinicMind’s Credentialing Services, you ensure that your practice is enrolled correctly with the right payers, avoiding costly delays and lost revenue. 4. Staffing & Payroll Labor is often the largest expense for a chiropractic practice. Salaries for front desk staff, billing personnel, and office managers add up quickly. Some practices opt for part-time employees, but hiring and training can be costly if turnover is high. By outsourcing administrative functions to ClinicMind’s Virtual Office Services, you can reduce staffing costs while ensuring efficient practice operations. 5. Marketing & Patient Acquisition Many chiropractors underestimate marketing costs. A well-rounded strategy—including website management, SEO, and digital advertising—can range from $500 to $5,000 per month depending on the size of the practice and competition in the area. ClinicMind’s Marketing Services help chiropractors attract and retain more patients without overspending on ineffective marketing strategies. 6. Compliance & Risk Management HIPAA compliance, documentation audits, and risk management aren’t optional—but they’re often overlooked. Chiropractors might spend $1,000–$3,000 annually on compliance services or risk expensive penalties for non-compliance. With ClinicMind’s Compliance Solutions, your practice stays protected, avoiding unnecessary fines and liabilities. Are You Overspending or Missing Key Costs? Managing expenses effectively ensures long-term success for your practice. By evaluating your costs across billing, software, credentialing, staffing, marketing, and compliance, you can determine where you’re overspending—or where gaps might be costing you money. Want to see how outsourcing can save you time and money? Meet with a ClinicMind consultant today to explore how we can streamline your operations and reduce unnecessary expenses.

Chiropractic Credentialing: How To Avoid Delays & Get Paid Faster

March 3, 2025

For chiropractors, navigating the complex world of credentialing can be a daunting task. Without proper credentials, practices can’t receive their reimbursements, delaying patient care, and missing opportunities for growth. Whether you’re a solo chiropractor, part of a group practice, or expanding your network, having a streamlined credentialing process is essential. That’s where ClinicMind’s CredEdge comes in—a comprehensive solution designed to simplify chiropractic and mental health professional credentialing, ensuring accuracy, efficiency, and compliance. The Importance of Chiropractic Credentialing Credentialing is more than just paperwork—it’s a crucial step in establishing your legitimacy with insurance companies, government payers like Medicare and Medicaid, and other healthcare organizations. Without proper credentialing, you won’t be able to bill insurance providers, which directly impacts revenue and patient access to care. The process involves verifying education, training, licenses, and work history, among other key qualifications. However, the manual credentialing process is time-consuming and prone to errors, and delays. If not handled correctly, chiropractors can face costly denials or contract terminations. Common Challenges in Chiropractic Credentialing Many chiropractors struggle with: Long Processing Times – It can take 90-120 days to complete credentialing, and errors in applications can cause further delays. Complicated Requirements – Each payer has unique criteria for credentialing, making the process overwhelming. Medicare & Medicaid Complexity – Government payer credentialing involves extensive paperwork and ongoing compliance. Renewals & Re-certifications – Chiropractors must stay on top of expiring credentials, insurance renewals, and compliance updates. How CredEdge Streamlines Credentialing CredEdge is ClinicMind’s advanced credentialing service that takes the burden off your shoulders, ensuring a seamless experience from start to finish. 1. Full-Service Credentialing Help From initial applications to ongoing maintenance, CredEdge handles the entire process—including Medicare and Medicaid credentialing. 2. Faster Credentialing & Fewer Errors CredEdge’s automated tracking system minimizes human error and accelerates processing times, so you can start billing sooner. 3. Multi-Payer Credentialing Expertise Our team has experience working with private insurance providers, Medicare, Medicaid, and worker’s compensation programs, ensuring you’re credentialed with the payers that matter most. 4. Compliance & Ongoing Support With real-time monitoring, we alert you when renewals are due and ensure you stay compliant with payer requirements—reducing the risk of credentialing lapses. Why Choose ClinicMind’s CredEdge? Time Savings – Focus on patient care instead of administrative tasks. Revenue Optimization – Avoid reimbursement delays and denials. Expert Support – Work with credentialing specialists who understand chiropractic needs. Seamless Integration – If you choose to use ClinicMind’s EHR and billing system, it’s fully integrated for a streamlined practice management experience. Our team also collaborates with your billing department and credentialing experts to ensure your office operates as a whole. Get Started Today Credentialing shouldn’t be a roadblock to your success. With ClinicMind’s CredEdge, you can ensure your chiropractic practice is credentialed quickly, correctly, and compliantly—allowing you to focus on what matters most: your patients. Contact us to learn more about CredEdge and get paid faster today! Seamlessly integrate credentialing with your billing system using CredEdge. Book a consultation to learn more Book a Consultation

Welcoming Dr. Igor Sobol to the Advisory Board

February 17, 2025

Healthcare practice owners face numerous challenges, including patient attraction, retention, staffing, regulatory compliance, and payer adversity. When left unaddressed, these obstacles hinder practice revenue, growth, and profitability. We are excited to welcome Dr. Igor Sobol, MD, PhD, to our Advisory Board. With a strong background in both medical practice and research, Dr. Sobol has played a pivotal role in integrating technology with healthcare delivery. At ClinicMind, we empower healthcare providers with scalable solutions to streamline operations and enhance efficiency. Dr. Sobol’s appointment marks a significant advancement for ClinicMind users. His insights will enhance our products, enabling providers to optimize workflows, improve patient engagement, and navigate the complex healthcare landscape more efficiently. His deep understanding of healthcare operations and emerging technologies will guide product development and strategic initiatives, reinforcing our commitment to excellence. ClinicMind continues its mission to transform healthcare through smart, data-driven solutions, equipping providers with the tools they need to succeed in an evolving industry. Read the Full Announcement Check out the full press release here: ClinicMind Welcomes Dr. Igor Sobol to Its Advisory Board.

Credentialing in Medical Billing Systems

February 1, 2025

Credentialing in medical billing is crucial for ensuring patient safety and maintaining the quality of care provided by healthcare providers. This process involves verifying providers’ qualifications, competence, and eligibility, playing a vital role in effective revenue cycle management. In 2021, the Credential Management Solutions Market had a valuation of USD 833.45 Million. Projections indicate that it is expected to reach USD 2526.34 Million by 2030, experiencing a compound annual growth rate (CAGR) of 17.7% from 2022 to 2030. The rising cyber threat risk has spurred demand for skilled experts, credential management solutions, and IT security compliance software in businesses and organizations. (Credential Management Solutions Market Size, Share, Trends & Forecast, 2023) Figure 1. Global Credentialing Management Solutions Market https://www.verifiedmarketresearch.com/product/global-credential-management-solutions-market-size-and-forecast-to-2025/ Medical Billing Systems in Credentialing Medical billing systems are critical components of healthcare operations. They are used to submit and follow up on claims with health insurance companies to receive payment for services rendered by a healthcare provider. The role of medical billing systems in credentialing is quite significant. Provider Information: Medical billing systems hold essential information about providers, including their credentials. This information is necessary for filing claims and verifying a provider’s ability to provide certain services. Claims Processing: One of the key steps in processing medical claims involves verifying the provider’s credentials. If a provider is not properly credentialed with a particular payer, claims for services rendered can be denied, resulting in lost revenue. Regulatory Compliance: Medical billing systems help maintain compliance with healthcare regulations, including credentialing-related ones. By ensuring providers are credentialed properly, the systems help prevent fraudulent claims and avoid potential legal issues. Integrating credentialing into medical billing systems can streamline workflows, improve accuracy, and increase efficiency. The integration can occur in various ways: Data Sharing: Medical billing systems can be configured to share data with credentialing systems, allowing for real-time updates of provider information. Automated Verifications: With the integration, systems can automatically verify a provider’s credentials during claim processing, flagging any issues for immediate attention. Credentialing Updates: Updates to a provider’s credentials can be automatically reflected in the billing system, reducing the chance of claim denials due to outdated credential information. Scheduling and Alerts: Medical billing systems can help manage credentialing timelines, offering reminders when it’s time for providers to renew their credentials, thus maintaining their eligibility with payers. Key Facts about Credentialing Applications Credentialing applications in the US healthcare system involve a significant volume of submissions. However, the success rate varies, with some applications failing to meet the requirements. The timeline for the credentialing process typically spans around 90-120 days, including the verification and contracting phases; per provider, there are 18 payers. For every 5 payer applications, 25 working hours of the hospital staff and physicians are consumed. Also, approximately 85% of the applications still need to be completed. (Shah, 2023) Figure 2. Basic Credentialing Facts Challenges in the Credentialing Process Incomplete or Inaccurate Documentation Incomplete or inaccurate documentation is a common challenge in the credentialing process. Thoroughly reviewing the application materials and seeking assistance, if needed, can help mitigate this challenge. Maintain clear records of all documentation submitted and maintain copies for reference and future updates. Insufficient Qualifications Meeting specific qualifications, such as experience, licenses, certifications, or exam scores, is crucial for successful credentialing. Regularly reviewing and updating qualifications, participating in continuing education, and seeking professional development opportunities help providers stay current and fulfill credentialing requirements. Lack of Adherence to Credentialing Standards Adhering to credentialing standards is essential for a smooth credentialing process. Familiarize themselves with the specific standards and ensure they comply with professional conduct, ethical behavior, and patient safety requirements. Regularly reviewing the credentialing standards and seeking ongoing education on changes or updates to these standards promote ongoing compliance and avoid potential challenges. Inadequate Professional References Successful credentialing requires credible professional references highlighting the provider’s skills, knowledge, and abilities. Establish professional relationships and seek references from respected individuals who can vouch for their qualifications and competence. Engage in professional networks to facilitate the collection of robust references. Disciplinary Actions or Malpractice History Providers with a history of disciplinary actions or malpractice may face challenges during credentialing. Credentialing organizations are concerned about the provider’s competence and safety. Prepare to address any disciplinary or malpractice history concerns and provide explanations or evidence of corrective actions. Seeking legal counsel or assistance from credentialing experts can help providers navigate these challenges effectively. (Shah, 2023b) Common Documents and Information Required for Credentialing Applications Typically, credentialing applications include: Educational Background and Training Documentation: Healthcare providers must submit comprehensive documentation that validates their educational background and training. This includes transcripts, diplomas, degrees, and records of specialized training, fellowships, and continuing education courses. Accuracy in these documents is crucial as they reflect the provider’s expertise in their specific field of practice. Licensure and Certification Details: Credentialing applications typically seek information about the provider’s current and past licensure status. This encompasses their medical license, board certifications, and any history of disciplinary actions or license restrictions. Malpractice History and Insurance Coverage: Disclosure of malpractice history, including any claims, settlements, or judgments, is standard procedure in credentialing applications. This information helps assess the provider’s risk profile and ability to deliver safe, high-quality care. Providers must also furnish proof of malpractice insurance coverage or alternative means of financial responsibility. Professional References and Recommendations: Credentialing applications often require professional references from colleagues, supervisors, or others familiar with the provider’s clinical practice. These references offer insights into the provider’s professional conduct, clinical skills, and teamwork abilities. Recommendations from respected professionals carry significant weight in the credentialing process and positively impact the provider’s application. Practitioner Data Bank and National Provider Identifier (NPI) Registration: Providers are obliged to disclose any adverse actions or reportable events as required by the National Practitioner Data Bank (NPDB). This includes malpractice settlements, disciplinary actions, or exclusions from federal healthcare programs. Additionally, providers must obtain a National Provider Identifier (NPI) and include it in their credentialing application. The NPI standardizes provider identification across healthcare systems and ensures accurate tracking

Update on BOI Reporting – Wait and Watch

January 19, 2025

You’ve probably heard that there’s a legal back-and-forth going on in the courts regarding the Beneficial Ownership Information (BOI) reports. Here’s what’s happening and what it means. What’s the Issue? The U.S. government wants to require companies to report who really owns and controls them. These BOI reporting rules are meant to crack down on illegal activities like money laundering and tax evasion. Many countries already have rules like this. Without them, the U.S. looks like a safe haven for shady businesses. BOI reporting would help the U.S. stay credible and trusted in the global economy. But not everyone agrees with the rules, and some businesses have challenged them in court, saying they’re unfair or unconstitutional. FYI… The information won’t be public—it’s for law enforcement only. And most businesses will only have to fill out the form … themselves or with assistance (just like tax returns). Plus, the benefits of catching criminals far outweigh the minor inconveniences of compliance. What Did the Fifth Circuit Court Do? Recently, the Fifth Circuit Court of Appeals (covering Louisiana, Mississippi and Texas) said, “These rules can’t go into effect right now – we have to wait until the courts rule on the BOI’s.” This is called a temporary injunction, and it temporarily blocks the rules while the legal battle continues. They did not decide that the BOI’s cannot go forward – only that the filing deadline cannot be enforced (i.e., no penalties) while the BOI’s are being considered in court. How Did the DOJ Respond? The U.S. Department of Justice (DOJ), which enforces federal laws, wasn’t happy about this decision. They believe these rules are important for fighting financial crimes and want them to start as planned. So, they filed an emergency motion with the U.S. Supreme Court, asking it to lift the injunction. In simple terms, the DOJ is saying: “Supreme Court, we need your help right away. Let us enforce these rules while we sort out the legal stuff in lower courts.” What Happens Next? Here’s how it works: The Supreme Court Reviews the MotionThe Supreme Court decides whether to take up the DOJ’s request. They don’t automatically have to say yes—they choose which cases to consider. The DecisionIf the Supreme Court agrees with the DOJ, it will lift the injunction, and BOI reporting rules can go into effect while the lawsuits continue. If the Court denies the request, the injunction stays, and the rules remain on hold for now. So, for the moment, we wait and watch.