September 17, 2012
1. Stopping Fraud & Abuse
2. Becoming Compliant
3. Going For the Incentive
The government strategy of becoming compliant in Medicare, going paperless and getting an incentive to do so, is and will be effective in stopping fraud and abuse in Medicare.
One small problem. Much of what the government calls abuse is not abuse. It is the inability of Chiropractors to "Document" the Chiropractors necessity of care by "Federal Standards."
Since Medicare Carriers do not have the ability...(or do not want to)...review Chiropractic claims when they receive them...... ALL clean claims are automatically paid. However, then companies are hired by the Medicare Carriers to reclaim money from Chiropractors that do not do Medicare correctly.
When doing Medicare you must know how to document the Chiropractic necessity of care by "Federal Standards". Since most Chiropractors have never been shown or told how to "Document", a lot of money is recovered by these hired groups. The federal government calls this abuse against Medicare because the Chiropractor billed Medicare for a service that did not have documentation for payment that the government believes should have been billed as Maintenance Care.
Money is recovered by the hired firm, the Chiropractor has to pay it back, and statistics call that Fraud and Abuse against Medicare....simply because the Chiropractor did not know the correct way to do Medicare!
FIRST: Learn how to do Chiropractic Medicare correctly.
SECOND: Become compliant.
Finally....Contact your software company in regards to receiving incentives. We like Chirotouch.