Chiropractic Medicare Good Bye…. May 2019

Chiropractic Medicare Good Bye…. May 2019

After 35 plus years of providing Chiropractic Medicare information, answers to thousands of chiropractic Medicare questions plus lots of printed materials, DVD’s and CDs to help my fellow chiropractors and their Staff with Medicare…. It’s time to retire.

In doing so, I sincerely “thank” those that have attended “The Basics” Chiropractic Medicare Seminars all over America. It has been fun and exciting, plus, we have been in every major and many small towns in America.

“Thank you” to the Chiropractic Colleges, and Chiropractic State Associations who so kindly gave to me speaking engagements for their membership.

I will be ending my broadcast Chiropractic Medicare E-mail in 30 days, however you may have an interest in some Chiropractic Medicare and Chiropractic History materials before they disappear, especially since none of this information will be available for our profession in the future.

We still have considerable items in stock…. when they are gone, they are gone. These items will do me no good upon retirement so I am making them available to my fellow chiropractors so they don’t go to waste and at a great discounted fee (up to 75% off).

Items Remaining…. for 30 days:

1.) “The Basics” Chiropractic Medicare Program booklet and DVD

2.) “The Basics” Chiropractic Office Fundamentals Book 12th. Edition

3.) Chiropractic Medicare Audits and Appeals DVD and booklet

4.) Chiropractic HIPAA Forms and CD ready to use

5.) Medicare Chiropractic Compliance Book and CD ready to implement

SPECIAL:

Bundle #4.)  Chiropractic Medicare DVD and Booklet, The Basics Office Fundamentals Book, HIPAA book and CD, Par or Non-Par CD. 

Bundle #5.) The Basics Chiropractic Medicare booklet and DVD, and The Basic Chiropractic Medicare Compliance Book and CD ready to implement.

Other Specials… Chiropractic History:

D.D. Palmer’s Early Years, The Discovery of Chiropractic Presentation book and CD (includes a copy of “Sweet Home” New Boston, Illinois Historic Tour)

Zarbuck’s Chiropractic History. Collected Chiropractic History collected and written by Merwyn V. Zarbuck, D.C. including the historic Chiropractic Parallax. A real collectors piece for any chiropractor interest in chiropractic history. 

Super Special: Only place this Chiropractic History collectors item is available!

            First, D.D. Palmer put together small paper booklets called “The Chiropractor” and later B. J. Palmer continued publishing “The Chiropractor” that was used to produce the first Chiropractic Green Books (even though it was red). Those Palmer booklets are now available as Volume I and Volume II., “The Chiropractor” 1904 to 1906. (These will never be available again after 30 days)

“The Chiropractor” D.D. Palmer Volume 1 and “The Chiropractor” B. J. Palmer Volume II 1904 to 1906 

To order:

Call  1-800-692-4476   You may use: Visa, MasterCard and Discover or paypal.

All items will be available for 30 days or until stock is depleted.

Thank you everybody!!

Seminar in February 2019

New Seminar date!

Date: Thursday, February 21, 2019 Cancelled
Time: 1:00 PM - 5:00 PM
Location: O'Fallon, Illinois
Location address:
 Hilton Garden Inn O'Fallon

For questions please call: (618) 395-3162

Seminars in Washington and Oregon

Date: Saturday, November 4, 2017

Time: 8:30 AM - 12:30 PM

Location: Portland, Oregon

Location address:

 Radisson Hotel Portland Airport

 6233 NE 78th CT

 Portland, OR 97218

Hotel phone: (503) 251-2000 for direction purposes only

To register or for questions please call: (618) 395-3162

Date: Thursday, November 2, 2017

Time: 8:30 AM - 12:30 PM

Location: Pacific, Washington

Location address:

 Quality Inn & Suites

 415 Ellingson Road

 Pacific, WA 98047

Hotel phone: (253) 288-1916 for direction purposes only

To register or for questions please call: (618) 395-3162

Medicare Carriers, and LCDs, oh my!

Have you been to your Medicare Carrier’s website yet? Each state has a Medicare Administrative Contractor (MAC) with specific Jurisdictions. You should be familiar with it by now. If not, please go there today. You can find your Carrier by Googling your state name with “Medicare Part B” or going to the CMS link below:

https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Review-Contractor-Directory-Interactive-Map/

First item to research about your carrier, find your LCD or Local Coverage Determination. If you think all chiropractors in all states follow the same Medicare Guidelines, you are only half right! The Medicare Carriers determine the LCD by their own interpretation of the guideline. This is extremely important as of October 1, 2015. Unless you have been living under a rock, you know that we are using ICD-10 codes now and with that change came a brand new LCD. Make sure you know the codes you are allowed to use.

Second important item to know is your Carrier has an online portal. Whether you are a Participating or Non-Participating Provider, you can use their portal. It is a fantastic tool. You can get patient eligibility verification, duplicate remittance advice, submit corrections, submit re-determinations, check status of appeals, send a secure inquiry to the Carrier and receive a response within the portal. 

End of Year 2016 Seminars

~~~ End of Year 2016 Seminars  ~~~

Date: Thursday, December 1, 2016

Time: 1:00 PM - 5:00 PM

Location: O'Fallon, Illinois

Location address:

Country Inn & Suites

116 Regency Park

O'Fallon, IL 62269

Hotel phone: 618-622-8600 for direction purposes only

To register or for questions please call: (618) 395-3162

Date: Saturday, November 19, 2016

Time: 8:30 AM - 12:30 PM

Location: Portland, Oregon

Location address:

 Holiday Inn-Portland/Airport

 8439 NE Columbia Blvd.

Portland, OR 97220

Hotel phone: (503) 256-5000 for direction purposes only

To register or for questions please call: (618) 395-3162

Date: Thursday, November 17, 2016

Time: 6:00 PM - 10:00 PM

Location: Mukilteo, Washington

Location address:

 Staybridge Suites

9600 Harbour Place

Mukilteo, WA 98275

Hotel phone: (425) 493-9500 for direction purposes only

To register or for questions please call: (618) 395-3162

Date: Thursday, November 17, 2016

Time: 8:30 AM - 12:30 PM

Location: Pacific, Washington

Location address:

 Quality Inn & Suites

 415 Ellingson Road

Pacific, WA 98047

Hotel phone: (253) 288-1916 for direction purposes only

To register or for questions please call: (618) 395-3162

November 2015 Seminars

Date: Thursday, November 19, 2015

Time: 1:00 PM - 5:00 PM

Location: Indianapolis, Indiana

Location address:

 Hampton Inn - Downtown 

105 S Meridian Street

Indianapolis, IN 46225

Hotel phone: (317) 261-1200 for direction purposes only

To register or for questions please call: (618) 395-3162

Date: Saturday, November 14, 2015

Time: 8:30 AM - 12:30 PM

Location: Portland, Oregon

Location address:

 Holiday Inn-Portland/Airport

 8439 NE Columbia Blvd.

Portland, OR 97220

Hotel phone: (503) 256-5000 for direction purposes only

To register or for questions please call: (618) 395-3162

Date: Thursday, November 12, 2015

Time: 6:00 PM - 10:00 PM

Location: Mukilteo, Washington

Location address:

 Staybridge Suites

9600 Harbour Place

Mukilteo, WA 98275

Hotel phone: (425) 493-9500 for direction purposes only

To register or for questions please call: (618) 395-3162

Date: Thursday, November 12, 2015

Time: 8:30 AM - 12:30 PM

Location: Pacific, Washington

Location address:

 Quality Inn & Suites

 415 Ellingson Road

Pacific, WA 98047

Hotel phone: (253) 288-1916 for direction purposes only

To register or for questions please call: (618) 395-3162

New York Seminar 2015

Date: Thursday, September 17, 2015

Time: 1:00 PM - 5:00 PM

Location:  Farmingdale, New York

Location address: Office of Dr. Beth A. John

341 Conklin Street

Farmingdale, NY 11735

Office phone: (516) 249-2310 for direction purposes only

To register or for questions please call: (618) 395-3162

Chiropractors Transitioning from ICD-9 to ICD-10

August 17, 2015
Chiropractic Medicare 2015ICD-10 Change and Easy Transition

     As we approach the ICD-10 deadline, let us do a little preparation so the transition from ICD-9 to ICD-10 is easy. First question..... How many of you wish to become Coding Experts? I suspect NONE want to become Coding Experts.... so you will enjoy this article and it may even take a little pressure off.

     Secondly, to really take a little pressure off, CMS (Centers for Medicare & Medicaid Services Office of the Administrator) presented a letter to all Medicare Providers dated July 7, 2015 that contains a paragraph as follows:

    “For 12 months after ICD-10 implementation, Medicare review contractors will NOT deny physician or other practitioner claims billed under the Part B physician fee schedule through either automated medical review or complex medical record review based solely on the specificity of the ICD-10 diagnosis code as long as the physician/practitioner used a code from the right family.  However, a valid ICD-10 code will be required on all codes starting October 1, 2015” 

     That clearly means that after October 2015 NO ICD-9 codes may be used on any claim, not only to Medicare, but all insurances.  The transition must be 100%.  Prior to October 1, 2015, NO ICD-10 code are acceptable.  Wednesday evening, September 30 will be the end of ICD-9 codes forever.

     To prevent delays in payment, it is important to bill all your Medicare and insurance claims as quickly as possible prior to October 1, 2015.  So Thursday morning, October 1, 2015, all your patient diagnosis must be changed as you see the patient and do their S.O.A.P. notes.  If you bill each day electronically, make sure no ICD-9 codes appear on any claims.

     All certified software have special migration programs making it much easier to switch to ICD-10.  ChiroTouch, as an example, uses ICD-10 wizard in the diagnosis window to practice matching your present diagnosis with the new ICD-10 diagnosis.  Even though you are adding new ICD-10 diagnosis prior to October 1, no permanent changes go into the official records or any claim prior to October 1, as it is designed for practice only.

 As Chiropractors, remember, we are not reimbursed in Medicare to “treat” patient symptoms, but to locate and correct vertebral subluxations.  Your diagnosis should be a Chiropractic diagnosis with subluxations, degenerative joint disease, sprain/strain, neuritis, etc.  Practice makes perfect.....and we will soon get used to it. 

Help! My patient has Medicare and Medicaid, what do I do?

From time to time our office receives this question. You are a Non-participating chiropractor, your patient has Medicare and Medicaid, and you are unsure how to bill. 

Remember: ALWAYS BILL MEDICARE FOR A COVERED SERVICE. As a chiropractor, the only covered service in Medicare is the manual manipulation. However, the question was how to bill, so let's get to that.

As a Fee-For-Service Non-participating Provider in Medicare, you must accept assignment on a patient with Medicare Medicaid. You are allowed to collect unmet deductibles for Medicare. (Most of the time we take a small monthly payment plan for these individuals to meet that as they are on a budget.) They are on a fixed income and have met certain income criteria to be on the federal programs, no matter what the age. You must bill the covered service (the chiropractic adjustment) and mark box 13 as signed and 27 as accept assignment. For all other services you provide (that are not covered such as x-rays and therapies) make sure to have them sign the ABN notifying them at the time that these are not covered services, you are not required to bill those, and you may collect payment for those services.

Reference for Medi-Medi payment/billing requirements: (https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/Medicare_Beneficiaries_Dual_Eligibles_At_a_Glance.pdf)

            "Assignment - You must accept assignment for services furnished to dual eligible beneficiaries. Assignment means that you are paid the Medicare-allowed amount as payment in full for all Part B claims for all covered services for all Medicare beneficiaries. You may not collect from the beneficiary any amount other than the unmet deductible and coinsurance. Prohibited Billing Under Section 1902(n)(3)(B) of the Social Security Act, as modified by Section 4714 of the Balanced Budget Act of 1997, Medicare and Medicaid payments you receive for furnishing services to a QMB are considered payments in full. You may not balance bill QMBs for any Medicare cost sharing (including deductibles, coinsurance, and copayments) for these services. You are subject to sanctions if you bill a QMB for amounts above the Medicare and Medicaid payments (even when Medicaid pays nothing)."

Reference for covered services: (https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/bp102c15.pdf)

            "30.5 - Chiropractor’s Services (Rev. 23, Issued: 10-08-04, Effective: 10-01-04, Implementation: 10-04-04) B3-2020.26 A chiropractor must be licensed or legally authorized to furnish chiropractic services by the State or jurisdiction in which the services are furnished. In addition, a licensed chiropractor must meet the following uniform minimum standards to be considered a physician for Medicare coverage. Coverage extends only to treatment by means of manual manipulation of the spine to correct a subluxation provided such treatment is legal in the State where performed. All other services furnished or ordered by chiropractors are not covered. If a chiropractor orders, takes, or interprets an x-ray or other diagnostic procedure to demonstrate a subluxation of the spine, the x-ray can be used for documentation. However, there is no coverage or payment for these services or for any other diagnostic or therapeutic service ordered or furnished by the chiropractor. For detailed information on using x-rays to determine subluxation, see §240.1.2. In addition, in performing manual manipulation of the spine, some chiropractors use manual devices that are hand-held with the thrust of the force of the device being controlled manually. While such manual manipulation may be covered, there is no separate payment permitted for use of this device."

Reference for ABN use: (https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/Chiropractors_fact_sheet.pdf)

                "Option #2: A beneficiary selects option #2 when s/he agrees to pay out of pocket for the service in question and does not want a claim sent to Medicare. In accordance with the ABN, the provider would not file a claim, and the beneficiary would not have appeal rights since no claim is being submitted. (Please note that the patient can change his/her mind at a future time and request the claim be submitted.)"

ICD-10 Migration and Episode Care

Chiropractic Medicare 2015

1.  ICD-10 Migration

2. Episode Care

1.  ICD-10 Migration

     On October 1, 2015 the ICD-9 Code sets used to report medical diagnosis and inpatient procedures will be replaced by ICD-10 code sets.  Those using certified software should be compatible with both ICD-9 and ICD-10. Your software company will provide tools to change over to ICD-10 and have the training for the provider to properly code.  If you have questions about your software being able to "Migrate to ICD-10" please call your software company TODAY.

     If you are not paperless, you may wish to print out the ICD-10 codes for your review.  It will print over 60 pages.  As you review, you will soon see very few of the ICD-10 codes will be used in your practice. Review the list and mark your codes.

     The problem for our profession is real. Somewhere around eleven thousand of the 60 thousand practicing Chiropractors became paperless and Medicare compliant.  For those not using certified software, be prepared for major delays in reimbursement by Medicare and insurance companies.  I strongly recommend having ALL your billing up-to-date prior to October 15th of this year.

2.  “Episode”

     Medicare carriers are now reviewing Chiropractic care by “Episode” units.  I have no problem with that. Our job in Medicare is NOT treating patient symptoms, but correcting vertebral subluxations.  As long as you practice like a Chiropractor in Medicare.....the fewer problems you will have. YOUR SUCCESS AND SECURITY IS UP TO YOU!    

     Be a Doctor of Chiropractic........Remember, always tell the truth!   

CERT, Audits, and Security Risk Analysis

Newsletter

February 18, 2015

CERT, Audits, and Security Risk Analysis

     Every Doctor of Chiropractic and Chiropractic Corporation having an NPI number received a package from your Medicare Carrier called “CERT & YOU.”  It contained magnetic stickers, a flyer and a DVD.  This information is specifically for we Chiropractors to reduce the CERT error rate by directly engaging and partnering with each doctor to prevent CERT errors.

     “Watch the DVD” and go to your Medicare Carrier website to review “Medicare Policy & Review”.  Take this information serious, review it with the knowledge that we will be access to random audits by not only CERT, but by CMS, your Medicare Carrier with pre and post audits.

     Presently many Chiropractic offices are requested to present their “Security Risk Analysis.”  Review your software for this information.  Your certified software will have all the questions available for you and your staff to complete.  It is basically pretty simple....it just needs to be done.

     The biggest problem with CERT, and other audits, is that most Chiropractors are not doing Medicare correctly, especially documenting the “Chiropractic Necessity of Care”.  If you have attended our presentation or purchased our Chiropractic Medicare DVD....take a moment, review the material given to you and start producing “documentation” as presented....(remember – SOAP Notes are not documentation!)  Those that have our information know what “Documentation” is....use it correctly every Medicare patient visit so when audited, you will be successful.

New seminars is September 2013

New seminars is September 2013. See you soon in Washington State and Michigan.
For locations and dates, please see the Seminar Calendar link above or call our office.

Be a Chiropractor in Medicare

Be a Chiropractor in Medicare........Where in the federal law does it say we are supposed to “treat” our patient's pain and symptoms like other health care providers? It doesn't!
The federal law says our job as a Chiropractor is to locate and correct vertebral subluxations. So why do some Chiropractors “treat” their patient's symptoms until the symptoms are gone calling the adjustments “maintenance" or "wellness care” and not bill those adjustments for reimbursement? When the Chiropractor adjusts the Medicare patient, correcting vertebral subluxations, that is the covered service in Medicare. The doctor’s job is to learn how to “document” the need for the Chiropractic adjustment so our senior patients are reimbursed.

Free Webinar "EHR Stimulus - Why Moving Now Matters"

Free Webinar "EHR Stimulus - Why Moving Now Matters"
Newsletter
July 10, 2013

The EHR Stimulus payout amount will soon drop! Simply participate in our free webinar to learn how easy it really is to get your EHR stimulus check in the full amount*.
Join ChiroTouch and Dr. Gary Street “Medicare Guru” to learn about this government program. We will also have a Q&A with other practices that have gone through the process in 2012 and have received their checks.
Don’t lose out! Join our free webinar and:
• Learn what steps you can take to qualify for your EHR Stimulus funds
• Learn what your EHR system needs to provide
• Hear from chiropractors who have already attested and received their funds
• Get the latest developments on the EHR Stimulus Program
Thousands of chiropractors have received their five-figure checks from the EHR Stimulus Program - And more chiropractors have received their funds using ChiroTouch than any other software solution in chiropractic!
*Maximum payouts based on current ARRA EHR Stimulus Program

Thursday, July 11th, 10:00 AM Pacific/11:00 AM Mountain/12:00 PM Central/1:00 PM Eastern Time
Registration, follow this link: https://www2.gotomeeting.com/register/223233354

NOW IS THE TIME – DO IT TODAY!

Questions – If you have questions, or simply need information, give me a call and I will do my best to help you. This is probably the most important decision of your Chiropractic career!
Plan to attend our future Seminars:
Thursday, July 25th 1:00 to 5:00 pm
St. Louis, MO at the Hampton Inn, Westport
Call our office (618) 395-3800 to register

Newsletter ~ Two Questions

Newsletter
May 3, 2013
Chiropractic Medicare
#1. Who’s going to catch the audits?
#2. Mandatory Payment Reductions.

#1. Catching Audits..............

I have presented, time and time again, information in regards to Chiropractors becoming compliant in Medicare. And yet, only about one third have followed the Federal Mandate and Attested.

So....I shall say it again! Do you want to be in Chiropractic practice after 2016? If you don’t......just don’t do anything. If you do, and have not proceeded to becoming compliant, you are in your "Last Window of Opportunity". It’s over prior to 90 days to the end of the year!!

If you believe you do not have to become compliant, you are wrong! Both Medicare and Obama care require your compliance. Remember....it is against federal law to see a Medicare patient if you are not qualified.

AUDITS: So who’s going to catch the audits? Remember....72.9% of all Chiropractic claims have errors and we Chiropractors are being improperly paid...there will be audits.

Do you think the Chiropractor who has followed the Federal Guidelines, become Medicare Compliant using certified software, has attested, and has records readily available for review...or...the Chiropractor that has not become compliant, is not using certified software and not attested as to becoming Medicare compliant will be audited? The answer is not difficult! You begin with a certified software.

Questions? Give me a call! Don’t procrastinate!! This is important for your future in Chiropractic!

#2. Mandatory Payment Reductions...........

The Budget Central Act of 2011 requires, among other things, mandatory across-the-board reductions in Federal Spending, also known as Sequestration. The American Taxpayer Relief Act of 2012 postponed sequestration for 2 months. The order was set for March 1, 2012. In general, Medicare fees for service claims with dates of service on or after April 1, 2013, will incur a 2 percent reduction in Medicare payment.

Even though beneficiary payments for deductibles and coinsurances are not subject to the 2 percent payment reduction, Medicare payments to beneficiaries for unassigned claims are subject to the 2 percent reduction.

Have questions in regards to doing Chiropractic Medicare correctly, or becoming Medicare Compliant? Give me a call at (618) 395-3800.
Learn the correct way to "Document The Chiropractic Necessity of Care."

"Medicare Learning Network" (72.9% Chiropractic Medicare Fail Rate)

Newsletter

April 30, 2013

Chiropractic Medicare

"Medicare Learning Network"

(72.9% Chiropractic Medicare Fail Rate)

Well....we Chiropractors made the Medicare Quarterly Provider Compliance Newsletter again! (Volume 3, Issue 3 – April 2013). The very first report is Comprehensive Error Rate Testing (CERT) Special Study: Provider Types Affected: Physicians and Chiropractors.

Problem description:

The majority of chiropractic services claims errors in this review were the result of insufficient documentation. Note that the Medicare Fee-for-Service 2011 Improper Payment Rate Report’s finding that insufficient medical record documentation was the most common reason (72.9%) for improper chiropractic payment. (See "The Supplementary Appendices for the Medicare Fee-for-Service 2011 Improper Payment Rate Report," released on November 2, 2012 at http://www.cms.gov/research-Statistics-Data-and-Systems/Monitoring-Programs/CERT-Reports-Items/Nov2011Appendix.html on the CMS website.)

This type of error occurs when the medical records do not contain enough information for the reviewer to make a decision about medical necessity for the item or service furnished. Some common reasons for insufficient documentation errors were:

• The documentation submitted did not adequately describe the service defined by the billed CPT code, Healthcare Common Procedure Coding System (HCPCS) code, or HCPCS modifier;
• The documentation did not include the Date of Service (DOS) or the beneficiary’s name;
• The was no treatment plan documented to support a plan of care;
• The signature was illegible.

Other errors in this special study were categorized as medical necessity errors. These errors occur when the medical records contain sufficient documentation for the reviewer to determine that the services billed were not medically necessary based upon Medicare coverage policies.

A common reason for medical necessity errors was that the submitted medical records did not support the need for the service based on the Medicare National Coverage Determination (NCDs) and Local Coverage Determinations (LCDs). The rest of the medical necessity errors were due to claims in which the beneficiary symptoms were not related to the spinal regions manipulated.

Example: Mr. Jones’ medical record shows that he had an injury that led to a subluxation of the spine with acute back pain. However, as required by the chiropractic services LCD, the precise level of the subluxation was not specified by the Chiropractor. This claim was scored as an improper payment due to an insufficient documentation error.

Let’s Get Back to the Basics! The statistics indicate 72 out of every 100 claims filed were paid improperly. If you are going to stay in practice and do Medicare and Obama Care, you simply have to do it correctly!!

Recommendation – Have questions in regards to doing Chiropractic Medicare correctly, or becoming Medicare Compliant? Give me a call at (618) 395-3800. Learn the correct way to "Document The Chiropractic Necessity of Care"!

Important: Senior Medicare Discounts

Newsletter
April 22, 2013
Chiropractic Medicare
Important: Senior Medicare Discounts

If you have a health fair....or spinal screening....or some type of special offering in your practice for some type of special at a discounted fee, you can not discriminate against your senior patients. In other words....you can give senior Medicare patients the same discounts as you do your regular patients. If the discount is on non-covered services in Medicare, you can give those seniors the same discounts as your regular patients.

If the discounts are on covered services (98940, 98941, 98942), you can give those discounts to the seniors, however, you must pass those discounts on to the carrier. You can not advertise specifically for Senior discounts for non-covered services to Medicare patients, as doing so is a breach of federal law.

You can advertise discounts for covered services (98940, 98941 and 98942) as long as you pass that discount onto the Medicare Carrier.

Have questions in regards to doing Chiropractic Medicare correctly, or becoming Medicare Compliant? Give me a call. WE WILL DO OUR BEST TO HELP YOU.

(EHR) DO IT NOW!!!

Newsletter
March 19, 2013
Chiropractic Medicare
(EHR) DO IT NOW!!!

The Medicare Electronic Health Record (EHR) Incentive Program is still alive and well. Incentive direct deposits are taking place across the country in the amount of up to $18,000.00 for those who have successfully attested for 2012.

The amount of your incentive payment depends on when you began participating in the program. The incentive payment is 75% of your Medicare allowed charges up to a maximum annual cap.
"The total maximum incentive amount that you can be paid under the Medicare EHR Incentive Program is $44,000 over five consecutive years of program participation. As you can see, you receive the maximum incentive by starting in 2011 or 2012 . If you don’t start by 2014, you are not eligible to receive any incentive payment under the Medicare EHR Incentive Program." -Page 15 of "An Introduction to the Medicare EHR Incentive Program for Eligible Professionals" found here: (https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/Beginners_Guide.pdf)

Example: If you attested before the end of 2012, you have received up to $18,000.00 incentive money in your checking account. If you continue Electronic Health Records in 2013, you will receive another deposit in your checking account in the amount of up to $12,000.00. When you continue for 2014, you will receive another deposit of up to $4,000.00 and if you continue in 2015, you will receive up to a final $2,000.00 deposit.

If you start now and attest in a timely manner this year, you will receive up to $12,000.00, next year for 2013, and up to $8,000.00 in 2015 form 2014. If you wait to attest in 2014, you have waited to long, and then in 2016 you will begin receiving cuts in your Medicare fees and probably other health insurance fees for the rest of your practicing years. Those that are doing Electronic Health Records presently will continue receiving increases in the fee structure instead of cuts.

How do you begin? First, is your office software certified? If it is, then call your software company and get it going. DO IT NOW! It's later than you think! If your office software is not certified look for one that is and get going. We have used Chirotouch for over one year and love it. If you have an interest in Chirotouch give me a call and I can save you some bucks.

***NEW***

D.D. Palmer wrote "The Chiropractor" booklets each month, 1904 thru 1908. Those are what B. J. Palmer used to create the first Chiropractic Book in 1906. We now have those "The Chiropractor" booklets in two (2) large books. If you like history, these are a must! Call me or send an email for more information.

CAQH, CMS 855i, and Audits

Newsletter
March 4, 2013
Chiropractic Medicare
CAQH Reminder

Another reminder to update your CAQH Universal Provider Data Source credentialing. To update your application, go to CAQH Universal Provider Data Source https://upd.caqh.org.oas. Failure to update your information may jeopardize the relationship between you and your authorized participating plan.

CMS 855i Application, http://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/CMS-Forms-List.html, another timely form, must be completed every 5 years or anytime you have data change (name, address, etc.). Check your records to be sure your CMS 855i application has not surpassed 5 years. You may not receive a notice from your Medicare carrier, just denial of Medicare claims.

NOTE: Now that the EHR Registration and Attestation System comes to an end, I suspect we again will see Medicare audits. It will be interesting to see if the majority of Medicare audits will be with those Chiropractors that went through the Medicare Attestation and received incentive payments or will be done on those Chiropractors that did not become certified.

2013 Spring Seminar Schedule:
March 21 - Kokomo, Indiana at the Courtyard Hotel Kokomo – 1:00 pm to 5:00 pm, EST.
March 23 – Bluffton, South Carolina at Unitarian Universalist Church – 12:30 pm to 5:30 pm EST.

Judge Approves Change to Medicare Improvement Rule, Health Services

Newsletter from February 15, 2013
Medicare Settlement Means No More “Improve or You’re Out”
Originally Posted on 02/6/2013 by Amy Goyer 
Judge Approves Change to Medicare Improvement Rule, Health Services

     A Federal Judge has approved the proposed Settlement Agreement in the Medicare Improvement Standard case, Jimmo vs. Sebelius, clearing the way for thousands of Medicare beneficiaries to receive needed health services to maintain their current level of functioning.
   
     The settlement, which represents a significant change in Medicare coverage rules, ends Medicare’s longstanding practice of requiring people to show a likelihood of improvement in order to receive coverage of skilled care and therapy services.
   
     The Agreement, which is retroactive to the date of the suite was filed, January 18, 2011, includes skilled services covered by Medicare Part A and Part B, such as speech, occupational and physical therapy, nursing and home health services, even when the goal is maintaining the patient’s current condition rather than requiring that the patient improving.
 
     The Medicare law has never supported the “improvement standard.” Nevertheless, for decades beneficiaries have been denied needed services because they are not improving or have “plateaued”, sometimes with devastating results. The Center for Medicare Advocacy says providing maintenance services will save money in the long run, preventing decline, hospitalizations and need for more expensive services.

     The official approval of the settlement means the Center for Medicare and Medicaid Services (CMS) must develop and implement an education campaign to ensure that Medicare providers are not denying coverage for vital maintenance services to those with any chronic illness who meet other qualifying Medicare requirements.
 
    The “maintenance standard” is effective immediately. Even though we have not seen the official documentation that Chiropractic Maintenance Care is included in this settlement, we are presently requesting a specific answer from CMS. If you or someone you are caring for has a chronic illness or needs skilled services to prevent further deterioration, contact your health provider.

Originally Posted on 02/6/2013 by Amy Goyer, see original link below:
http://blog.aarp.org/2013/02/06/amy-goyer-medicare-pays-for-skilled-therapy-for-maintenance-with-chronic-illness/