IMPORTANT DEADLINE 12-12-12 FOR PQRS

Newsletter
December 11, 2012
IMPORTANT DEADLINE 12-12-12 FOR PQRS
(Physician Quality Reporting System)

 

The Chiropractors in our Chiropractic profession have worked for over 100 years to help Chiropractic grow and be accepted by the public. We have been very successful in being included into insurance plans, Medicare, Medicaid, PPO's, etc. However, now that we are in Medicare we have to meet qualifications and demands by the Federal Government to take part in reporting certain quality measures due to healthcare reform.

Please see link to the CMS Website for more information about PQRS (Physician Quality Reporting System):
 https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/downloads/2012PQRS_SatisfRprtng-Claims_Final508_1-13-2012.pdf

To determine if you are eligible to participate in PQRS:  
https://www.cms.gov/PQRS

Even though it is a voluntary program with incentives, it is also a program that will take away from your future earnings if you do not participate.

My guess is about 5 Chiropractors out of every 25 are participating in PQRS. This is NOT A GAME! This is serious business! We are going into the final window of opportunity.

The Physicians Quality Reporting System (PQRS), was introduced by the Centers for Medicare and Medicaid Services, and a new part of healthcare reform. The program created in 2007, established a financial incentive to eligible healthcare professionals to participate in a voluntary quality reporting program. Providers who participate and report quality measures receive a 0.5% payment incentive.

Why is it so important? CMS recently ruled that providers not successfully participating in PQRS by 2013 reporting period (January 1 - December 31, 2013), will have their Medicare reimbursement decreased by 1.5% beginning in 2015, and 2% in 2016. The 2012 reporting period is the last opportunity providers have to voluntarily participate.

It is easier than you think. However, it requires a certified software company to walk you through the paces. Please follow the links and get informed.

Learn, Compliance, Paperless & Attestation

Newsletter
October 22, 2012
Chiropractic Medicare
Learn, Compliance, Paperless & Attestation
Now is not the time to procrastinate!  If you plan on being in Chiropractic practice in 2015....listen up!  You have a choice.  Either get with it or get ready to retire!

Now that I have your attention, here are the steps necessary to wade through this Medicare process.  The process is not as extreme as first impression. 

1. Learn the correct way to do Chiropractic Medicare.  If you do not do Medicare correctly, all else will not be effective.  If you have attended our presentation or have our Chiropractic Medicare DVD & booklet, review the DVD and start doing Medicare correctly.
2. The Federal law says we must become Medicare Compliant. Follow this link: http://www.cms.gov/Medicare/Medicare-Contracting/MedicareContractingReform/Downloads/compliance.pdf  They provide seven (7) categories we must respond to by creating a Medicare Compliance Program and procedures in your practice.
3. Electronic Billing and Going Paperless
1. Nearly all Chiropractic offices are billing Medicare electronically. If you are not, you are going to be left behind and soon will be cut in Medicare reimbursement. Call your Medicare carrier, ask the carrier to help you bill electronically and follow their guidelines. Do not put it it off another day.
2. Going paperless is fabulous as long as you have a good Chiropractic software in your practice. I use Chirotouch software. This software leads you through the process of becoming paperless. I have to say, after doing written notes for forty-four (44) years, it is absolutely great to make a few clicks on the computer and not only have S.O.A.P. notes completed, but also produce "Documentation" by Federal Standards for Medicare, PI, etc.
4. Attestation: Once you have used and learned the software and follow the specific programs in the software, you will be ready to "attest" as to following the guidelines of a paperless practice. The government will now pay you an incentive dollar amount in direct proportion as to the number of Medicare visits you have. Learn more about the EHR Incentive Program. Remember....only the use of Certified EHR (those that meet specific federal standards for Meaningful Use) can qualify for incentive payment.  Do you know if your software is qualified? Follow this link: http://oncchpl.force.com/ehrcert

Have questions?
Give Dr. Street a call today at (618) 395-3800.

      

"Becoming Compliant"~Newsletter 09/17/2012

Newsletter

September 17, 2012

Chiropractic Medicare

     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.

REMEMBER: You are required to become Medicare Compliant prior to 2013.        December is coming quickly.

Step 7 of the 7 Mandated Steps "Responding to Detected Offenses, Developing Corrective Action Initiatives, and Reporting to Government Authorities"

Newsletter

March 26, 2012

Chiropractic Medicare

"Becoming Compliant"

Step 7 of the 7 Mandated Steps

Dear Doctors and staff,

Our future is not merely something that happens to us, but something that we participate in creating.  If we do this constantly, we can create an organized environment that works for both Chiropractors and Medicare.

I am finding the majority of Chiropractors have no idea, as of yet, their mandated responsibility of becoming Medicare compliant by the end of 2012.  Some DC's have stuck their heads in the sand hoping it all will go away.  However, about 10% to 20% of my fellow Chiropractors are collecting information and have made the move to become compliant.  Those are the one's that will be in a strong Chiropractic business in 2014.

You first must know the correct way to do Chiropractic Medicare, then, you must know how to protect personal health information you have collected from your patients, and last, you must become compliant in Medicare.

   

Medicare Compliance Step # 7: Responding to Detected Offenses, Developing Corrective Action Initiatives, and Reporting to Government Authorities

Our guidebook has complete written guidelines in reference to responding to detected offenses, developing corrective action and reporting to government authorities.  It has written policy about Internal Investigations with 30 categories already prepared for your office.  It contains a Case File Report, Log of Non-Compliance form, Post-Audit Monitoring Report, Release Statement, Progressive Discipline Policy, Discipline Documentation Form, Human Resources Department, Guidelines for Interaction between Compliance Department and Internal Audit Department, Exit Interview Questionnaire, and How to Report Medicare Fraud.  It's already completed for you and your staff.

Becoming compliant in Medicare can be fairly easy or so difficult many will not even try.  That is up to you.  We have put all the difficult stuff together for you.  Now you must decide. Are you going to become compliant?  (If not, you won't have much of a practice in 2013-2014.)  Yes, you will attempt to become Compliant and must be ready by the end of this year.

Have questions? Give Dr. Street a call today at (618) 395-3800.

Spring 2012 Seminar Schedule:

*Thursday, March 29, 1:00 pm - 5:00 pm at Urbana Country Club, Urbana, IL

*Thursday, April 19, 1:00 pm - 5:00 pm at the Chariot Hotel - Louisville, KY

*Thursday, May 24, 8:30 am - 12:30 pm at King Oscar Hotel, Auburn, WA

*Thursday, May 24, 6:00 pm - 10:00 pm at Staybridge Suites, Mukilteo, WA

*Saturday, May 26, 8:30 am - 12:30 pm at Quality Inn Oakwood, Spokane, WA

To Register Call:  (618) 395-3800

Step 6 of the 7 Mandated Steps "Enforcement through Publicized Disciplinary Guide-lines and Policies Dealing with Ineligible Persons"

Newsletter

March 19, 2012

Chiropractic Medicare

"Medicare Compliance"

Step 6 of the 7 Mandated Steps

Dear Doctors and Staff,

Seems like a slow process, however, several Chiropractors and their staff are realizing "becoming compliant in Medicare" is different than learning the correct way to do Medicare.  Even though Chiropractors have a chiropractic Medicare billing error rate of 67%, that has very little to do with becoming "compliant." The error rate of 67% simply means the majority of Chiropractors and their staff does not know the correct way to do Medicare. Becoming compliant in Medicare is when you have implemented the seven (7) mandatory steps in your practice to stop fraud and Medicare abuse.  Over the past several weeks, I have been talking about each of the seven mandatory steps.

Medicare Compliance Step # 6

Enforcement through Publicized Disciplinary Guide-lines and Policies Dealing with Ineligible Persons:

You must have written policy for your practice that apply appropriate discipline sanctions on those officers, employees, staff, etc., who fail to comply with applicable statutory Medicare requirements and with the contractor's written standards of conduct.  You shall have a list of policies which include specific sanctions.  You shall have factors considered before disciplinary actions are imposed.  You shall have a hand written guideline in regards to Progressive Discipline along with the elements of a progressive discipline system.

You shall also have written policies and guidelines in regards to the employment conduct with ineligible persons.  Your guidelines should include how to conduct an employee background check along with an employee application and screening that answers all the necessary information in regards to an employee application.

The purpose of these seven (7) steps in Chiropractic Medicare Compliance is to stop fraud, abuse and errors.  As you will see....the program is extremely effective.  Next week we will cover item # 7, "Responding to Detected Offenses, Developing Corrective Action Initiatives and Reporting to Government Authorities" as mandated by the government.

Becoming compliant in Medicare can be fairly easy or so difficult many will not even try.  That is up to you.  We have put all the difficult stuff together for you.  Now you must decide if you are going to become compliant.

Have questions? Give Dr. Street a call today at (618) 395-3800.

Spring 2012 Seminar Schedule:

*Thursday, March 22, 1:00 pm - 5:00 pm at Staybridge Suites - St. Louis, MO

*Thursday, March 29, 1:00 pm - 5:00 pm at Urbana Country Club, Urbana, IL

*Thursday, April 19, 1:00 pm - 5:00 pm at the Chariot Hotel - Louisville, KY

*Thursday, May 24, 8:30 am - 12:30 pm at King Oscar Hotel, Auburn, WA

*Thursday, May 24, 6:00 pm - 10:00 pm at Staybridge Suites, Mukilteo, WA

To Register Call:  (618) 395-3800

Step 5 of the 7 Mandated Steps "Auditing and Monitoring - Risk Areas"

Newsletter

March 12, 2012

Chiropractic Medicare

"Becoming Medicare Compliant"

Step 5 of the 7 Mandated Steps

Dear Doctors and Staff,

Anthony Robins reminds us, "It's not what's happening to you now or what has happened to your past that determines who you become.  Rather, it's your decisions about what to focus on, what things mean to you, and what you’re going to do about them that will determine your ultimate destiny."

Becoming compliant in Medicare can be fairly easy or so difficult many will not even try.  That is up to you.  We have put all the difficult stuff together for you.  Now you must decide. Are you going to become compliant?  (If not, you won't have much of a practice in 2013-2014.)  Yes, you will attempt to become Compliant. (And, you must be ready by the end of this year.)  It’s Decision Time. You can sit down and spend about 3 months putting together your Chiropractic Medicare Compliance Program or give us a call. We have it completed for you.

Medicare Compliance Step #5:  Auditing and Monitoring - Risk Areas:

Internal Auditing is an independent, objective assurance and consulting activity designed to add value and improve our business operations.  It brings systematic discipline to evaluate and improve the effectiveness of risk management, control and the contractor's commitment to comply with all applicable statutory, regulatory and Medicare Program requirements.

Internal audits are performed by specific staff, depending upon the numbers employed.  Those doing the audits are trained so they are competent to identify potential issues within critical review areas.

Written reports are issued to CO (Compliance Officers) and contractors.  The contractor can then follow up on specific reports of non-compliance. 

Exit Interview Questionnaires should be developed and used to determine if exiting employees observed any violations in the Compliance Program.

Risk areas are determined by both auditing and monitoring activities with a compiled list of areas that are typically vulnerable to fraud and other misconduct.

This is Number 5 of the seven mandated areas we must address.  Next week I will discuss #6:  Enforcement through Publicized Disciplinary Guidelines and Policies Dealing with Intelligible Persons.

The purpose of these seven (7) steps in Chiropractic Medicare Compliance is to stop fraud, abuse and errors.  As you will see the program is extremely effective.

Have questions? Give Dr. Street a call today at (618) 395-3800.

Spring 2012 Seminar Schedule:

*Thursday, March 22, 1:00 pm - 5:00 pm at Staybridge Suites - St. Louis, MO

*Thursday, March 29, 1:00 pm - 5:00 pm at Urbana Country Club, Urbana, IL

*Thursday, April 19, 1:00 pm - 5:00 pm at the Chariot Hotel - Louisville, KY

*Thursday, May 24, 8:30 am - 12:30 pm at King Oscar Hotel, Auburn, WA

*Thursday, May 24, 6:00 pm - 10:00 pm at Staybridge Suites, Mukilteo, WA

To Register Call:  (618) 395-3800

Step 4 of the 7 Mandated Steps "Developing Effective Lines of Communication"

Newsletter

March 5, 2012

Chiropractic Medicare

"Medicare Compliance"

Step 4 of the 7 Mandated Steps

Dear Doctors and Staff,

"Look for the Silver Lining."  In 1914, Thomas Edison's New Jersey factory was all but wiped out by a massive fire.  The total damage came to more than $2 million; however, the buildings we insured for only $238,000 - because they were concrete and thought to be fireproof.  Edison himself was there that night and watched most of his life's works go up in flames.

The next morning, walking among the ruins, Edison said to his young son Charles: "There is great value in disaster.  All our mistakes are burned up. Thank God that we can start anew."  Three weeks after the fire, Edison unveiled the world’s first phonograph.

The Chiropractic Medicare Compliance Program will "start us anew".  Even though it is quite a hassle, it will assure we are doing Chiropractic Medicare correctly and will surely cut down fraud and abuse in the Medicare program.

Step #4: Developing Effective Lines of Communication:

We must have developed a system in our offices for staff to report suspected non-compliance.  Those reports may be issued to the Compliance Officer or Contractor, by way of a "drop box", hotline phone calls, or both direct contact or anonymous.  A specific chain of command will deal with any reports of non-compliance, and the Compliance Department shall maintain a detailed log of all reports.

The purpose of these seven (7) steps in Chiropractic Medicare Compliance is to stop fraud, abuse and errors.  As you will see the program is extremely effective.  Next week we will cover item # 5, "Auditing and Monitoring Risk Areas" as mandated by the government.

Have questions? Give Dr. Street a call today at (618) 395-3800.

Spring 2012 Seminar Schedule:

 *Thursday, March 22, 2012

1:00 pm - 5:00 pm at

Staybridge Suites - St. Louis, MO

To Register Call:  (618) 395-3800

*Thursday, March 29, 2012

1:00 pm - 5:00 pm at

Urbana Country Club – Urbana, IL

To Register Call:  (618) 395-3800

Step 3 of the 7 Mandated Steps "Conducting Effective Training and Education"

Newsletter

February 27, 2012

Chiropractic Medicare

"Making the Transition"

Step 3 of the 7 mandated steps

Dear Doctors and staff,

The transition from silent to sound movies was difficult for most silent stars.  In her portrayal of Norma Desmond in "Sunset Boulevard" (1950), Gloria Swanson, once a silent screen actress, captured the bitterness and sadness she and others experienced when talkies emerged. In a famous scene, Norma retorts, "We didn't need voices...we had faces." Charlie Chaplin also clung to the older medium, creating several silent films during the 1930's, a decade otherwise dominated by "talkies."

Silent starlets were Mary Pickford and Lillian Gish, along with Clara Bow and Louis Brooks, never made the "talkies" transition like Greta Garbo, Marlene Dietrich and Jean Harlow.  They just faded away.

All health care providers, including Chiropractors, are facing a transition today. By the end of 2012 we either get with it NOW like Greta Garbo and Jean Harlow or by 2014-15 we will fade away just as Lillian Gish and Clara Bow.  We have known this is coming for several years.  It is here.  It is decision time NOW. Do you plan on being in Chiropractic practice on 2015?

If you do plan on being in a Chiropractic practice, you must become Medicare Compliant and prepare to become paperless in your office functions.

Step #3 in Becoming Medicare Compliant:

Conducting Effective Training and Education

Your Compliance Officer, under the direction of the Contractor (owner/doctor) shall develop training for new employees/staff and doctors.  Refresher training should re-emphasize Medicare statutory, regulatory and contractual requirements and the contractors (Doctor's) Code of Conduct.  Compliance training shall be presented by the Compliance Officer or designated staff in a specific procedure issue.  Specific training subjects for both formal and informal training will be specified by the Compliance Officer under the direction of the Contractor.

The purpose of these seven (7) steps in Chiropractic Medicare Compliance is to stop fraud, abuse and errors.  As you will see the program is extremely effective.  Next week we will cover item # 4, "Auditing and Monitoring Risk Areas" as mandated by the government.

Have questions? Give Dr. Street a call today at (618) 395-3800.

Spring 2012 Seminar Schedule:

 *Thursday, March 22, 2012

1:00 pm - 5:00 pm at

 Staybridge Suites - St. Louis, MO

To Register Call:  (618) 395-3800

Step 2 of the 7 Mandated Steps "Medicare Compliance Officer (CO)"

Newsletter

February 20, 2012

Chiropractic Medicare

Step 2 of the 7 Mandated Steps

Dear Doctors and Staff,

Someone in your office must become a "Medicare Compliance Officer". Either the doctor or a key staff!

You and your staff must produce "Essential Duties" for a Compliance Officer (CO) and have written compliance policies and procedures developed with the assistance of a Compliance Committee which directs the operation of the Compliance Program especially the Medicare duties and responsibilities.

The Compliance Officer (CO) is the point-of-contact for all employees to assure all are compliant in Medicare.  The Compliance Officer (CO) is also the company "watch dog".

You will need to designate a secure, but accessible, area as your "Compliance Department".  There you will be able to receive confidential communications from staff and conduct internal investigations.

The "Compliance Officer" is expected to gain and maintain a thorough understanding and appreciation for Federal, State and local laws, rules and regulations relating to the commitment to comply with all applicable statutory, regulatory and Medicare program requirements.

Next week we will cover item # 3, "Conducting Effective Training" as mandated by the government.

Knowing the importance of learning the correct way to do Medicare by federal standards and becoming Medicare Compliant are two important things for your office today!

Have questions? Give Dr. Street a call today at (618) 395-3800.

Spring 2012 Seminar Schedule:

*Thursday, February 23^rd, 2012

8:00 am to 2:00 pm

Utah Chiropractic Physicians Association

Salt Lake City, Utah

Chiropractic Medicare, Medicare Compliance, and a bit of Chiropractic History

*Thursday, March 22, 2012

1:00 pm - 5:00 pm at

 Staybridge Suites - St. Louis, MO

To Register Call:  (618) 395-3800

Step 1 of the 7 Mandated Steps to Becoming Medicare Compliant

Newsletter

February 13, 2012

Chiropractic Medicare

Step 1 of the 7 Mandated Steps

Dear Doctors and Staff,

With the negative reports from the office of the Inspector General in regards to the poor track record of Chiropractors "documenting" the Chiropractic necessity of care along with the high rate in billing Medicare claims, we now find ourselves having to deal with a "mandatory" Medicare Compliance Program.

To stop errors, fraud and abuse in Medicare, Chiropractors and staff are requested to begin the Medicare Compliance Program.  A step by step procedure with time lines for compliance and information regarding Electronic Health Records Incentive Program.

If you choose not to become Medicare Compliant, by the year 2014 you probably will not have any Medicare patients and will lose a large number of Insurance Company privileges.

Centers for Medicare and Medicaid Services are preparing to implement the combination of HIPAA, protecting personal health information, along with addressing the high error rates, fraud and abuse in Medicare.  In doing so, each provider is required to bill electronically using ICD-10 codes uploaded onto a server clearinghouse also compliant using 5010 software.

As you proceed through this process, keep aware of the time lines and testing necessary to get to the next step.  Consider the incentive to be successful in both financial and protective of you and your patient's personal health information.

Step 1 of the 7 Mandated Steps:

a.       Written Policies and Procedures.

b.      Developing a written Standards of Conduct.

c.       Written Duties and Responsibilities of Management by (Owner/Doctor).

d.      Compliance Officer, Essential Duties.

e.       Compliance Committee and Duties.

f.        Retention of Records and Information Systems, Policy, Information,   

                                                               i.      General Guidelines.

g.       Compliance Element Policy, Meeting and Managers Annual Performance

                                                               i.      Evaluation.

The GOOD NEWS is we have this all completed in our Chiropractic Medicare Compliance Book and CD. The CD contains all the policies, procedures, detailed compliance training, reporting systems, disciplinary guidelines and policies, corrective action and self-audit procedures.  Our Medicare Compliance CD is in both Publisher and Word docs, ready for your staff to download, review and personalize for your Medicare Compliance.

If you have questions, please give me a call 618-395-3162. ~Dr. Street

Three Important Areas

Newsletter
February 8, 2012
Chiropractic Medicare
Three Important Areas We ALL MUST become Proficient In!

Dear Doctors and Staff,

This is the year for Chiropractors in Medicare.  Last year the Inspector General indicated that out of 100 claims filed to Medicare by Chiropractors, 67 had errors.  They believe they have overpaid Chiropractors by millions. With that in mind, nearly every Chiropractor filing Medicare claims will be audited in 2012.

There are three key areas in which we must be prepared:

First, we must know the correct way to provide great Chiropractic care to our seniors and document by federal standards. You must know the correct way to do Chiropractic Medicare!!! If you don't know the correct way to do Medicare an audit will be devastating.

The second area of our concern is HIPAA (i.e. knowing how to protect personal Health Information in your office, developing your in-house HIPAA policies, procedures and training.)

The third area of concern is becoming Medicare Compliant. By the end of 2012 each and every Chiropractic office must be aware and prepared for the seven (7) areas of compliance set by the Federal Government.

We offer many helpful items to help with these areas to help you get prepared. If you have questions, comments, concerns about Chiropractic Medicare, please give me a call at 618-395-3800.

Warmest regards,
Dr. Street