Chiropractic Billing Compliance | How to audit-proof your practice
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.”
Is there a way to audit-proof his chiropractic clinic?