Dr. R. A. Foxworth, FICC, MCS-P
We hadn’t even passed the ICD-10 implementation deadline when the Office of the Inspector General (OIG) began rattling chiropractors’ cages.
There was nothing totally new in the OIG’s September report, but there was nothing reassuring either. As always, the OIG continues to state that chiropractic documentation is mediocre, at best, and as a result, it urges CMS to put more intense measures of scrutiny in place. It also threatens to make good on the provisions of The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which became law in April 2015 requiring preauthorization for services provided by chiropractors with aberrant billing or high rates of denial.
Your members are going to be flooding your phone lines asking what this means for them, and they’ll want you to be ready with answers.
So what’s got the OIG up in arms? Research they’ve gotten back from studying 2013 claims:
- Chiropractic services have the highest improper payment rates among Part B services according to CMS’ Comprehensive Error Rate Testing Program
- Past OIG work shows 40 to 47% of all DC claims were for non-covered maintenance therapy
- In 2013, $76 million Medicare reimbursements were considered “questionable”
- In 2013, Medicare paid $21 million for chiropractic services without a Medicare-covered diagnosis
Your members will be looking to you to help them figure out how to negotiate ICD-10, figure out which codes Medicare will accept, determine the difference between medically necessary and clinically appropriate care, and avoid audits. All in your copious spare time, of course.
The good news is, you’re not alone here. ChiroHealthUSA is by your side, with great digital educational offerings. We invite your members to sign up for one of our FREE webinars in the month of November including:
- “The First 100 Days – 8 Keys to Creating a World-Class Patient Experience” with Joey Coleman
- “CHUSA 101” with our own Dr. Ray Foxworth
- “Is the New OIG Report on Chiropractic Documentation an OMG or a NBD?” with Kathy Mills-Chang
We also have a collection of several short videos that will help your members learn more about both remaining compliant AND growing your practice using ChiroHealthUSA. Please stop by our booth at COCSA this month to learn how ChiroHealthUSA can help keep your members educated, engaged and supporting YOU!
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Why is the Discount Challenge prize amount $15,024? Because that is the average “per-occurrence” fine for Medicare inducements. That’s not $15,024 per patient, that’s not per provider, that’s PER VISIT. Stinks, doesn’t it? To us, the prize amount is worth the investment if we can help our profession better understand proper discounting.