Into the Fire
Poor Communication Turns Up the Heat in the Office How do staff problems affect Ben’s chiropractic practice? “Ben? Can I talk to you about something serious?” Ben turned to his wife in surprise. Carmen was usually easygoing, taking a relaxed attitude even in serious situations. “Of course. What’s up?” “It’s the girls at the pizzeria.” Like many pizza places, Ben knew, Carmen’s had lots of part-time help, including students and musicians who needed a day job. The work tended to be fun and casual, even though Carmen ran a tight ship. She had a lot of turnover — what restaurant didn’t? — but she rarely had staffing problems. “I’m usually the one complaining about my staff,” Ben said. “You go with the flow.” “I know,” Carmen agreed. “I think we’re a happy workplace, and the systems are organized enough that the people can relax. But we have this new delivery guy…” Carmen hesitated. “Spit it out!” joked Ben. “Well, okay, he’s really cute. Whenever he’s in the shop, the girls hang out near him, flirting, instead of doing their work.” Ben couldn’t help laughing. “That’s your employee problem? Listen, I have staff absences, paperwork backing up, information silos that mean we constantly have questions that can’t be answered because the only person who knows the answer is off –” “You aren’t even listening!” Carmen objected. “I can’t bring this up with the girls without insulting them, and I can’t bring it up with the new guy at all. I can’t fire him for being too cute –” “Sorry, Carmen,” Ben insisted, “you don’t know what staff problems are if your idea of a staff problem is how to avoid hurting somebody’s feelings. My people are competent, but there doesn’t seem to be enough communication among them to keep the paperwork and billing going smoothly. We end up looking bad to the clients because their files can’t be found, or missing out on billings because the paperwork has errors. Those are staff problems.” “Maybe you’re right,” Carmen said. “Those do sound like more serious problems. Are you paying enough attention to your workers?” “That’s part of the problem, I’m sure,” Ben admitted. “I’m in with patients all day. I don’t have time to oversee the staff, and I guess they all have a lot of freedom to set up their own systems…” Carmen laughed. “If everyone just does what he or she wants, you can’t call it a system.” “Well at least I’ve got you laughing,” Ben said. “Listen, just tell your people to get back to work. You’re letting your embarrassment over the situation make it seem more difficult than it is.” As they got ready for bed, though, Ben was wondering. If that was the biggest staff problem Carmen faced in her business, why was he constantly troubled by staff problems in his? How do staff problems affect Ben’s chiropractic practice?
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?
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?
Win $500 for Telling Your Best Patient Story
Win $500 for Telling Your Best Patient Story! Have you had any funny situations with your patients? Would you like to share them with us? We would love to hear your stories. Tips for Your Story What made this patient so special? How has this experience affected you as a Chiropractor and/or your practice? How does this story inspire you, your practice, and other Chiropractors Watch Dr. Brian Capra’s patient story video: Entry Qualifications Must be a Genesis user Like us on our Facebook page and simply post your patient success story with the hash tag #Genesispatientstorycontest Feel free to add video and pictures ( no more than 5 min. video) 300 – 400 words If you are not active on Facebook, e-mail us at marketing@vericle.com.
