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Trouble Brewing

 In Chiropractic Compliance, Chiropractic EHR, chiropractic software, ICD-10, ICD-10 for Chiropractic
Insurance collections will increase with Genesis Chiropractic Software.By Kathleen Casbarro

ICD-10 spells a major adjustment

What will Ben’s chiropractic office face with the changes in insurance reporting?

Carmen sat on the sofa next to her husband and pulled her feet up under her. “Ben,” she said, taking his hands, “I want to know what’s going on. You picked at my homemade manicotti, you provided no challenge at Wii Bowling, and you didn’t even do the voices for Jonathan’s bedtime story.”

Ben smiled ruefully. “You’re right. I’ve got something on my mind,” he admitted. “Remember I told you about the new codes for insurance reporting?”“ICD-10 codes?” Carmen thought back to the previous week, when Ben had told her some government changes would affect his chiropractic clinic. “I remember you didn’t seem to know just how they would affect you.”

“Ignorance might have been bliss! I just found out that the effects are going to be significant. The AMA estimates that complying with the changes will cost a practice like mine in the neighborhood of $83,000.”

“That’s not a neighborhood we’d feel comfortable in,” Carmen protested. “Things have been rough with the practice already–”

“I know,” Ben agreed. “It’s already so stressful dealing with uneven cash flow, I don’t know where I’m supposed to come up with the funds to cover this kind of investment, but it’s not optional. We have to complete these changes by October 1, 2014, or we won’t get paid at all.”

Carmen frowned. “Are you sure it has to cost that much? I’m pretty good at pinching pennies.”

“I know you are, but this isn’t like negotiating with your suppliers at the pizzeria. I can’t negotiate with the government, and the the new ICD book has 1,107 pages of non-negotiable changes. We’ll need software upgrades, changes in billing practices, training for all the staff… that’s all going to cost.”Carmen and Ben both stared glumly ahead.

“Even if you figured out some way to do everything yourself, you’ll have some opportunity costs,” Carmen said. “You’d have to cut down on the patients you see or the other work your team is doing. I’m at your place a lot and I never see people sitting around doing nothing. You’re already running efficiently, so extra time is the same as extra money.”

“Exactly. Plus, any change increases the risk that we’ll be audited or that the insurance companies won’t pay claims. We don’t yet know what will be considered medically necessary under the new system, but we’ve heard that there’ll be opportunities for cherry picking. That means that our choice of words in the notes we write up could affect whether or not we get paid.”

Carmen shook her head. “You’re already dealing with non-payment of claims, aren’t you?”

Ben nodded. “I just don’t see how we’re going to get through this.”

“Things are good at the restaurant. And, as I said, I’m good at pinching pennies.”

Ben forced a smile. He was lucky to have Carmen, and he knew she’d do what she could, but the stress was getting to him. This was definitely not what he had dreamed of when he had set up his practice.

What will Ben’s chiropractic office face with the changes in insurance reporting?
ICD-10 diagnosis codes for ChiropractorsGenesis Chiropractic Software billing network