Why Risk It?

Dr. R. A. Foxworth, FICC, MCS-P

Flash quiz: Would you tell a patient to continue wearing 5-inch stiletto heels because she hasn’t turned an ankle so far?

Or how about this: You’ve probably never suffered severe electric shock, so maybe you’d feel okay about fiddling around inside the outlets with a screwdriver never turning the power off?

Closer to home: Malpractice insurance. You may never have been sued, and depending on which statistics you consult, your risks for being sued in the future are likely low. And yet, we’re guessing you wouldn’t feel comfortable practicing without it.

Most doctors would likely never undertake or advise someone else to engage in high-risk behaviors like the above. And yet, all too many chiropractors engage in one of today’s most high-risk behaviors of all: sending in sloppy documentation and practicing with only a loose understanding of HIPAA and OIG compliance rules. After all, as more than one doctor has told us, “I’ve never been audited, so I think I’m fine.”

This is, in a word, insane. No one ever gets audited, until the very dark and stressful day that they do. And we can tell you from years of experience that plenty of colleagues have been audited, fined, or assessed penalties. Understandably, they don’t brag about it. And so you, and many of your fellow chiropractors, exist in a bubble of myth and false assurance.

These sobering facts, gleaned from the Office of Inspector General’s Work Plan, should give you pause:

• Over ¾ of OIG’s funding is dedicated to Medicare/Medicaid oversight. That means scrutiny of chiropractic documentation is well-funded and intense. Yes, “they” ARE out to get you if you don’t play by the rules.
• Third-party payers follow Medicare’s lead. So even if you don’t see many Medicare patients, private insurers are putting you and your practice under the same microscope.
• The government cashes in big if they catch you making even well-intentioned compliance and documentation errors. The OIG estimates its recoveries from audits and investigations at around $5 billion per year.

Auditors are looking for patterns of aberrant or incorrect coding, lack of medical necessity, and compliance illegalities such as improper time-of-service discounts, dual fee schedules, and inducements, the latter often innocently committed while marketing and advertising your practice.

You need a compliant financial policy that includes ChiroHealthUSA. ChiroHealthUSA is a provider-owned network that works in conjunction with a Discount Medical Plan Organization (DMPO) providing you a simple way to offer legal, network-based discounts to not just the under-insured, but also to cash and “out of network” patients who become members. And that means you can rest easy that your practice’s financial policy is in complete compliance.

It’s easy to become a provider. There’s no cost to you or your practice and it’s just $49 per family per year for your patients. Click here to find out more about how becoming a ChiroHealthUSA provider allows you to run your practice with peace of mind, knowing that in the event of an audit, you minimized your risks of fines and penalties related to improper financial policies.