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Complacency Over Compliance Can Cost You.

Tuesday, May 23, 2017   (0 Comments)
Posted by: Sheri Ryan
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Complacency Over Compliance Can Cost You.

These days, it seems like there are more ways to run afoul of the regulations than there are rules. And there are SO many rules, guidelines, laws, and policies that many doctors have only a general grasp of. When I talk to colleagues at conventions and seminars about staying on top of compliance issues, I often hear, “I don’t want to deal with it. I just want someone to take care of it for me.” Comments like this concern me.

Just the Beginning

Last fall, the Office of Inspector General made headlines over poor chiropractic documentation. In a report titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services," the OIG recommended that CMS turn up the heat. In January 2017, chiropractors across the country began to feel the pain of increased scrutiny and more records requests for documentation. It’s no longer a question of IF you’ll get audited, but WHEN. What steps are you taking as a provider to ensure that you are prepared for a records request? Do you have a system in place to ensure that records requests are submitted in a timely manner (within 45 days)? Are you aware that by ignoring records requests, you receive a 100% error rating?

Joined at the HIPAA

Are you HIPAA compliant? If your only preparation for a HIPAA audit was purchasing a manual and placing it on a shelf in your office, then you had better get busy. These manuals are meant to be customized to your practice, and there is no such thing as an off-the-shelf, one-size-fits-all compliance manual. Additionally required, there are self-audits, training for new and existing employees, and more. If you're scratching your head and wondering if Susie at the front desk is taking care of your compliance program, then you have a problem. If you have taken the time to customize your HIPAA compliance manual in the past, make sure that you are taking the time to review and update it. This is a living document in your office that should be reviewed on a regular basis.

Resistance is Futile. Adoption is Profitable.

Do you have an OIG compliance manual? Have you conducted an internal audit? Do you have a designated compliance officer? If so, does your compliance officer have the training to effectively carry out his or her duties in your office? OIG compliance is essential in helping you and your team understand healthcare fraud and abuse laws and the consequences for violating them. Fines and penalties can be devastating and they are something YOU have control over by implementing a compliance program. It will help you and your team become empowered to detect and correct potential errors in your practice and believe it or not, help you become more profitable. How? Because as you begin to audit your files, you will find services you didn’t bill for like that exam you did on what was supposed to be a routine visit. The higher level CMT code on the patient that warranted a 98941 instead of a 98940. And don’t forget about the extremity adjustment that you don’t perform all the time on a particular patient, but you did today. 

Compliance is an essential part of any practice and can help improve your bottom line in two ways. Don’t lose money due to fines and penalties, and don’t miss revenue by not capturing all you do every day. There are online resources, webinars, and classes at most state association conventions. There are many other resources to help you and your team stay on top of your compliance program. You can also work with specialized consultants to guide you in taking the right steps for conducting the necessary audits, employee training, and building your compliance program. If you need additional help with building a more compliant practice in 2017, you can find a list of our trusted partners at


Dr. Ray Foxworth is a certified Medical Compliance Spe­cialist and President of ChiroHealthUSA. A practicing Chiropractor, he remains “in the trenches” facing challenges with billing, coding, documentation and compliance. He has served as president of the Mis­sissippi Chiropractic Association, former Staff Chiro­practor at the G.V. Sonny Montgomery VA Medical Center and is a Fellow of the International College of Chiropractic. You can contact Dr. Foxworth at 1-888-719-9990, or visit the ChiroHealthUSA website at Join us for a free webinar that will give you all the details about how a DMPO can help you practice with more peace of mind. Go to to register today.


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