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

Click here to download the transcript.

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.

Empowering Women in Chiropractic – A Chiropractic Birthday Buzz in Your Community F4CP Dr. McAllister

Click here to download the transcript.

The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. 

Hi everyone. And thank you for joining me today for ChiroSecure’s’s Facebook live presentation, delighted to have you with me. We’ve got a lot to cover today and very important information. I know we’re all going through the pandemic and it’s not been easy for any of us, but with the help of a little spice of fun, a little bit of happiness. And then we walked through some of the things that are going to be so important for your community to engage in. I’m going to start with today’s corporate sponsor. Thank you. ChiroSecure has been so generous, but also please look at these corporate sponsors. That’s, who’s helping us make a huge difference, an impact in the world that we’ve never seen before. So let’s start with looking at everyday opioid awareness as we go through, and we start looking at our optimum awareness and how the chiropractic birthday celebration is having an impact. I just want to share.

So just to make sure you saw the 125 years of chiropractic celebration, I want to share some fun facts with you. You can share this in your YouTube videos. You can share it. Um, maybe you have an, an E newsletter that you’re sending out, but let’s celebrate 125 years of drug free chiropractic care. Another fun fact is did you know that in 1979 chiropractic in New Zealand, the report of the New Zealand commission of inquiry into chiropractic was published. This was the first government commission to adopt a full judicial procedure, hearing evidence on oath and subject to cross examination. When examining patients, this is a big next step for the chiropractic profession. We also noted that in 1988, the world Federation of chiropractic was formed. So many fun facts that all of us just need to jump into. Remember today is all about celebrating our birthday box and we could not be more happy to do something for our community.

That really, that here’s a little sheet that just shares with you more about the fun facts that are available. The other best part of this particular handout is that it has the latest, greatest research in it that you can also share with your medical community. Maybe there’s a physical therapist in the community that you want to share a little bit more about chiropractic or a physical therapist, a pardon me, a medical, um, physician who’s into orthopedist or a, um, acupuncturist. The more you share the better we’re going to be able to examine and exhibit the benefits of chiropractic care. Now there’s a lot of parents at home right now with little people and those little people need something to do well, what better way than to get them coloring and to share with them the benefits of chiropractic care. So happy birthday chiropractic. And as you can see, we’re looking to enjoy our celebration, even though we’re during some very difficult times, if we can just spread a little bit of sunshine and a whole lot of happiness, we’re going to do so much better for our community.

We have trifold brochures that are celebrating 125 years of chiropractic excellence in your community. One of the things that I think is very important is you, as a thought leader in your community, want to be able to share your clinic and your expertise no better way to do that than to share some of these important information pieces on your website, your website, or any social media platform that you have allows you to adopt the information that you want your community to know about who you are and what you do in your practice. Speaking of that, let’s use your social media platforms, Facebook, Twitter, and Instagram, to really get to know more about chiropractic. Here’s about three of our social media infographics share showcasing a little bit about the fun of chiropractic. There’s nine of them. So you could get started today. And by September 18, you will have shared with the community that you are proud to be a chiropractor, celebrating 125 years of growth.

And that really makes a lot of buzz because people need positive information out there in the communities to make them feel like we’re getting kind of back to healthcare and not sick care. I want to also share with you in our birthday box is a very nice way to explore the celebration a little bit deeper and have something that you can hang on to for years to come. That is our commemorative chiropractic coin. You can go to frcp.org/one 25, and you can get one of these beautifully crafted coins. On one side, you can actually Pell pate the spot and the hands. And on the other side, it’s showcasing 125 years of chiropractic excellence. This is a special way because in many other professions, they have challenged coins. In fact, one of my patients gave one to me. I felt blessed that they did so, and it was a celebration of their profession.

And you could do the same in celebrating, maybe, you know, another chiropractor that mentored you. Maybe there’s an instructor that you’d love to share this with a state association leaders or just a friend, a family member, or a colleague that has made a difference in your life. FRCP your dollars. Go back to our national funding. So every dollar that comes back into the foundation is going to go back out in national advertising. So feel free to get your coin at FRCP dot or slash one, two, five. Now I just went through a birthday present box. Isn’t it nice for all of us just to open up something that really makes us feel good and happy in these days. And the answer is yes. So if you’re a member of the foundation, you have a birthday box waiting for you. How do you get it? You can see there’s a line there that really opens it up.

It’s it’s a clicking go and you found your birthday box ready to go. This is how you get your staff members excited too, because if you’re not passionate about what you’re doing, your staff will know, and I know you’re passionate cause you wouldn’t be on this. Facebook live with me right now. If he didn’t want to celebrate chiropractic 120 fifth anniversary. Now let’s go over some updates, fabulous updates from the foundation. One of them being very important and that’s today on thrive global as thought leaders, we need to be able to share with our community more than just, yes, we do chiropractic adjustments, but we really care about their health. And as I said, we’re in a pandemic. So one of the ways that we can share with our community is getting on our platforms, Facebook, LinkedIn, and Twitter pages on thrive global. Today, you can go on our FRCP Facebook site and you will see an article about how to blow off steam today.

And what does steam stand for? Steam is an acronym for stretching, strengthening, having a cup of tea, meditation and mobilization. Isn’t that what chiropractic really wants for all of our patients be able to enjoy your day by enhancing your health and really having the excitement of being able to ensure that you’re not just drilling down into your computer, but that your chiropractor’s reminding you on how to blow off some steam. And that’s the way that we capture their, the audience. We give them information that’s relevant to them right now. I know personally behind my screen, 16 hours a day can be really difficult, but as we start to help our audience and our community learn more about what’s important, just getting up and moving around or making yourself some tea or learning a little more about meditation. These are all fabulous things that you can do.

So get out there and help your community blow off some steam today. Let’s talk more about September. As you know, the foundation for the past four years has put together drug free pain management awareness month. This is an outstanding way for us to connect back with our communities and let them know that we do not offer drugs for painkillers so that we are helping them take care of their health in a natural holistic way. We want you to submit your September’s drug fleet proclamation to some of your council, men members is this important and why? Yes, it’s important if you don’t believe me. One of the top headlines that’s trending right now is on wall street journal wall street journal title today was state associations or States are looking for $24.5 billion in restoration for the opioid epidemic. $24 billion in litigation is being had right now.

And that’s because of the opioid crisis. So we want to still continue the awareness and the opportunity to connect with the community representatives and a proclamation. Isn’t a fabulous way to do that. Also, if you want to reach out and bring your proclamation as well as a new ebook. Now look at this beautiful new ebook. This ebook is a opportunity to open the conversations. It’s talking about our effective drug free FirstLine approach to pain. Remember 50 million people during a pandemic are actually creating a world of more sadness and depression that we need to help them with those 50 million suffering in chronic pain need to know. We care need to know that we’re right there with them. And that trying a non-pharmacologic logical option is right there with you in your practice. These pages, we’ll talk a little bit about chiropractic care and more importantly, how they can find your office. So that ebook should be on your website. I’m hoping that you’ll put it out there on a LinkedIn article, or maybe you’ll put it onto a E newsletter that you’re sending out to your patients. Don’t even be afraid to do a YouTube video, just flipping through the book and talking about correct.

Okay, take care.

We’re here to help you in marketing. The August monthly roadmap is out and it’s a click easy step through your, your front desk and your chiropractic assistant or your office manager should be aware of this roadmap resource because week by week, moment by moment with you, it’s going to give all of the ways to which we can connect with our patients. It happens to be for August. We’re focusing on motor vehicle accidents, her particularly, um, in the personal injury, we have one infographic that you can see on the other side of the screen, the sign about chiropractic’s role in personal injury cases, more specifically, maybe an MBA. We bring this up because we want patients to think of us first, when they’ve been injured, not last, which is how oftentimes being 25 years in this profession. I see patients that come in years after an injury.

So we want them to be fully aware week by week on what we do, especially if they’ve been in an accident. Now I want to thank you for being part of the foundation. If you’re not frcp.org, we’ll help you get more information. Don’t forget. Next week, we have a fantastic opportunity to be back here on the Facebook with ChiroSecure, ready to listen to another opportunity and information that they so generously give you week by week. Last but not least, remember when we get together next time we will be celebrating 125 years of chiropractic Goodness. It is you that makes the difference. It is your messaging to your community, that makes us one of the fastest growing healthcare professions in the nation. And I am so proud to call you my colleague and I’m hoping you’ll join me in celebrating September 18th. Happy birthday chiropractic!

Please subscribe to our YouTube Channel (https://www.youtube.com/c/Chirosecure) Follow us on Instagram (https://www.instagram.com/chirosecure/), LinkedIn (https://www.linkedin.com/in/chiropracticmalpracticeins/) Periscope (https://www.pscp.tv/ChiroSecure). Twitter (https://twitter.com/ChiroSecure) If you have any questions about today’s show or want to know why ChiroSecure is still the fastest growing malpractice carrier for over 27 years, then call us at (866) 802-4476. or find out just how much you can save with ChiroSecure by visiting: https://www.chirosecure.com/quick-quotes/malpractice-quick-quote/.

Empowering Women in Chiropractic – Tools to Take the New Normal by Storm – Dr. Julie McLaughlin

Click here to download the transcript.

The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.

Here are some addiotnal gifts for VCITA:

Start a free trial from our website by using this link: https://www.vcita.com/?invite=Webinar&utm_source=Facebook&utm_campaign=Julieshow

Cchedule a demo with this link: https://live.vcita.com/site/vcita.sales/online-scheduling?service=289tixik1ymrp6hw&vtm_cp=Julieshow&invite=Webinar

You can also contact Rachel Rachel@vcita.com

Welcome to ChiroSecure’s empowering women in chiropractic the Facebook live show for successful women by successful women. Proving once again, women make it happen. Join us each week as we bring you the best in business growth, practice management, social media, marketing, networking leadership, and lots more. If it’s about women in practice and business, you’ll hear it here. [inaudible] now join. Today’s host dr. Julie McLaughlin, as she talks, learning, living, and teaching. And now here’s dr. Julie.

Hello everybody Dr. Julie McLaughlin here from Vital Health Protocols with Empowering Women in Chiropractic. I’m so happy you joined me today and thank you so much, ChiroSecure for putting the show on. So let’s everybody give them thumbs up and in some love, and, uh, let’s get started. I want to make sure that you all are going to be introduced to my friend, Rachel superhero from the VCITA. Rachel is a marketing expert who specializes in helping businesses make the most of technology. She started her very first business when she was still in college, helping local small businesses build their web presence and shift from offline to online. Rachel is currently the product marketing manager at VCITA, which I love that it’s at all. And it’s all in one platform. It helps small businesses manage clients appointments and scheduling from one place. Rachel manages the communication with the CDs community over a hundred thousand business owners. So Rachel, welcome to empowering women. Hi Julie. It’s so great to be here. Hi everyone. Thank you so much for having me. I’m so excited about today’s show. Uh, it’s going to be great. We have so many things. I’ve so many questions for you, so let’s get started. So what are you seeing to be the most common created businesses challenges that you’ve seen because you have a lot of customers, I’m sure you’ve seen a lot.

Absolutely. So first of all, um, this is, uh, we can bring up our slides. Now. This is, I mean, this is a really great question because I think, you know, everyone is dealing with, with their own, you know, challenges. I mean, I’ve, I’ve been working from home now for almost six months and, you know, with two little girls at home, it has, wow. I mean, it’s, it’s a completely different reality. Um, and I think it’s very helpful to sometimes hear about, you know, other, other business owners and other doctor’s challenges to kind of help and brainstorm as a community and come together with solutions that can really help us and, you know, share the knowledge, share the tips. I’ve been seeing a lot of that lately and I’m really loving it. Um, we’ve been hearing really, there’s a very wide range of challenges. Um, I think there’s, there’s a lot of, there’s a lot of stuff that kind of has to do with regulation.

It depends a lot on where in the world you’re from, but things are changing so fast. You know, there’s, there’s different restrictions. Like how many people you can have in your rating room at once, or, you know, what happens if someone calls in from someone, a patient that was in your clinic last week calls up and says, you know, Oh, I’m a confirmed patient. You know, what do you do next? You have to close down. There’s just like, it’s, if things keep it’s just like sort of continues to shift and it’s, it’s very hard to sort of comply with all that and change your clinic and change your, you know, your workflows so fast to match all that into, you know, keep your, yourself and your team and your customers safe. Um, there’s also a lot of challenges with kind of, you know, people, um, either having to reduce their head count or having people go out on sick leave or just, you know, sort of managing their clinic and, and sometimes the same volume of customers, but with a smaller skeleton staff.

So there’s all these stuff that you might have, you know, you might have a person that usually does your scheduling or your billing, and suddenly you’re stuck doing, seeing your patients and doing so many of these additional administrative tasks that are so time consuming and sometimes really hard to juggle with everything else that’s going on. Um, we’ve, we’ve also heard a lot about, you know, um, doctors that are, that are seeing a decrease in volume, seeing less patients coming in, a lot of patients that are concerned, high risk patients that may be worried about leaving the house and orient, you know, try to really reduce, you know, the time they spend out of their home and maybe even avoid coming into for routine checkups or anything that really isn’t an emergency.

Yeah. Oh, I totally get it. I have seen all of those things in my practice and I know you see businesses all over the world and it’s interesting. We are all, all feeling the same pain. So what kind of tax tasks that you do, um, can be automated? How can we make this easier for us to navigate this crazy as you guys have to see this a business unusual?

Absolutely unusual. Unusual is I guess the word it’s, um, it’s really, I mean, there’s so many logistics that are going on, you know, so, so like we talked about before a little bit, how, you know, suddenly, you know, you have to be on the phone and answer the phone and, and schedule patients and reschedule patients. And, you know, people are calling you up and saying, you know, Oh, I can’t come in on Monday. I have to come in next week. Or, you know, someone suddenly, you know, you’ve, you’ve reserved a space for someone and suddenly they just don’t show up. There’s just like all these logistics and all these moving pieces when it comes to coordinating your schedule. And, you know, you’re spending precious time on all these additional tasks and that’s time that you easily could have been spending senior clients. So the first element is really getting the scheduling down, you know, finding a workflow that works for you and works for your staff, finding a way to sort of automate that, not sitting on the phone day in, day out, getting people to fill in your slots, giving people, um, hopefully like an automatic way where they can see your availability and find this lock that works best for them.

Um, there’s also a lot of stuff with payments. So, you know, calling people on the phone, reminding them about payments, or even just, you know, having people call in and give you the credit card. There’s also a safety issue with payments. Now, you know, some, some I’ve heard like from a couple of staff members saying that they feel uncomfortable handling cash or handling, you know, whatever hundreds of credit cards, every single week, there’s just sort of like another something that you have to worry about. So finding a way to sort of digitalize your, um, your payment flow is actually something that can be extremely helpful and help you keep your team safe, which is major. Oh, I love that. Yeah.

Yeah. I love that touchless payment. And, uh, it, it takes the whole payment process away from any kind of exposure. Right. But it also helps you really get down to the business that you need to help the patient and you don’t have to deal with that payment because it’s all automated. Do you ever find that some doctors worry that it’s not the personal experience with the automation?

So that’s, that’s interesting. That’s something that we, that I do that does come up a lot with conversation with doctors and other small business owners, you know? Cause when you serve a community, when you’re working in a community, you have, you do have these relationships with people, you know, it’s like, I’m sure this happens all the time that you’ll see someone like, I dunno in the supermarket or something, they’re like, Hey, you know, you haven’t been to the clinic in awhile. And I think that’s something that, you know, it’s, it’s really an asset for your clinic because your relationships, that’s, that’s one, probably one of your businesses, you know, most precious assets and you don’t want to definitely don’t want to lose that. You don’t want to compromise your level of service, but when you work with the right tools, I find that you can actually enhance that connection and strengthen those relationships.

So like for example, what we do with the VCITA, we have these automated, um, text message and email reminders that go out before meetings. So like, Hey, don’t forget. You know, I’m really looking forward to seeing you tomorrow or thank you so much for dropping by this week. We look forward to seeing you again, these, you know, these little, it’s like the small gestures, these text messages and emails really go a long way and actually do help you give that extra personal experience that you, might’ve not even been able to give if you didn’t have these tools in place.

Yeah, absolutely. I love that. I know. I can’t believe

Since I did this automation because Hyde lost my staff and I came back. It was just me. And so I’ve been doing these and I’ve been able to realize that patients make appointments at like one or two in the morning. You know, they’re not telling novice, but they’re able to do it through your automation. I love that. That’s great. It really gives you, I think once you have this online scheduling system where anyone can access anytime and from any device in anywhere, it really it’s kind of like staying, you know, keeping the lights on 24 seven. Cause you know, people would have a busy day at work. They don’t necessarily have time to call the clinic, but they will have time to, you know, log into your client portal at whatever it is before they go to bed and schedule their next appointment. That’s awesome.

So what does that look like? So I do have a couple of screenshots that I grabbed off your own website. Joey, you did a great job setting this up and you guys, this is, this is Julie’s website. So you see how Julie has like a little popup window on the bottom. This is the Caseta widget. So basically what it is, it’ll pop up every time someone visits your website, whether they’re an existing customer or a new, a new patient that you haven’t worked with yet. Um, and it, it prompts them to schedule and you can completely customize this, obviously, um, you know, putting your own, text, your own image, and then that will take, um, the potential client to the service menu. So that’s the screenshot you see on the left. So this is, these are Julie’s services. Again, completely customizable. You put in your own services, you can put a little descriptions, you can choose an image.

And then once the, the customer, the, or the patient chooses the relevant service, it’ll take them to this calendar, which is a smart calendar. So you have to set up this calendar. So it knows when you’re available or when your staff members all are available and you can have different availabilities for different services. So it’s all customizable. You can set everything up. It’s also, it’ll adjust itself to the time zone. If you’re working with different time zones and all your patient has to do is just find the time slot that works for them and book their next visit. That’s awesome. That is awesome. So how would you suggest that the doctors improve their patient loyalty? That’s that’s a big question because, you know, in times like these, we really want to be able to sort of secure our revenues, moving forward and have a clear understanding of, I mean, you know, half of 2020 has gone by, but there’s still pretty much half of it ahead of us.

And we’re really want to try and get an understanding of what that year is going to look like. You know, what the revenue cashflow situation is going to look like and curating care plans is something that can really help, you know? So when you have someone that comes in and I know Julie, I know you do this all the time, I’ve heard you talk about it. When you have someone, you know, come into the clinic, you can try. And if they need, you know, some sort of ongoing care, you know, instead of just saying like, okay, you know, you need to come in for adeno, whatever, four weeks, twice a week or three weeks, once a week, instead of just like kind of leaving that up in the air, you can say, come let’s, let’s take a minute to schedule your next visit. And you actually open the calendar or have them open the calendar from their phone. They view there, but your availability. And then that way everything is set up in your calendar. So, you know, if you have to, if they get, if they have to get like their nails done or their hair done, or do anything else, they already have your appointment in the calendar. That’s not going anywhere. They’ll schedule their whole lives around that.

Yeah. I absolutely loved that. So we call it advanced multiple scheduling. So we always ask them, you know, what days work best for you? Oh, Tuesdays and Thursdays, we do like morning or afternoon morning. Okay. Early morning or later morning. Later morning. Okay, great. We’ll schedule you at, you know, 10 30 Tuesdays and Thursdays for the next four weeks or whatever their care plan is. And that automation in itself saves me so much time. And now I do have a part time staff person. And so when that person comes in, they get their reminders. We don’t have to say, Oh, let’s schedule your appointment or you missed your appointment. And I love what you said is yeah. We become the most important thing in their schedule because it’s all set up and they getting their nails done and picking up the dog from the groomer that comes around our appointment.

Exactly. Yeah. There’s also, we also have, um, in the Cedar, there’s a new feature. We’re just about to launch in a couple of weeks. I know this. Isn’t not all clinics can use this, but it’s a, it’s basically a booking, um, a package booking feature. So you can do the thing where you schedule, you know, each visit individually. Um, you can also, if this applies to you, you can also pre-sell visits. So you can sell a package of visits and say, I don’t know, like if you do massage therapy, you can say, um, come and book 10 massages, pay for eight. And you know, you get this discount you pay upfront. And then, um, the patient can come in into, into the system and book their next visit. Anytime they like, and the system will recognize them because there’s a login process. So instead of asking them to pay every time, it’ll recognize the package credits and then just automatically, um, kind of like click re reduce brim, deduct a credit from the package. So this is something that we’re really excited about. I think a lot of clinics can really get great use out of it and it’s going live in a couple of weeks or so

I am so excited that I did not know about that. That is a big surprise for me. And I am so excited because we do have massage packages in our office. And it is a pain that we’re recording the manually. Like when, when did they come in? When do they pay? Oh my gosh, that will be awesome. Automation.

I think customers are going to love it because you know, it takes away from that annoying kind of tedious process of, okay, every time I have to come and pay in the end, it does boost loyalty. And cause you know, clients are invested in your, in your clinic. They’re invested in your business this way. Once they have these prepaid sessions, even if you do have to, uh, you know, eventually shut down for a couple of weeks or you have to move things around, you know, that these people aren’t going anywhere because they’ve already invested in your business and they will be back the day you reopened.

Absolutely. And you know, when they come in, we don’t want them thinking about payment, payment, payment, every time we want them to think about their health and their care they’re getting.

And so having that so they don’t have to touch it is wonderful. Yeah. I actually, I grabbed a couple of screenshots. This is just like an illustration of what it will look like. You know, the kids. So it’s, this is, this is actually just a yoga example, but it’s basically, you know, instead of booking the one yoga class, you can use book like a yoga package. And then just another idea for maybe some of you were where you’re looking for other ways to sort of stay in touch with customers or with patients that you haven’t been in touch with for awhile, you can use, you can use Wisetta or, or any other email automation tool to send these greetings. You know, at the end of the day, it doesn’t matter. It doesn’t matter so much what tools you use. As long as you get this stuff done, you should really use it on email platform that gives you inspiration and helps you stay in touch with people.

So, you know, even if they’re not coming into the clinic, you can still send out an email that says, you know, Hey everybody, I hope you guys are safe. I see this, I saw this interesting article, um, and I thought you’d really benefit from it. Or here are five ways, five great tips for saying, stay at home or, or, or dieting at home or working out at home or really anything, you know, that’s wellness and fitness related. These are just some examples. These are actually, um, like preset templates on buseta. So if you create a vc.com, you will already have these in your account and you can of course customize them and make them your own. But it’s just some good inspiration to give you the ideas. But I love that. I love that we sent out quite a few cause we did webinars health webinars for our patients all through our shutdown for COVID and the patients were able to interact and talk with me on there, but we send out emails to everybody and we had a really, really good response on that.

So even start to have an online presence for your practice, that’s a really great question. I mean, it’s, it’s kind of like, everyone’s talking about, you know, Oh, you have to move your business online. You have to do this online, that online. And it’s actually, you know, not so clear what that actually means. It’s like you wake up in the morning and you take your business online, you take your clinic online. What does that, like, what does that even look like? What is the first step? Um, and I have to say like over the last couple of months, I have been in touch with so many doctors or, or professionals like within the wellness space that have, step-by-step made this remarkable transition where they took their customer base, they took their existing service and found a way to pivot that into an online environment so they can continue seeing patients in the clinic, but also have this, you know, kind of, um, side stream of revenue where they’re seeing patients online.

And this is great, you know, for, for a couple of reasons, you know, you can see people that maybe are worried about going out of the house. You can, you know, it’s very, it’s, it’s, um, it’s very efficient. So instead of having people, you know, waiting around for, in your living room, in your, in, not in your living room, hopefully, but in your waiting room, um, you know, they’re all, each one of them has their own little zoom appointment. They know exactly what time they have to log on, you know, and then you can give them like a remote consultation. Um, I’ve been seeing this work really, really well for, um, you know, different types of professionals and for doctors specifically, um, the first, the first thing you really do need to do is be able to, um, you know, enable your customers to make these online bookings.

So you have to find a flow, find an experience that works for them to help them understand, you know, what kind of services they’re going to be, um, you know, consuming online, give them an easy way to book that service book there and see your availability and then hopefully even pay for that service online and then get a link, a zoom link. So when the time comes, it’s literally a click, they can connect from anywhere. Um, you can be in your clinic, you can be at home. So just again, that’s like you have to, when you, what if you’re trying to think of, you know, how you can set up your online practice, you really need a way to put your services online. So people understand what you’re, what it is you’re selling, what they’re going to get, make it easy for them to schedule.

So they understand, you know, when they, they can find a slot that works for them, make it, make a payment option available so they can pay up front. So you don’t have to start dealing with payments when you have a person online and of course give them clear instructions. So you want to say, you know, okay, at five o’clock tomorrow, you know, here’s your zoom link, we’re going to connect via zoom. Um, and actually, you know, in, in the VCITA, we’ve done, we’ve done this zoom integration. So when, when you use the scheduling flow that I showed you just a bit earlier at the envy, the patient will get an email that looks like this. So it’s like, okay, you know, you’re registered, this is your appointment. This is when it is, this is the zoom link. You know, you can add it to your calendar.

You can add a personal note. So this really gives, gives your, um, this gives your patients everything. They need to start consuming your services online. And it’s a good, it’s a good investment to make now because, you know, I mean, I really hope this will be over soon, but we don’t. The reality is we just don’t know. And depending on where you are for many of us, the winter is still ahead of us. So it’s a good time now to invest in these infrastructures that that’ll help you, um, you know, move some of your services online now and possibly all of them online, um, in the future.

No, absolutely. So when, when I got shut down, I up, so that’s when I started doing all of this and I started doing tele-health with the patients through zoom, sending them the reminders, just like this, and it worked out so, so well. And now that I’m back in the office, I’m able to do adjustments on patients. I’m able to do exams and, and therapies, you know, the hands on stuff, but we do a lot of functional medicine. And so all of our report of findings for the labs, we are still doing through telehealth because I don’t want to be, you know, in one little room and the patient doesn’t want to be in one little room going over paperwork so I can share their screen. And I want the train them that there are other ways to see me. And there’s other ways to come in contact with me because we don’t know what the future holds and they shut us down.

I’m I’m near Chicago. So we’ve been shut down quite a bit. Um, I want them to already be trained that they don’t lose their chance to have consultations with me just because it got shut down and they’ll already know it because they’ve experienced at tele-health. And I’ve had a lot of comments from going over the labs with patients. They’re like, wow, we really liked doing this tele-health because it, it feels like, you know, that screens right in front of them, they can have their spouse, you know, in on the consultation where a lot of times they couldn’t come in with. Um, so it’s been really, really awesome and we’re kind of training them for whatever, whatever the future holds we’re going to be prepared.

Yeah. And I think I just want to add something that I actually heard about yesterday. You know, I’ve, I’ve been speaking to some doctors that were a little bit concerned about their clientele and how they may adapt into this online environment. So guys, I just have to tell you this story the other day, I was trying to connect to a zoom call for work. And my mom who is not, I’m sorry, mom, if you’re watching this, I hope you’re not, but he is not. I love you, but she’s not a technical person at all. Like, she’s exactly the type of patient that I’d be concerned about and say, Oh man, like, I don’t know if she’s going to be able to walk onto this zoom. Like the way I know her, she’ll probably end up, like, I don’t know, posting something on my own Facebook page.

And I was near, I was, you know, struggling to connect to zoom and suddenly she swoops in grabs my phone. She’s like, no, no, no, you have to set this up. You know, you, you push the wrong button and she’s showing me how to connect to zoom. So I guess if there’s also something that has happened in these times is like some audiences that you would not expect to be. So tech savvy and easy to adapt to an online environment are actually really able to bridge that gap and, you know, kind of pivot into this online sphere.

Yeah. Oh, absolutely. Absolutely. So if doctors want to learn more about the VCITA, how can they learn more about what you guys do is I think that’s super, super important.

Sure. So first of all, you’re welcome to hop onto our website. [inaudible] dot com. You can take a look around if you want to learn anything more about features. We have a 14 day free trial. You don’t even need to enter your credit card. You just put in, you know, your email address and start setting up your account. So you can open a free account, you know, start looking around, get a better understanding of how it can work and what kind of value it can bring to your business. And if you would like to hop on a call with one of our, um, product specialists, we give free demos. So if you want a demo, if you want a demo with one of our representatives, again, no commitment, no credit card. It’s just a phone call for you to try and understand if this is something that can work for you and trying to understand how the VCITA can bring value to your business. Um, so you can, first of all, I can do that on our website, but what I recommend is you just write the word demo in the comments and put your email address there. And someone from the CDL will reach out and schedule a demo with you.

That’s awesome. Well, thank you so much, Rachel. I think that we all got really good ideas, do level things that we can do to try to keep our practice going and having diverse to reach everybody. So it’s been great. And so thank you everybody for joining us for empowering women with ChiroSecure, let’s make sure we give them lots of thumbs up and hearts and, and be sure to tune in in two weeks where Dr. Nathalie Beauchamp will be our host for empowering women. So have a great day everybody. Bye bye. Thank you everybody. Goodbye.

Join us each week as we bring you the best in business growth, practice management, social media, marketing, networking, leadership, and moms more. If it’s about women in practice and business, you’ll hear it here. We hope you enjoy this week’s Facebook live event. Please like us on Facebook comment and share. We look forward to seeing all of you next week for another episode of empowering women in chiropractic. Now go ahead and hit the share button and tell your friends and colleagues about the show. Thank you for watching. Have a beautiful day. This has been a ChiroSecure production.

Please subscribe to our YouTube Channel (https://www.youtube.com/c/Chirosecure) Follow us on Instagram (https://www.instagram.com/chirosecure/), LinkedIn (https://www.linkedin.com/in/chiropracticmalpracticeins/) Periscope (https://www.pscp.tv/ChiroSecure). Twitter (https://twitter.com/ChiroSecure) If you have any questions about today’s show or want to know why ChiroSecure is still the fastest growing malpractice carrier for over 27 years, then call us at (866) 802-4476. or find out just how much you can save with ChiroSecure by visiting: https://www.chirosecure.com/quick-quotes/malpractice-quick-quote/.

The Coming Epidemic: Manifestations of Prenatal Stress – Monika Buerger

Click here to download the transcript.

Now here’s, today’s host

Dr. Monica Berger.

Hello everybody out there in Cairo Facebook land. And to those of you that are not chiropractors. Welcome to look to the children’s show. And again, thank you Kira secure for giving us this platform to get our message out and to keep educating the amazing chiropractic profession I wanted to bring to you today. Something that’s very near and dear to my heart and is so incredibly critical that we as professionals in the chiropractic around really need to understand this material. Whether you look at work with families and children at not, this is, um, information that we are going to be needed to be mindful of from here on out, given the paradigm that we are practicing in now and what is going on in the world and the COVID epidemic or pandemic the consequences of what we’re experiencing. Now, in addition to how the world was before this pandemic, the two combined are, um, essentially leading us up to what I’m referring to as a next epidemic.

And what I’m talking about is not a specific disease or diagnosis or label. It is the effects of prenatal stress. So again, whether you work with preconception care, prenatal care, um, pediatrics, if you work with anybody, this information, um, is a must know, and it’s extremely, extremely profound. So what I’m going to try to do is take you, um, set up a PowerPoint. You can see my slides. I’m going to take you kind of through a mini course, um, from prenatal stress and what that’s going to look like down the road or what that does look like down the road. This is information that is bast. It’s profound from the new world of neuroscience. I’m not making this up. I’m not overstating it. I’m not overexaggerating it. And if we look at, in the depths of neuroscience, this is this information that I’m going to talk to you about today is the foundation.

It is the basis for the neurobiology of disease. I want you to sit with this, the basis of the neurobiology of disease, physical disease, and especially mental disease, mental illnesses. So let’s dig in a little bit again, please, please pass this information on to all of our colleagues. This is such profound information that is, is going to set the foundation for generations to come. No joke here. So this paper came out a few weeks ago in regards to prenatal stress. And it specifically how moms are proceeding stress in this particular time look pretty much probably 99.9% of the global population is experiencing some kind of added stress due to the situation we’re in stress. Anxiety, anxiety has gone drastically up during this time. What does this mean for the pregnant mom? And what does this mean for the offspring? It’s huge pregnant moms right now.

This came out of, I believe Alberta, Canada, but what they showed is pregnant moms. Um, the prenatal period and the early weeks postnatally that they’re pre COVID stress levels would be reported about 15% in the current paradigm, their depression in regards to depression solely Precoa time, 15% current paradigm about 41% depression anxiety. Their prenatal reporting of anxiety is about 29%. And in the current paradigm is about 71%. These are the vast jumps in pre and pregnant mamas experience, depression and anxiety. Okay. They also looked at, which was very interesting is, um, exercise rates. Okay. Um, prenatal activity rates and about 65% of pregnant women report that their exercise levels has gone down during the COVID period. About 15% of said up at about 21% say it’s been staying stagnant. Okay. What does this mean? Why is it a big deal? Again, this information is hands down where, how we’re going to see generations to come.

The program that the premium programming that’s happening now in utero is bast and profound. We know from the neuroscience literature, that when a mom is stressed, the enzyme, the gene that works too as a barrier protective barrier to the fetus, keeping cortisol out of not being able to pass the placental barrier, that enzyme it’s called, um, hydroxy steroid dehydrogenase too. Don’t worry about the name of it. Bottom line is that enzyme is protective to the fetus and it doesn’t allow more than 15 to 20% of cortisol should not pass up the central barrier. More than that passes a placental barrier, a dynamic cascade of neurophysiological consequences. Cause that fetus is exposed to more cortisol, which is neurotoxic. This is very much associated with preterm birth and low birth weight with which those two factors in the world of neuroscience has been shown to be key in the neurobiology of disease, lifelong disease of offspring, especially mental health and a lot of cardiovascular. Okay. So we need to minimize the stress. Bottom line is we needed to minimize the stress on those mamas.

Um, low protein levels also, um, will inhibit that enzyme. The enzyme needs good proteins to work, um, and, uh, B3, niacin my moral, my story for this lecture or for this presentation, I wanted you to understand that wow, stress is altering fetal development. And one is by cortisol, excess cortisol exposure. That is very neurotoxic. So we need to have these mamas under care to help regulate that stress of which we’ll talk about when we finished it at the end of this little presentation, but I want you to understand that prenatal insults maternal stress is one of the biggest ones, psychosocial stress, psychosocial stress is stressors. We all have, especially these days, right? Worried about your job, paying the bills and going out in public. Just those dynamics that pregnant mamas have extra psychosocial stressors that they report that is the fear of giving birth. The concern about being birthed that is magnified in this particular crisis.

We’re under, are they going to be allowed to have a birth partner in the room or not? They’re having to mask the whole time in why they’re in the hospital. Are they going to be separated from the baby? All these extra things. The number one psychosocial stressors that, um, pregnant mamas report is, or pregnant couples report is giving birth to an offspring with, um, developmental challenges. So they have these extra stressors happening. All right, we know that these premial stressors are leading to, to circuit, uh, developmental circuit changes in the brain, prefrontal cortex, amid Dilla, hippocampus, incredibly profound connections, especially between the limbic system and the frontal lobe, which we know from neuroscience, that connection or that misfire, that misconnection between the limbic system and the prefrontal lobe is the basis of mental illness. Okay. This is from the medical literature. And of course, then we’ll get the labels as a result of this at this prenatal stress.

Now we get the labels down the road, add ADHD, autism, et cetera. So it’s really kind of works like this. We use it, it used to be referred to as a two hit model. Now they’re looking at it as a three hit model. We have genetic factors, which actually are epigenetic factors. Okay? So we have these epigenetic loads that are vast right now hit number two is prenatal stressors, psychosocial stressors, depression, anxiety, everything that is up ramped right now with, I mean, globally, the third head is a subsequent hit that can happen up to 20 years later that finally tips the scales. And this is really the basis of most mental illnesses and individuals in mental institutions. And whether it’s a viral load that is especially if, if mama right now has had, COVID why she’s pregnant. That is a viral load that’s that fetus is exposed to.

So we have stress. It leads to enhanced cortisol, passing the placental barrier neurotoxic insult on the developing fetus and the developing nervous system, other genetic predispositions. And now down the road, another key hit can happen. It can be anything, it can be viral, come back bacterial. It can be from inoculations. It can be a poor bonding with mom and dad, whatever. So we know that prenatal stress also alters the microbiome. The mom, I’m just going to brief over this, but this is incredibly incredibly important for us to understand for supportive measures from mama during pregnancy. So a couple of key strains of bacteria have been known to be altered or, or, um, deficient in pregnant mamas under stress. And these particular strains are also coincide with supportive measures, four key areas, the brain like the Olympic system and the frontal lobe. So more of the story is stress wipes out the microbiome wipes out, excuse me, these critical bacteria, which all can alter function of these key areas of the brain.

Okay. Lactobacillus, rhamnosus, and material to those strains abberant um, or, um, deficient microbiome of mom leads to a deficient microbiome of the vaginal microbiome. So next moral the store on next golden Pearl, it doesn’t matter. A lot of people are concerned about, um, seeding of the microbiome or giving probiotics. If a baby is born via a Syrian section, because they say, well, baby, didn’t get a exposure to mom’s bathroom, microbiome. Hello, newsflash. If Michael biome of mom is poor vaginal microbiome, mom is going to be poor, whether they were born vaginally or not, they could still have a dysbiotic offering. The baby can not have a optimal microbiome, even if they’re born vaginally. So we may still need to help support that after birth, because we know a dysbiotic a, a, a non-sufficient microbiome, well also alter, um, an absorption of key nutrients. And these key nutrients are going to be imperative for metabolic function for metabolic demands on the developing brain.

So stress equals altered. Maybe pre stress is very much related to preterm birth and low birth weight altered microbiome of mom altered vaginal biome of mom altered microbiome, but baby lack of absorption of key nutrients needed for metabolic development, metabolic support of the developing brain key structures of the brain. So we have stress or infectious load. It earned again, it, it alters the maternal microbiome. It alters the microbiome, the baby. It is shown in neuroscience that this will change the trajectory of neurodevelopment of the baby. However, early intervention measures chiropractic care. For sure, especially during the prenatal period, trying to deescalate the stress load on that pregnant mom, deescalation of stress on mama is deescalation of stress on the fetus equals a more optimal chance of neurodevelopment.

When we look at fetal development, we have to look at autonomic nervous system development and bagel tone development, which that critical window of neuro-development is in the end, the second, and into the entire third trimester of birth, absolutely even more critical weeks, 35 on what we’re seeing in this COVID world is an increase of C-sections. Whether that’s because of stress or not, um, an increase around 37 weeks, this is a critical, critical message because we also know that the microbiome of baby, um, if deliberate, if, if born before 37 weeks, um, has a higher chance of what we call this necrotizing enterocolitis, okay. Inflammation in the gut, which is going to be another, um, another factor in their neurodevelopmental trajectory. This is bagel tone. Um, so prenatal stress lowers, heart rate variability and mom and baby mom and baby, which this equals abberant, um, development of the ans autonomic nervous system and bagel tone decreases the function of a culinary trick anti-inflammatory pathway. That is Vegas that’s bagels, baby, that’s his pathway call energetic anti-inflammatory call energetic anti-inflammatory pathway. This is the big kahuna to downregulate inflammation and upregulate the immune system.

When this is down-regulated this thing called zonulin, that that functions it, uh, it controls the, the tight junctions in the gut. Not allowing them to say open and end up with a leaky gut or gut permeability. So you see the, see the picture I’m painting right now. This is incredibly important to understand, because this is the basis of neurodevelopment. We also know that heart rate, variability, vehicle tone, and mom, the baby’s going to mimic the big tone of the mom. Baby is going to be born. It’s called fetal programming with mom’s stress response. The way mom is perceiving her environment, perceiving her stress and adapting, neurally, adapting. We all talk in our, in the chiropractic profession about neural adaptation. The nervous system has to adapt to our stressors the way that mom is perceiving her stress, her environment, and the way she’s responding to it will be Feedly programmed that fetus and that offspring will adopt her stress reactions and her stress patterns. And that will alter their vehicle tone, their heart rate variability and their ability to distress it, to adapt, to stress their ability, to calm their ability to digest their ability to be an eLearning Grossberg. So we also know that prenatal stress is, um, very much so tied to a neuromuscular development.

So it is tied to, um, sensory modulation, how they perceive their world through the 10 sensory systems, sight smell, sound, touch taste from the outside world and our inner interoceptive inner sensations, which are the Stabler proprioceptive, um, sensations coming from the viscera from the immune system, the immune cells and from the microbiome. So all of these can be dysregulated average, sensory modulation or input to the CNS is going to lead to Averitt, neuromuscular output pre and neuromuscular output. Motor output will then alter sensory input. It’s a loop, but we also see that prenatal stress is very much associated with neuromuscular tone and neuromuscular development in the offspring neural muscle motor tone, motor motor control core pastoral control is associated with things like asthma allergies, dyslexia, ADHD, scoliosis.

So what happens prenatally and how that fetus is preprogrammed by mom’s stress response, and mind you that study. I decided that we just got in regards to the COVID crisis, a vast increase in reported depression and anxiety in pregnant mamas. They also reported lower exercise about 65% reported decrease in their exercise regime. We also know from neuroscience literature, that prenatal exercise during the prenatal period enhances a vagal tone in the offspring. So if you look at the entire picture, that dynamic what’s happening right now, we must be mindful. We must be knowledgeable. We must be educated at a little higher level because what we’re going to see downstream, it may be two years in these offspring. It may be in six months, it may be in their twenties. It may be when they start to go to school and they get slapped with the label of ADHD. Cause they can’t sit still because they have poor postural tone. We must understand that what we lay the foundation of as now is going to have a profound effect on generations to come. And we got, we need to be able to acknowledge it to, to be recognized these red flags in practice.

We, we look at. So if you have an older child coming in, you need, you should look at the history. When were they born? What time period, what was the prenatal stress exposure, but also be mindful that if you’re seeing pregnant women, right during this time period, neuroscience research also shows that even if, when, when these stressors have been resolved, they’ve done a lot of work looking at, um, disasters and, and the, the am longterm effects on offspring during Nat, during when moms are experiencing national disaster, like, um, earthquakes, like even the Holocaust, like, um, one big one is called project ice storm. It was regarding an ice storm up at Canada. And the stress that prenatal stress on mom was then, um, nine 11, all these hallmark disasters, floods. They looked at the implications on the ops spring, and they all show a, uh, uh, post traumatic stress disorder, response, higher anxiety, higher depression levels, um, cardio increased risk of cardiovascular disease.

Even if the mom conceived two years after that disaster had dissipated. So my message to you is we need to be mindful of the potential that we’re going to see down the road, preterm natal, prenatal stress, higher risk of preterm births, um, or assisted bursts higher. I’m getting pinged on social media all the time about, um, increased risk of breach presentations. That’s going to happen. Breach presentations, um, are, can be, there’s a tie between thyroid dysfunction and the mom and a breech presentation. When mom is under all the stress and the adrenals are compromised. It’s going to compromise the thyroid. You can’t stabilize a thyroid unless you stabilize adrenal function. So it stands to reason we’re going to see more of these breech presentations. Plus mom is much more physiologically, stressed out, much more tense. Um, so we may see more assisted birth, more [inaudible] section, which we’re tending to see on babies being delivered during this Cub of time.

Um, more assisted deliveries. Maybe I have not that statistic yet in regards to, um, section of forceps, but these all play a huge role in the trajectory of neural development down the road. We’re going to see more. We’re ready. We ready before this cupboard crisis have seen a vast increase in babies presenting with more agitation, colic difficulty with feeding difficulties sleeping. This is the pattern you’re going to start seeing more and more of. Then we lead because their, their nervous system is so tapped out and their immune system is compromised. They can’t nearly adapt increased in infectious load, higher risk of chance of antibiotics early in life. One dose of antibiotics wipes up the microbiome for life. It alters the microbiome for life. It can never reestablish back to its original microbiome. After one dose of antibiotics, we may see hyper or hypo more chances of hypo muscle tone because of the neural muscular, um, mal adaptive development, more developmental motor delays, um, or development delays in general.

And this is going to up even more. So our rates of labels of autism add ADHD, oppositional defiant disorder, developmental coordination disorder, whatever label you want to put forth. So my message to you is early intervention chiropractic care is going to be incredibly important for pregnant mom and that baby. But remember, they’re going to be born into this world are ready with difficulty in neuro adaptation. Less is more for these little fiddle farts children that are born and they’re stressed and they’re colicky and they’re hard to console and so forth. It’s harder to bond. And that, that leads to a less maturation of the social engagement portion of the Vegas. Another story for another time, the microbiome, I understand that many of you may not be comfortable or may not wish to venture in supporting the microbiome, but I can tell you that this is absolutely a critical key, important point that you need to understand.

And if you don’t feel comfortable, maybe reach out to a colleague that feels comfortable helping support that microbiome. The adjustment’s going to do that, but in this day and age, we need to look bigger and deeper. I know we need to understand how to foster optimal sensory motor development, get yourself in a program, take classes, but we need to be able to recognize these red flags because the sooner we can intervene, the better the chances for that little fiddle fart, longterm. And again, I thank you. You know, when we should start thinking about how we’re going to articulate our message, going forward from a pain based, you know, to a brain based model. And hopefully this information helps give you some, some nuggets to think about and to investigate and to further study and learn and understand because we are going to need this information and we’re going to need to get this out to the world because this crisis has changed generations to come that have not even been born yet.

Um, so I’ll leave you with sit with that. Um, here is there’s. I have many classes that you can go to and I have one and one coming soon just on the effects of prenatal stress and what we need to think about. So I’m going to close with that, with that said again, thank you Kira secure for being an amazing vehicle for us to get this information out and more than ever, we are needed, um, to guide the world and help in truth and knowledge and education of how we can change the trajectory for generations to come. Um, I will see you next month with an incredible surprise, amazing guests, um, and you can be with dr. Eric Kowalski the first Thursday of August until then keeping amazing and keep being out there and changing lives.

Empowering Women in Chiropractic – Digital Marketing Trends & Tactics – F4CP – Dr. Sherry McAllister

Click here for a copy of the transcript.

Welcome to ChiroSecure’s Facebook Live. I’m absolutely delighted to have you join me. I’m Dr. Sherry McAllister, the executive vice president of the Foundation for Chiropractic Progress. We’ve got a great topic for you. This is going to focus on digital marketing trends and tactics. Why is that important? Well, hold onto your seat. Let me explain why, and some awesome opportunity for you to really get to know more about the digital trends.

But as usual, before we get started, we have to thank our fantastic corporate sponsors. Because as always, they’re the reason that we’re able to do presentations like this, be able to market the benefits of chiropractic care around the nation and in your community, to help you prosper and showcase that you’re the expert in spinal health and wellness. So let’s get started. Great stuff today. Thank you, ChiroSecure for always sponsoring our Facebook Lives.

Now, what are we going to cover today? We’re going to have some fun. We’re going to review the ins and outs of digital marketing. Don’t be afraid. This is all about really getting personal. We’re going to get personal with our marketing today. We’re going to tell you what that really means, and why it’s important, the latest trends and tactics you can pick up and utilize in your practice, as well as the latest and greatest foundation for chiropractic updates that we want to share with you.

Now, as we get through, remember I just said, we’re going to be talking about personalization, and what does that look like? So with digital marketing, as I showed you here, our overview is now going to begin.

So according to HubSpot, digital marketing encompasses all marketing efforts that use an electronic device or the internet. Businesses leverage digital channels, such as search engines, social media, and email, and other websites, to connect with current or prospective customers.

As we talked about, personalization. Remember that a person’s name is, to that person, the sweetest and most important sound in any language. The key to this quote is that by personalizing your digital marketing, you are winning friends and influencing people. Thank you, Dale Carnegie, for the inspiration that still holds true today. In fact, in today’s world, personalization moves beyond the first name. Giants like Amazon, Target, Netflix, Nike, and Spotify have data and analytics to develop a highly-customized experience, where they’re giving relevant messages at the right time, and consumers love it.

Personalization is the future of digital marketing. In fact, one study showed that 79% of consumers feel frustrated if the content they are viewing isn’t tailored to them. By 2021, we anticipate a significant increase in fully-personalized websites beyond first name personalization.

Chat bots. What’s a chat bot? Hang in there with me. Chat bots communicate naturally with people viewing our site, and can answer questions in real time. The Foundation has a chat bot set up on our Facebook page, thanks to the support and guidance of ChiroSecure’s marketing guru, Dr. Alan Weinstein.

Here’s a snapshot of an example. When you visit the Foundation page and reach out via messenger, you receive the welcome message. You have the option to pick what you’re interested in, and this allows the Foundation team just a little more time to respond back to the user, without making them wait too long. It also allows the user to know their message was received, and can either provide the feedback they are looking for directly, such as membership information, or if it’s a more in-depth question, we can tackle it manually on our end.

Most chat bots are implemented on websites, and automatically pop up when a user visits your page. Chat bots are another means to providing a personalization of digital marketing services, in allowing your patients, or your audience, to get their questions answered quickly.

Now we also have Facebook autoresponders. This is another tool you can implement today on your practice Facebook page. The Facebook autoresponder message, using the link on the slide, and you’ll see it down there on the bottom, you can access the how-to guide to set it up on your screen. Facebook autoresponders is a simple, easy to use personalization, and it’s much like a chat bot, that it responds to users reaching out. With this you can incorporate a standard message that the user receives, even if you’re not around. That’s the best part.

For example, many practices set up the Facebook autoresponder with a message that says, “Thank you for your message. If this is urgent, please contact the practice directly.” And you leave your phone number. Many receive several messages each week with people just wanting to check in, or schedule an appointment by sending a Facebook message.

A busy practice may not be checking their Facebook throughout the day, but if you have the autoresponder set up, your users will feel the reassurance that their message was received, and then direct them to the appropriate needs. It also allows you and your staff time to review the messages and respond as needed.

Content creation. Listen, content is king. Content creation is a big piece of digital marketing. In order to boost your SEO, and reach your target audiences digitally, you need to have your content on your website, email marketing to your members, and their patients, as well as on social media. When you are a member of the Foundation, we provide you with a constant stream of relevant, timely content, for you to share with your patients, so they can build their digital footprint as well.

What about analytics? Well, everything at the Foundation we do is test and measure. By tracking your digital marketing campaigns and reviewing your analytics, you can get a sense of what your audience demands in the future. The Foundation uses Google Analytics to track our website downloads, views, and open rates for our content.

As for email marketing, we use Constant Contact, where we can track the analytics of our open and click-through rates. This actually allows us the opportunity to see what content works best for our members, and spend more time in our digital marketing in these areas.

We really care about our members, and we want you to feel confident in your community, that you’re being able to represent, as an expert, to your patients, with quality content and research, so they feel confident they’re coming to the right chiropractor. And you and I both know, it is a sense of security for them, when they’re getting constant information.

Now speaking of constant information, let’s go to SEO. What does SEO stand for? Search engine optimization. Now I’ve mentioned this a couple times, but here’s one definition of SEO. It’s the practice of increasing the quantity and quality of traffic to your website through organic search engine results. This refers to techniques that help your website rank higher in search engine result pages, like Google, or Bing for example. Being conscious of websites, SEO is important, because the techniques involved with SEO are constantly changing, due to search algorithms.

To ensure your website is optimized fully for users to find you online, we actually recommend that you work with your web provider to incorporate keywords and meta descriptions to boost your ranking, and to keep this top of mind.

Speaking of top of mind, while SEO may be difficult to navigate, we put together a how-to guide on the four ways to improve SEO through content marketing. The link to download this guide is on the bottom of the slide. And this will walk you through easy ways that can help you boost your visibility online.

Now while you’re online, we want you to also understand artificial intelligence. The name artificial intelligence or AI is exactly how it sounds. It refers to robots or machines having the ability to work like humans. AI uses a combination of different features, such as chat bots and voice assistants to quickly find answers.

Now for instance, Alexa and Siri are voice assistants that provide excellent customer service, just like a human. They could take orders from the users, and work behind the scenes on your behalf. Voice-powered assistants and search options, such as Google, Alexa and Siri, are useful in digital marketing. Voice assistants can search for things, read text loudly, and even voice dictate text messages for you, so that you can be hands-free. Searching using these voice assistants can also be helpful in business and adding to local SEO. Voice search also boosts the use of artificial intelligence, and prioritizes the searches involved.

Transparency. Research indicates that companies producing transparent and easy-to-digest information are likely to retain 94% of their consumers. That means that if we’re actually being transparent and finding easy-to-use material, such as the Foundation for Chiropractic Progress’ materials, that’s going to boost and retain 94% of your online patients. Exciting news.

Now in order to improve your patient’s transparency, you also need to establish your company’s core values. What is it about your company that you stand for, or your practice? So we want it to be like an open book to patients. Tell them as much as you can about who you are, and the business you provide. Also, if a patient reaches out, try to respond immediately. That boosts their confidence level in your practice.

Provide your patients with the opportunity to offer constructive criticism, so you’re encouraging them to give different suggestions, to help improve your brand. Actually by facilitating a community around your brand and making the communication a two-way street, in a very friendly, nonjudgmental tone, you are well on your way to building transparency amongst your audience, that being your patients.

Now I want to share with you some very exciting F4CP Updates, because our members mean everything to us. Yes, we have SEO. Yes, we’re trying to get transparency going. Yes, we have chat bots, all of these tools and trends that are so important. But let’s be honest. If a patient can’t read quality material, they’re not going to have the confidence in chiropractic, whether it’s your office, or the profession in general. So we are currently in a pandemic, and we need to recognize that the most important thing we can do for our patients right now is reach out to them in this pandemic environment, and make them feel secure, that they can reenter safely through all of the means that we put into play.

And so I want to share with you some of these updates that I think will be very helpful, for you to really give back and connect with your patients, starting with mind, body, spirit. Align with our Enhance Your Health campaign through chiropractic care by using this eBook. The eBook is titled Complete Health Includes Mind, Body and Spirit, which highlights ways in which you can enhance their health, the patient’s health, especially now during this pandemic, from stress management, inadequate sleep, to the obvious chiropractic care. This eBook is going to walk the reader through steps they can take to optimize their health.

I’ve included the link on the slide. So please, feel free to share it, with this new resource with your patients, and the community at large. I know it will be deeply appreciated in stressful times like now.

Now we also have a Recovery Roadmap. Thanks to Breakthrough Coaching, we now have this Recovery Roadmap for your reference, that provides the how-tos for rebounding your practice from COVID-19. From temperature-taking, to hygiene, to handling visitors, and reopening with furloughed employees. This roadmap walks you through how to return to a semi-normal state, with new protocols in place, for a happy and healthy environment.

Remember, they’re coming back to you because their health is now top of mind. We want to keep them aware. We want to keep building on the benefits of chiropractic care as they see it now, in a completely new healthcare environment.

COVID-19. Working with the Foundation’s corporate sponsors, we’ve gathered our COVID-19 related materials, and we’ve put them together to help our doctors. And we sent out a second email with the updated resources. And you’ll see that there’s a link below. And that link is going to help you get the latest, greatest information in regards to our toolkits, our webinars, our videos, and new research about COVID and chiropractic practices, as well as opportunities to receive personal protective equipment, tips for running your practice during the outbreak, and free email marketing systems for use. There is a wealth of knowledge included within this email from the proud corporate sponsors of the Foundation for Chiropractic Progress, as well as enhancing your health through chiropractic care resources that will be included.

I want to thank you so much for joining us today. We are all in it together. This is a new era of healthcare, and the Foundation wants to partner with you synergistically to reach your patients with the highest quality, and to showcase the benefits of chiropractic care.

Don’t forget, as always, next week is another ChiroSecure Facebook Live Group. Join them back here next week. I will join you on August 18th for another Facebook Live with the Foundation for Chiropractic Progress. And I hope you will join me back here again. Thanks for your time. Have a fantastic week.

Please subscribe to our YouTube Channel (https://www.youtube.com/c/Chirosecure) Follow us on Instagram (https://www.instagram.com/chirosecure/), LinkedIn (https://www.linkedin.com/in/chiropracticmalpracticeins/) Periscope (https://www.pscp.tv/ChiroSecure). Twitter (https://twitter.com/ChiroSecure) If you have any questions about today’s show or want to know why ChiroSecure is still the fastest growing malpractice carrier for over 27 years, then call us at (866) 802-4476. or find out just how much you can save with ChiroSecure by visiting: https://www.chirosecure.com/quick-quotes/malpractice-quick-quote/.