Empowering Women in Chiropractic – GY Does the Payer Never Cover My Care – KMC University

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Hi, this is Yvette I’m with KMC University. I hope that you’re able to hear me today. We’ve had just a little bit of a hiccup as we’ve been getting started. Um, I will be able to share my screen in just a moment with you all and get everything moving in the right direction for us today. But again, I appreciate ChiroSecure for inviting me to join you for today’s call and hope that we find this time together to be very informative for you in your office. Wanting to take a quick moment, just kind of update you on where I’ve been. Since we were last here, I was at a client’s office last week and was able to notice that there were some significant issues going on and which is common. When we go out to do an onsite visit, we love doing them. There’s nothing like walking in and seeing fresh with our eyes, what we know to be wrong.

I hear commonly, I don’t know what I don’t know, which is very true. And I think if I had a dollar for every time that I heard that I would probably be a very wealthy woman. And that’s why people come to things just like what Kira secures putting on, or maybe even come over to KMC university for help. But last week, the very topics that I’m teaching on today was so laid out as, as an issue for this office, that we were able to make some changes quickly. I have a coaching client. I don’t take them often. My, my hands are quite full here with what I do at KMC University, but have been able to make a lot of progress with them on this very topic. And I think one of my favorite things that I heard recently, and I, I actually teared up.

I had spent quite a bit of time helping my particular coaching client with her fee schedules, getting the foundation set, to make sure that she was set up for success. And I got an email the next morning I was tired. I’m not going to lie to you. I was like, I’m so, so exhausted. And I thought, man, is it worth it? Is it worth it? And I get up the very next morning and here’s an email from her that I, I cried. She said, Yvette, I was so afraid of those three little dots that would show up and show me this whole list of errors. And it took me hours and hours and hours to correct it. She said they were gone. She had a couple, but they could fix them. So we were able to make some fast progress. And it’s probably the most powerful thing you can do in your practice is be proactive.

Instead of being forced to be reactive. She said, I cannot begin to tell you how much time that I saved. I had a coaching call with her this morning and it’s been such a game changers. And I want to give a little piece of that to you. Obviously I’m not going to be getting it on your system and setting things up appropriately, but hopefully some of the tools that I’ll share today and answer some of those questions that may be out there, that I hear all the time will be beneficial for you and your clinic. So we’re going to go ahead and get that PowerPoint started for you and definitely cover as much ground as we can in the short time we have together. But I had to just take a moment and tell you from my heart, what I saw last week, I’m not going into depth.

That’s their story. I’m sure you have your story in your clinic, but please know that a lack of foundation, a lack of training of your CAS will spell a disaster for your practice. It did for this one. And, uh, I literally, when I left, I don’t tell this to too many people, but now I’m telling it out here on Facebook world and out in the world of Congress secure and all who watch. I cried when I left, I literally started crying. I have next, maybe that wasn’t the COVID thing to do, but it was the thing here. And I cried because I realized such work ahead of them. I’m honored to have the opportunity to walk this journey with them, but please, please, please think about these foundational pieces. Think about training your staff. I’m telling you what, I couldn’t even say. The numbers nine, eight, nine, four one.

And that staff understand that there’s a problem in your office. So make sure they’re getting the training they’re needed. They’re needing for you to be seated successful. And the doctor was so afraid staff was going to walk out and I told her, I said, one reason staff will walk out of your office is because they’re untrained. They don’t know their expectations. And some things they don’t have to necessarily be trained on if we build the foundation appropriately. So hopefully some of this will be a little bit of foundation, but training for you and your staff today. So as we move along, going to talk quickly about the things that we’ll cover in this call today, um, we are going to cover the art of using appropriate modifiers, that there was so much that was left undone, that they were chasing their tail. I looked at the report from their biller, looked at the report from their clearing house and it was so massive and realizing it was probably just simply the modifiers not being put in their system.

Their ledgers were a mess, nothing matched. They were creating, I don’t know how many different case types to manage it. And while I was there, it was, I was kind of peculiar. I’d done some training. And one of the staff members defaulted to her old system and she went back and created a new case type. And I’m like, may I ask why you did that? And she said, well, well, that’s the way we’ve done it. I said, but understand the groundwork that I have laid for your office. You don’t have to do it that way. So improved efficiency, definitely improved having to go from ledger to ledger, to ledger, to find out where to find things and chase your own tail. Getting the foundation set up correctly is just paramount.

Also an issue

With denials, you may be seeing can come specifically, um, can come specifically from the, uh, diagnoses pointing that you may or may not be doing. So let’s talk about that for really quick. Anytime we’re doing a spinal CMT service with the muscle therapy, maybe we’re doing the nine seven one four zero. We know as an NCCR bundle that those cannot be reported in the same region. However, well, what if you adjusted the cervical and maybe you did some, uh, work in a hip with the myofascial release. If you just use the traditional ABCD, I did ABCD for this ABCD, for that ABCD, for that look at your claim form. If am box 24, I believe it’s easy says ABC D you have not mastered the art of diagnoses pointing that CMS claim form is the only thing that they really get to tell the story of what happened in that clinic.

And did you really do that nine seven one four zero four, the whole spine at the same region, you did the spinal CMT. We’ll talk about that a little bit. Um, coverage limitations, and how that applies out the patient responsibility. Other big pitfall of this office I was at last week, and then just recognizing their requirements for non-coverage. We know Medicare has an ABN form, very specific rules to that, uh, when we use it, when we don’t use it. And what do other payers say? It’s not the ABN form, but it may be a little bit similar. So let’s go ahead and dive right in. When we’re talking about the modifiers, I went out to one of the Macs, Medicare administrative contractors, and I pulled a sheet that they had that showed all of the different modifiers. And I thought, my gosh, you know, we really think in chiropractic, we’re in a very small code set, but when it comes to modifiers and I’ve started pulling them off, I’m like, all right, well, there are a lot.

And these categories that apply several, I got to leave off. So don’t worry. I didn’t pull surgical over here. And I didn’t pull some of these different therapy codes that we don’t deal with or those things. But I thought it was really interesting that the modifiers that we deal with in the office are going to be regarding the advanced beneficiary notice. We know that the CMT code get the a T or the GA, hopefully not the GZ. That means you didn’t get the ABN sign before you did that maintenance adjustment. Or for that series, we don’t have to get them signed to every visit, but there’s some specific rules and that GA and GZ are used one or the other, depending on the proper execution of your Arabian form, bilateral. And did you do that on the left? Did you do it on the right?

We have the chiropractic modifier. That’s the 80 can’t use it. Please. Let me impress upon you. Something that I see every day it came to the university is a very high usage of 80. Oh yeah. Well, that’s built into our fee schedule. We build that every single time and I just sit there and I’m glad I don’t always share my video because I’m going, Oh, it’s either or Oh, like that, because we don’t always use the 80 modifier. I dare to challenge anybody who uses that constantly, unless you completely discharged patients, your pain office and you discharge them, tell them don’t come back until you have an issue that could be active, a treatment that we’re rendering for you for your condition. That may be the extreme, but it’s going to be very hard to substantiate that 18 modifier, especially when your box 14 tells them it started about three years ago, a statutorily excluded modifiers, which is with Medicare, G Y Medicare.

You may have noticed the title of what I was going to cover in day G why Medicare do you never, ever, ever cover this? And, uh, we just have to go with the flow of what they tell us to do then that I touched on just a minute ago, those NCCR bundles, where they say, well, you can’t do this together. Uh, these two don’t go on the same. You can’t do this in the same region. Oh, you can’t do a spinal CMT service at any and M service in the same. Well, okay. That’s why we have 25 modifier. That’s why we have an X S that’s why we have a 59 modifier. Um, that takes us down into that evaluation and management modifier fee for time compensation. Maybe somebody needs to come in and maybe needs to, uh, fill in for you for 60 days.

If you’re going to be out of the office, you will have your fee for time compensation. You may also have when there’s reciprocal, uh, billing, that’s going on, which I didn’t list here. Technical components, the TC, the 26 on some of your, um, of your radiology services, telehealth. That’s big right now. I will tell you a tele house. You may want to check individual payers and then the therapy modifiers, which for us generally that third one down is where we live in the outpatient therapy, which is that GP. So you may be seeing some denials with Medicare, a VA with United healthcare regarding therapy, nine, seven codes of the GC, or two eight, three, simply because you’re leaving off the GP modifier. Now we know with Medicare, always get, gee, why Medicare do you never cover this? And then GP goes with it. There’s too.

So with all of your services that you do for Medicare, there is only that certain subset of the 97 and the [inaudible] that actually have to have two modifiers. The rest are either gee, why? Because gee, why Medicare? Do you never, ever cover that? Or we have the 80 or the GA and the, hopefully not the G-Eazy. Um, so keep that in mind. So we’ll go ahead and move along to the next. Now, one of the things I hear hear commonly, well, I was told I have to do this modifier first, or I have to do that modifier first. Well, when it comes to coding, we think of this in the realm of payment, modifier and informational modifier. Some people have the words statistical modifiers, but I want as far as to go that deep and say, all right, tell me which ones have to go first.

Now from a coding perspective, payment modifiers, go first. Then you put your information, all the ones that kind of tell us the story. Well, Medicare, I know you don’t cover it. Well, this was a part of therapy care. Well, this was a part of this. And they literally listed out. Those that would apply to chiropractic care would be your, uh, technical component professional component, which you would be using with your x-ray, believe it or not. And, um, Massachusetts, I did an onsite visit back in March and before I got there, I took one of my DCS with me. That’s on staff here. And she told me, she said he never gets paid from blue cross and blue shield for x-rays. And I said, well, that will stop. The minute I hit the door. I’m not tolerating that that’s not okay. I went and I did medical policy research and found out there was no exclusion.

And so we sat down to dinner Sunday night, we sat down to dinner with the doctor and I said, that bucket is right here. I’m done with that. That’ll be settled in the morning. Well, anybody who knows me, it’s not waiting til the morning I got on. And I started doing some research and I’m started sniffing something. And I’m like, what’s going on here? I get up the next morning. I think her name was Suzy. I got ahold of I’m there with blue cross and blue shield of Massachusetts. And I said, tell me what’s going on. It was the strangest thing I’d ever heard. I had to train one team member to be able to handle this. I wrote some policy on how it worked. They had you send the TC with one NPI, the 26 with another. So if you’re in Massachusetts and you’re having an issue, I encourage you to reach out to us because I have all this written out for them.

So I know how to help you guys fix it, but it’s crazy. But know that those are your payment, modifiers, your bilaterals, your a technical professional component. And you can see there at the bottom. It said these payment modifiers are not limited to the first position, but if another pressing modifier, it goes to talk. But pricing modifiers always go first. So some people like to argue with me, is it GP or DUI first? Well, next screen. It really doesn’t matter. It’s an informational modifier. So it can go in either direction. Um, some people say, well, I’ve always heard it’s this one, right? Here’s the Mac telling you, these are informational modifiers. And these modifiers, um, should be placed after the pricing modifier. So we go back, we see pricing modifier. And then we see the informational. Now that we have that out of the way.

And then it really doesn’t matter if you got your GP or your G why first let’s go on. We can see here that as far as the 80 modifier, which we referenced, I told you, I do not feel that all spinal CMT services will have the 18 modifier. I can just about say 99% of the time. It will not. Again, if you’re a pain doctor and telling them, I don’t want to see you, you send them out for wellness care and they only come to you for active treatment, which doesn’t mean you’re flipping diagnoses codes to get more coverage. Oh, we’ll change it up here. Oh, okay. So we’ll, let’s change the date of onset. That’s not how you manage it. I encourage you to go look at the stipulations of using the 18 modifier, because right here, straight from Medicare, not from your vet’s library, but from Medicare’s library, we see that there is inappropriate usage.

When we use the 18 modifier for maintenance services, Medicare defines maintenance. We have to observe and recognize, but they are who defined maintenance. So as a doctor, you get this big you’ve. If you’ve seen me talk before on here, you’ve seeing this, this big bubble of clinical appropriate thinking, because you’re a doctor, you’re free to think that’s your bubble to thinking, but inside that bubble was a little compartment way over here, where the payer, Medicare, whoever it may be says, well, this is my bubble. You put in my bubble only so much. You keep thinking what you want, but watch what that does. It really shrinks down on what they accept and on what you build to them as medically necessary care. Um, and getting that concept down, really reduce your risk. I know that’s what all this is about. Really reduce your risk and, uh, really will assist out in times of audit, record review and things like that.

You don’t want to have inappropriate billing, nor do you want to have false claims act violations. I can tell you I won’t go into detail, but in the short time that I spent with this office, we had to write four compliance incident reports. And it’s just the start. So make sure that you are doing things up. Propriate like, um, next we’re going to look at payer specific modifiers. So you’ve got your Medicare maintenance here. I told you it’s or Z Jay Z a GA. I got my ABN ahead of time Jeezy. Oh, geez. I forgot it. You’re not going to collect, but still make sure you get the appropriate modifier on, um, if the patient already was touched, jeez, you forgot if the patient wasn’t touched yet. And you’re telling them ahead of time. It’s GA I got that ahead of time. Always verify with the Medicare advantage companies.

Um, I had some around here where I’m at in West Virginia that, uh, did not observe this GAGC. They actually spoken that language that a lot of commercial payers speak in. And that’s S eight, nine, nine zero. I’m going to pause here for a moment. Cause I think it’s important for someone to know here today. Um, when you’re submitting services to Medicare, the patient has elected option one on that ABN form for the spinal CMT to go over for maintenance, please be cautious when you get payment from the secondary. Now, if they have a true secondary supplement, won’t do it, but they have a true secondary. So around here, we have a lot of federal blue cross blue shield, Medicare primary, federal blue cross, and blue shield secondary. No, that, that secondary generally does not talk in the language of GAGC. They talk in the language of a state nine, nine zero.

So when you send it over to Medicare and it’s maintenance, because patient chose option one, a lot of times you’re going to be paid from that true secondary, which is a mistake. Yes, the air just left your room. I encourage you to do proper verification of services with that secondary. And when that secondary pays you, when Medicare said looked at it as maintenance, you need to notify that secondary payer that they paid an error because it was maintenance. You may have to go back and switch to [inaudible] to get it, to go across. Definitely look into this further because I commonly say, well, they’re secondary covers it really. I know federal blue cross and blue shield, like the back of my hand. And I can tell you right now that they don’t cover maintenance. Look at the medical policy. You’ll be able to find out there that they don’t.

And when you get paid, unfortunately, the patient’s not going to be happy. But if you get audited, your office will be a lot happier. And that’s who you have to protect. Um, as we move along, we can see that we have also some payer specific again with Medicare, but it also hits over there in that land. You see me dropping out is gee, why Medicare do you never cover it? Every service minus spinal CMT. And then I’m not even talking about GX. If you want to talk about it, give us a call. I don’t think you should ever talk about it. Um, because there’s other ways to handle that. But then there’s that GP got some PT, got therapy going on and therapy plan of care. We see that Medicare requires it, VA UHC. And then I put down there. What about your payer? Do you know, that’s where you go out and refined all these medical review policies as specific questions, uh, keep in touch with those payer specific, uh, bulletins that they release their webinars and things like that.

Know your payers and know what their modifiers are, because what you’re going to end up doing is just like the office I’m coaching right now. Like I said, I don’t coach very often, but there’s sometimes I have to come out because of complexity of issue or a specific topic. And I have to take someone on and get us over this hurdle and then pass them on over to someone else. Similar with Kathy, we both will take some intense cases and pass along. But many times we find it’s at this very root of modifier issues. The denials are piling. They’re not understanding how to fight it. And really the fight was way back here. And it was in being proactive modifiers for statutorily excluded services. I’ve talked about that. Gee, why is the only one for the ENM and the x-ray and then on all the therapy codes, we have a combination.

So you can see that I laid that out there. And when they have a supplement, it’s a voluntary submission. It really is a voluntary submission to Medicare for their statutorily excluded services. Um, as we move along, we have those distinct things that are separate and distinct. This is a denial, automatic denial. I’m just going to put it out there. You’re not going crazy. Uh, probably I think it was back around 2017 for some of the payers. They implemented a new software at the payer level that said we’re throwing out every 25, every 59 excess out of here. It’s an automatic, prove it to me. Um, so don’t take that laying down because really all they’re doing is saying, prove it to me. But no, when you are using those that you are meeting the bullet points to be able to substantiate using the 25, it was separate and distinct. No, the policy on what qualifies with that payer know what happens when they say, I only allow one of these a year. Okay. How do I shift this responsibility to the patient? Sorry, patient. You owe me today. Wrong answer. If you’re dealing with Ash,

You’ve got it.

The form that has to be filled out every single time signed off on every single time you’re going to do a service. They don’t cover. Medicare was spinal CMT will allow you to do it for up to one year unless it’s interrupted by another period of active care. So you’ve got to know the payer you’re dealing with. You’ve got to know what the contract says, what the policy says on shat, on shifting over the liability to the patient. Sometimes it’s possible. Sometimes it’s not 59 modifier in our land. If you’re having to move over to the X series, remember this 59 means it’s something above and beyond. This is how you’ll never forget it. X S it’s an X S of something 59. Generally. We’ll cross walk over to the excess modifier. Xs is more distinct in its description. A lot of payers will say default back to the 59.

If you can’t use one of the excess ECC or XPX you, uh, but typically access will work quite well. But again, we talked about the nine seven one four zero the nine seven +1 497-124-9711 two. Those codes generally cannot be performed in the same region as the spinal CMT. If you are. It’s just part of the work of the CMT service. If it’s truly separated and you’re not using diagnoses pointer, it reminds me of Barney Fife, um, that shot himself in the foot all the time and just make sure you’re not shooting yourself in the foot. And you’re like, but that shouldn’t be, what story did you tell on your claim form? That’s the only thing they get to say, tell the story from the beginning and up your chance on getting paid without having to be reactive, be proactive, common chiropractic modifiers for radiology services, Aetna, uh, Medicare started it.

We know that doesn’t pertain to us, but it’s like one, two, three, here comes a little duck, four, five, six, and a little duck. Aetna was one of the first ones. If you’re using digital, if you’re not using digital film in your own plain film include the FX modifier. We will see more and more payers going towards this plain film. I’ll call it penalty as if it doesn’t take you more time to go back and develop that in the suite and deal with all the smells and all that. But they say FX modifier. I put down there, the blue cross and blue shield of Massachusetts. So you could see that that 26 and TC separate MPIs, crazy, crazy, but it was their rule. And guess what they’re getting paid now. Um, the G Y the FX, what does your payer say? KX? We’ve seen a lot of KX.

It used to be years ago when I worked for a third party billing company, KX was more with just your, uh, therapy clinics, your outpatient, occupational, physical, uh, clinics. We saw that, but I’m seeing that come up more and more, uh, could even be in your DME stuff. Ladder reality. We’ll notice that we have some of the modifiers coming in as in your LT and RT your fee for service time compensation or your reciprocal billing. Those are some of the others. Uh [inaudible] you got somebody coming in, um, and they’re going to be covering for a period of no more than 60 days at a time, or maybe somebody just filling in from their office from a distance. Obviously some rules around that DME in you, a new unit are, are they’re renting it LT specifies the left R T right. Uh, you’ll see that a lot with, um, however, you’re doing your billing with orthotics, a one unit LT, one unit RT or two, uh, definitely want to verify with your payers on any other requirements that may be there.

So where does this all lay out? As you’re looking here on my screen, um, this is common issues we have, um, I encourage you to take a screen snip right now, uh, because it’s more than what I’m going to talk about. So you might as well take a look and take Kate take advantage of Watson front of you. This is one of our tools from KMC university, but it is 24 III with the diagnoses pointer where we’re seeing the issue. Um, one thing just to put in front of you, October 1st, there were some updates to some ICD 10 codes, make sure you’re not using any deleted and always using those more specific codes that were just released, uh, kind of staying cognizant of our time. Uh, just make sure that 24, he tells the story. Where did you do the scene? Empty. Okay. Abe C and C.

Great. Where did you do the nine seven one four zero because you can’t do a, B, C, D. Oh, yeah. I did that in F don’t put ABC D down there. It happened enough. That’s your story? Stick to it. This is the only way to be proactive. Get your modifiers on here correctly. Get your diagnoses pointers on here correctly to up your chance. And again, it’s not foolproof because they want you to chase your tail. As we move along to the next slide, you can see some of them that we just highlight those areas, and you can see they’re a little bit better, kind of without all the garbley around it, that we’ve got 24 elide out there as one of your big places of issue. And also in D those you’re modifying your diagnoses pointers. Um, no, anything that you’re putting on that claim form has your signature at the bottom.

You may not be getting out your pen and writing your name every time, but I bet you, it says signature on file. So be careful of anything that you’re sending out, uh, because if you haven’t read the back of the form, I encourage you to do that. I pretty much lays it out there that you know what you’re doing, and you’re testing, you know what you’re doing when you’re sending it. And by signing the other side, you take all liability. I tell people, know your risk. If you’re willing to do auto bond speed and your 25 mile an hour school zone be prepared for that penalty that comes along and they tell you ahead of time, what it’s going to be. So if you’ve never taken the time to flip over that CMS 1500 form do so, it is a federal document. Make sure you’re doing it appropriately.

So going back, recapping a few things, making sure on your, uh, in CCI edits, which member back in the beginning, I talked about your CMT, your ENM services, your CMT, your, um, muscle therapies and things like that. Utilize your diagnosis, pointing, utilize appropriate modifiers, reference your payer policy, follow the rules and know that they have them there for a reason. Why do they not allow CMT and ENM? Because there is a pre post and intro work to the, to the CMT service that does mimic some Waterman and M service. You’ve got to evaluate, especially if you’re a full spine adjuster, you’re evaluating, you’re doing some form of evaluation, but there’s times it’s above and beyond that. And that’s when your documentation should prove it back it up 25 modifiers should stand and appeal as necessary KMC university and our third party billing and collections department down in section six or seven.

If you’re our member, you’ll see that we already have template letters that you would use for these very situations for appeals. When they try to deny your CMT with your evaluation of management, when they try to deny your CMT with your muscle therapies, there’s a whole host of them that we have there. Um, one of the biggest ways I told you to build it out is making sure your modifiers are correct input, output, whatever you’re putting in at the very beginning, when you get the key to that software, remember this is success. The key to success, turning that key to the software, set yourself up for success from the beginning, because if it’s not there, it’s not going to show up in that imageable low it. And we’re going to have all kinds of issues. Now, this one, I didn’t what I gave you here in front of me as that sample wasn’t Medicare.

So nobody scrutinized me. You’re missing the T or the GA. I’m not, I’m using this for an example of something like UHC, where you’ve got to have your GP modifier on there. And it was an addition. So I needed my 59 or maybe my excess with this payer, make sure you build that foundation. So when you hit that little magic button, it automatically does the work. Why chase your tail, having your staff go back and say, okay, that’s UHC. I did GP here. Who’s next 150 patients later. You don’t have time for that. Set yourself up for success. I think this is kind of my unsaid job here at KMC university is the passionate about that. And usually if somebody needs their fee schedules blown out, I, they purchase multiple hours with me and I set it up remote in as if I’m sitting there and fix it for them.

And then again, remember your diagnoses pointing, where did it happen? Don’t tell me your CMT and your exercise or wherever you can have your exercise and CMT together. But tell me where you did it. Your CMT needs to say, this is where I adjusted. Don’t let it tell us a region. You didn’t adjust and same with your exercise. If you didn’t exercise from STEM to stern, don’t tell me, catch me right in the middle and tell me, I just did STEM. And let me know where you went. Um, as we’re coming towards a little bit closer to close, we’ll know that 10 minutes is the average length of time. It takes to locate and research and medicals payer policy all throughout this I’ve said, know what your payer says? It’s your key to success. Know how to set yourself up? If I had moment, which I don’t, I don’t work in an office anymore.

I work at KMC university, but I would blow your mind with all of the medical review policies that I keep here for my staff to reference, to help our clients. And it’s not all of them. I had over 150 policies before I left the local office. And I needed to know that the health plan of the upper Ohio Valley did not pay for spinal CMT services. I also needed to know, well, how do I have the patient pay for that? Oh, I use your form. I give it to the patient at this frequency before we do it. And then I can charge them. Got it, got it. And then my fee schedule would keep that as a patient fee. Then we look over here that 55% of DCS and CAS admitted. They didn’t seek guidance. Shame on you, shame on you. You’re setting yourself up to send in a services under a code that they say is experimental and investigational you’re success.

You’re setting yourself up for denial. After denial. You’re setting yourself up to lose money. No one can afford that. If you had that old Facebook video, ain’t nobody got time for that. No one has time to lose money. And when you lose money, because one, it got denied. Your staff has to chase it. Your staff doesn’t know what to do. You’re just setting yourself up for failure. A lack. The plan is a lack to succeed and just make sure that you’re doing that correctly. Looking at medical review policy is very easy. I’m the queen. I’m known to have a magical computer, but while I was traveling on the onsite last week, one of my specialists said, I need some help and they couldn’t find it. And they’re like, I know you don’t have your magic computer on, which is right here. This is the magic computer, but you know what I said, it’s not my computer.

I just found it on my phone. And it’s kind of a joke around here, but it literally took me no time to find exactly what that client was looking for. Answered the question like that. Ask them if you don’t, can’t find it on their website, ask them Aetnas is the easy. Everybody has an assignment from here. Go Google, Aetna chiropractic policy and read it. It’s going to scare you. I promise it scares everybody. Uh, this is theirs. Go look for it yourself. We don’t have time to go over it, but I’m telling you, please, please, please has oxygen on standby. Especially if you do any of the services that they say is experimental and investigational, it will blow your mind. The last office I worked in, we had to go off, off, off. Why are we even in with that net? They don’t cover anything.

We do. They have a right to monitor. This is in Nebraska, that they have a right to monitor your compliance program. So know that. And anytime you’re going to do a new service in your office, investigate, check your board, check your payer, check your coding. Don’t rely on the person who made that piece of equipment. I’m not going to call Magnolia homes. That’s where this is from Magnolia, my Magnolia and heart. Oops. Well not going to call them and say, how do I code this? How do I code this? No, you have to know how to code it per the CPT guidelines. CPT tells you how to code it, FDA, how that thing was approved. So I’m, I’m pulling out really quick just to show you this tells you how to code it. Not the manufacturer. They may have an idea that can point to it, but know for a fact exactly what that is.

And then in charging the patient, find out what you can do to charge the patient and have them be liable. Is it with Medicare and ABN form? Is it, you don’t have to do the ABM form for the statutorily excluded services with Medicare. Does the payer have their own policy? Can you use a generic one like in the office management section of the KFC library and section one, uh, we have that in there for you and just know the rules. Do they cover rehabilitative therapy and keep your fees consistent? Don’t change your fees or your code because they’re cash. No, the rules. This was specifically from Arkansas blue cross and blue shield. They have their own form. Limited patient. Financial waiver is common language. It’s definitely not going to be ABN because they don’t speak that language. But know if the payer has their own in closing.

I don’t know if you know this yet, but you should know by now KMC university keeps their ears very low to the ground. Sometimes we’re slower to say something than others because we know it’s in comment phase and we’re not going to cause unnecessary havoc. But we do know that the ICD 10 change took place. And it is an in comment it’s in live and we have every tool that you need to help navigate through that, uh, ABN implementation. Remember that that is going to be due on January 1st and in M coding. Um, if you’re a member of KMC university, you can find the ICD 10 codes on the dashboard top, right? ABN implementation is down on the bottom, right in the ABN alphabet soup lesson. And then the new ENM coding is going to be on the right under our recent webinars. So you’re going to notice all the tools you need there.

Uh, if you need any help and you need some KMC University, just know that we have you covered, uh, definitely appreciate you guys attending today. If you should have any questions, there’s our phone number. You know where to find us, press option one. Tell them that crazy lady. You talked to me today and told me all this crazy stuff about everything that I have to do and get myself set up for success. I encourage you next week. I pardoned for going on a couple of minutes to join with Dr. Sherry McAllister, when she’s going to have your next session of Growth. And I’m sure you’re going to have a great time. She’s an excellent speaker. I’ve enjoyed looking at some of these. Thank you for attending.

Thank you for letting me spend some time with you today. I hope it’s been helpful. I know it should have been have a great day. Bye. Bye.

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