Chiropractic Compliance | Check exclusions list to avoid denied claims
Dr. John Davila explains the importance of checking the LEIE or list of exclusions of individuals or/and entities for all staff members at your clinic to avoid chiropractic billing issues such as compliance risks and denied claims.
Dr. John Davila talks about the significance of the List of Exclusions of Individuals and Entities for your chiropractic clinic in the video below:
Cystic Fibrosis Services: $308,000.00. Radius Hospital Massachusetts: $334,000.
Susony Hospital Puerto Rico: $382,000. Saint Francis Hospital Connecticut: $80,000.
In a 6-week period of August 2013 the Office of Inspector General, recouped $1.2 million from these hospitals for one simple reason: someone on their staff was excluded from serving Medicare patients.
My name is Dr. John Davila of Custom ChiroSolutions and today I want to talk to you about something very, very important that you should be looking at as far as compliance goes in your office.
It’s the LEIE or list of exclusions of individuals or/and entities. Now, the reason this story is important is for a very simple reason, a couple years ago I had a client and he had a problem getting his Dr. his associate Dr. Registered with all these different insurance companies, and he couldn’t get the insurance companies to pay even out-of-network benefits and then he tried to get Medicare to register this Dr. and that didn’t work either. Next thing you know, he’s calling me going “Hey listen, I have all this money outstanding. I have these different issues.”
We went in and looked and guess what– the first thing you do when you get a compliance manual is, check your employees. He didn’t know that. He didn’t know how.
And that’s what we did for him. We came in and checked all of his employees and low and behold, the Doc he was trying to get registered was excluded about two years earlier from the Medicare program. Now the Dr. was cleared of all charges, he got his license back to practice, but Medicare didn’t let him back in.
Major, major problem. So, what I want to do today was just bring this up because I think it’s really important for you understand that you need to check your employees. Now this Dr. didn’t know how to do it, we did. What we had to do was get him set up with a compliance manual and get this process going for him and that way he checked his employees.
So if you’d like to know more about how to get a compliance manual in your office, especially to go ahead and check your employees on a regular basis, especially if they’ve been excluded from Medicare and if they’re on this LEIE list, let us know. You can give us a call at (800)-974-3479. If you dial extension 2 and ask for Stacy, she’ll go ahead and set you up for a free 30 minute consultation and we’ll get on the phone together, me and you and we’ll talk about how to get a compliance manual in your office. Now remember, call us now 800-974-3479 ext two.