Empowering Women in Chiropractic – Playing the Compliant Discounting Game

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As we jump into those slides together, uh, we’re going to be able to see what we’re going to be working on. It’s your vet from games, university. So glad to see you. And as I stated, we’re going to be playing around with the complaint discounting game today. Sometimes it’s a little bit difficult to know exactly what you’re going to do, and we’re going to get started with those slides so that we can get moving quickly. As you know, I try to keep it power packed and moving fast as we go. So as we start the slides now, uh, we’re going to be able to move along and get those things underway. Are you ready? Welcome to 2021. So today, while we’re talking, we’re going to discover how we can do legal discounting options. So many times here at KMC university is I’m bringing in clients who are coaching my own clients or just doing consultations.

Overall. We noticed a lot of issues in the way that people are discounting, even with some of their compliant coupon offers that they think they have, just because someone told you to do it and they’re getting by with it down the street doesn’t necessarily make it okay. We always need to verify those things, make sure that they dot all the I’s cross all the T’s as far as any federal regulations, any type of other things may be going. So always want to make sure we have that in place. We’re going to also recognize where you may have some inconsistencies in your patient fee schedules learn how to properly implement some hardship agreements in your office and men. It may be appropriate to use something more like a professional courtesy policy. So again, these are the things that we’ll be covering today. Um, as we move into the rest of our slides and I do walk them, you, I do appreciate Carver secure giving me these opportunities to speak to you and coming to you again from KMC university.

So as we talk about this one person said, very famous person said, your fee is your fee is your fee. And you know, with real estate it’s location, location, location, but when it comes to having compliant fee systems in your office, it is your fee is your fee is your fee. And we want to always make sure that we’re abiding by those rules dotting our I’s again, crossing those T’s just so we can be compliant rest at night. Don’t worry about the fee police to come get you and say, Oh, that’s wrong. And we’ll figure out who some of those players may be. And then we need to figure out where are the discounts coming from? So we’ll have some that are imposed that are like some of our regulated contracted. And then we may have some of those that are a little bit more elective in nature.

And we’ll talk about those. So we’ll get a clear understanding about that as we go along today. So as we continue to move forward, I’ve kind of wanted to start with some of the dangers and pitfalls that you could fall into. If your fees are not compliant in your clinic. So oftentimes we’ll see inducement violations. We’re not necessarily doing it to induce some may be, but we’re not necessarily doing some of our practices to induce, but it’s what necessarily our intention was. It’s what the perception is by those governing entities. Many times, anytime we have an issue in our fees or any other area with our billing, it’s no balls into the next area of false claims act. Nobody can afford these things. Number one, you don’t want to have recoupments number two, you don’t want to have any issues with, um, what you’re going to be noticing.

Um, when you’re sending over to a pair and they’re saying that’s inappropriate, or we’re going to find out somebody else who’s playing some really dirty tricks lately. Um, as we go along and then the anti-kickback violations, we need to make sure these are not being identified with our office. And we’re going to learn how to safeguard that as we go along. So Medicare vocabulary goes inducement and remuneration. So when we’re talking about that inducement, that’s influencing someone to come in and, uh, maybe giving away something for free. That’s, uh, maybe higher than the value that’s allowed or we’re giving away discounts through our waiving of copays deductibles and things like that. You may not give any item or service away that exceeds $15 or $75 aggregate, um, to a Medicare patient. This really falls over into federally funded patients. And what happens is when it falls over here, generally, you’re finding a lot of the payers piggybacking on this and saying, Hey, you know, we can’t do this for, uh, for our patients either, or our patients.

You need to have fraud, waste and abuse in place because you’re dealing with us. Everybody’s moving to this model. But right now we know that there are penalties imposed from federal entities when we do inducements and the remunerations waiving copays and things like that. So it’s in the regulation. We have the, the patient solicitation, anti inducement provisions. You can see it here on the screen, someone who’s offering or transferring to a Medicare and Medicaid beneficiary, any remuneration that the person knows should or would likely influence their decision to come in. This is applicable to Medicare and Medicaid. We know that VA, uh, moves over into that and we have some other programs and you’re talking about the affordable care act. And some of those things, you gotta be very, very careful. And why said you can’t afford it? Look at the bottom sentence. It says up to a $10,000 penalty for each wrong for act.

Oh, all right, well, let’s get it stopped. Now. We can’t afford to be over here in playing in the non-compliant game. You know, where it’s like playing Stratego, we’re playing chess. We got to move our pieces just right. We can still get to the other side and win what we want to win, but we avoid being captured and avoid the bomb when you’re playing Stratego. And we just want to make sure that we’re matching the right places together. And we’re still moving towards our goal of being profitable, getting our patients in the door and not scaring them off. So as we go ahead and move to our next slide, we’re going to talk about again a little bit more about that remuneration. We’re going to waive your copay. I had a local dentist, um, asked me several years ago when I was working in the local clinic.

He said, what my office thought we’ll do is we’ll have a doctor or even our staff members get treated. We’ll submit it to their insurance, just to help them meet the deductible. And I’m asking you to do that for me. I know you do a write off for doctors and, but I want you to submit it because I know you’re going to write it off. And, um, I want that way. It’ll help me meet my deductible. It’s not going to hurt you guys. I’ll still pay the bill. Uh, he did not like my fight back. I said, I can’t do that. I can not waive your deductible or copay. I don’t have any financial, uh, hardship in place or anything saying that this is okay for you. And he got a little Tifft. He said, I do it at my office. I can’t help what you do at your office.

We can see it’s usually way well laid out, especially in our federal programs, but we can also find it in our commercial programs. So always be sure that you’re just, again, dotting I’s and crossing T’s that we’re playing our chess pieces or our Stratego pieces. Right? And we’re being a little bit more intuitive where those bombs may be laying there waiting to capture us. So we’ve got to be so careful. We had a poor guy, all the one chiropractic. He was in Iowa. And this is out. We’re not, this is not something we’re displaying of one of our clients. This was something published. You can go find it on the department of justice website. Yourself probably could do it through the Google search of any type of search engine would bring this up. But while he was doing, he’s like, Oh, my poor Medicare patients.

They can’t afford a STEM. I hear this all the time. I’m not joking. I am not kidding you one bit. I hear it constantly. Well, they can’t afford it. Medicare doesn’t cover it anyways. Why does it matter? All I have to do is pull this up on the screen and say, this is why it matters. They feel, even though your intent was to help them out, they feel your intent was to influence them to come to your office because maybe Dr. So-and-so down the street is an offering that, but you’re sitting here going, yeah, Yvette, the doctor so-and-so down the street is offering that. I’ve never talked to them. I don’t know what’s going on there. And we can’t help if they’re doing it wrong, it doesn’t make their wrong BR right. So we’ve always got to be careful, but this poor guy in his innocence and just trying to be nice, ended up with the $79,919, uh, payback that he had to do.

And you can see there after the highlighting, it hit the anti-kickback statute. And the false claims act happened between. And look at that span of time, they looked at, they looked at a long span of time. You can pull it up and read a little bit more. But, uh, the thing is, is that you’ve just got to be so careful. And as you know, the old saying goes, don’t let your good be evil spoken of always make sure that if you’re going to do good, you can do the good or you find the legal way to do the good. And we’ll talk about that. So the biggest thing that this member rev represents is that we want to avoid dual fee schedules altogether. This is not something that you want to have in your clinic. And I’m going to just kind of hit the nail on the head here in a minute.

When I tell you why a with somebody you’re not expecting it to be somebody playing tricks, I told you earlier, they’re playing these crazy tricks on everybody, but we want to figure out what is the dual fee schedule, because it can misrepresent charges to a carrier. I had the pleasure to do an onsite back in October, we talked about it a couple of times, since I was here, they were just having the patients pay $55 here. I’ll take your credit card right here, $55. And they were billing the insurance company 150 I’m like, how did you know that was their co-insurance their copay? Oh, well, we just do it. Uh, we’re out of network. I just sat back. And I said, well, that will stop. It has to stop. Now we have to clean this up. And, uh, needless to say, they’re probably one of the top producers with one of the medical discount plans.

I’m going to talk about here in a little bit, because we got that straightened out for them. Again, false claim act violations. And then it may very well violate your provider agreements. Think about it. You know, we’ve got blue cross patient Lang here and blue cross representative behind him, PI patient here, PI representative behind them, cash, patient, ear cash, patient behind them. Everybody has the same thing. Everybody goes to the front desk together. You will bill your insurance. Two 50 we’ll bill you two 50 and that’ll just be 50 today. Same service don’t work it. And very well may violate your provider agreements, but keep watching here. It is the PAI complex. I cannot stress with you how much this is happening. We had one of our members call him the other day. What do we do? Oh Lord, what do we do? Well, we’re like, well, first may we do a consultation with you to see if we can get this worked out together, figure out what you did, figure out what needs to be cleaned up and what we need to stop.

And we looked at it and what had happened is they had Geico, give them a call and say, I don’t have insurance. I was just calling to figure out if you have a cash break for your patients. Oh yes. If you don’t have insurance, your visit will only be blocked. Next check. That’s what they send. And guess what? They reported them. They reported them for having a fee schedule that they were giving to cash patients that they weren’t giving to them. There was no legal reason. So everybody starts with the same fee. There was no justifiable legal reason on that next line for a deduction that said they should get something. There was nothing regulating it, nothing contracting it. They were just giving it because that’s the way they do their cash patients. Well, state, farm, and Geico doesn’t understand why that doesn’t pass along.

So we ended up having some pretty major issues. There got to clean it up, got to write some policy. Luckily we were able to work on it a little bit creatively with them. Uh, obviously some reeducation of the staff up front at the front desk and how they’ll answer the phone needs to take place. But overall, their feast systems need space systems needed to become compliant. So we talked a little bit about those impose discounts, the ones you can’t do anything about. You signed the dotted line, you get the dog and pony show that comes along with it. So those are the regulated, which is more like your Medicare, your worker’s comp, some personal injury, no fall and Medicaid. Can’t do anything about it. It is what it is now. Your workers’ comp and personal injury. Mainly your personal injury can differ from state to state.

Sometimes you can expect your full, uh, reimbursement of whatever your charge is. Other times you’re going to be part of some type of regulated or some type of contracted because you’ve got a silent PPO or maybe they’re pigging backing on some other type of pair. Then we have those contracted discounts, which are, I signed the dotted line because I want to be a provider with blue cross. I signed the dotted line because I want to be a provider with Aetna. This payer, that payer, these are those you can avoid. These are the conundrums you can get into, especially when you have those per diem payers that say I’ll pay you $65 a visit, no matter what you do. We have people all the time trying to circumvent that we’re like, Hmm, go back first, read your EOB. Did it tell you it can go to patient responsibility.

Now, go back and read your contract. Look at your medical review policies. Make sure that you know, what you’re doing is appropriate. This is why you can’t take your fees lightly in your clinic. They have to be every I dotted and every T crossed in order to be compliant and be most profitable. I think when you’re looking at impose discounts, one of the most profitable things you can do for your office is one take the services that you do and find out does that payer exclude them. Aetna has a very long list of CMT services. They consider experimental and investigational. Are you on that list? Does it even make sense to go in is everything you do on that list of experimental and investigational that’s one step. The next is if they won’t give you your fee schedule or a fee schedule prior to enrolling with them, ask a peer down the street, Hey, what does it look like for the fee schedule for this insurance company?

Know what it costs for you to be profitable in your clinic, and then gauge if you can go in before you sign the dotted line. Because remember once we signed the dotted line, we are now either regulated, contracted with an imposed discount. Can’t do anything about it. So you get out and with Medicare, we know you can’t get out how to give that commercial one more time. So that relationship with the payer and network, it really starts here. The doctor joins the payer, the patient pays the premium. They have an insurance card, you have this type of agreement. Everything comes back to the central hub of that payer and that network telling you what you can charge. That relationship is between the provider in the patient. But again, a lot of times we’re relying upon that and that requires the enrollment of the doctor and, and the enrollment of the patient into that plan.

So again, this is going to be part of your imposed, contracted, regulated, uh, type of discounting. That’ll go on. So we’ll skip over to the next part, which everybody’s probably wondering why are you taking so stinking long to get to this part about it? I need to know how I can do discounts. You told me what I can avoid. Now tell me what I can do, because now that you scare me to death, I need a way to deal with these patients that are cash, or maybe don’t have a great insurance plan. Maybe don’t want to use their insurance plan. Maybe have limited benefits. So let’s go there together. There really are. There really is one fee in your office that is if your spinal CMT for a nine, eight, nine, four, one is 55, then it’s 55. Then it’s 55 and it’s 55 next payer.

It’s 55. Everybody starts at the same level. Now the next line down. Why? Why is it not 55? Tell me why it’s not well, because it’s regulated. Okay, great. Well, because it’s contracted great. Well, because they’re a cash, they’re a cash patient. Okay. Can we talk about that cash patient for a moment? How large is that discount with discount by half, sometimes 75% wrong answer. We’ve got to make sure that’s within spec. Although the federal government has some rules that we believe are five to 15% on a time of service discount. Do you know that your state or your payers may have something to say, but again, we’ve got the actual fee next line down. Why shouldn’t they pay that fee? And we’ve always got to make sure we have checked with every entity that we’re doing that appropriately. So again, the discounts go imposed an elective.

We’re on the elective side. Now these are the ones that are at your discretion that you decide to implement in your clinic. As we move down, we’ll go the other direction. We can see that those are elective fees could be your five to 15% time of service savings, financial hardship, professional courtesy, or maybe your discount, medical plan participation, something like Cairo health USA to where they are set up in most States, I believe the only state is Washington, where they’re not in where you can offer your patients a compliant discount, go to bed at night and know you did it right? Setting up your own fees in your office. So even though it may fall in kind of that contract land, it’s your fees that you picked. We already know insurance. Isn’t going to pay you your full fee. You’re not going to chase your tail with this cash patient.

Why not give them a little bit of a discount? Uh, so they don’t have to pay you 565. Maybe they pay you 200. Plus the joining fee to Cairo health, which covers them and all their dependents for an entire year. It’s crazy. It’s like Costco or Sam’s, but these are the elective discounts that you can do, but you have to do them right again, dot the I’s and cross the T’s. So again, actual fees, discounted fees, or where are we going to focus our attention? And here are four possible fee structures that will help you pass the muster. When it comes to doing this compliantly one charge your actual fee. My fee is my fee is my fee. And if you’re cash, that’s my fee. That’s my fee. Absolutely. You charge it to the insurance company. They come back and say, write it off. You write it off.

Everybody going out the door gets charged the same. That is super compliant, no issues. Everybody pays your actual fee. You’re not discounting. You could charge a reasonable time of service of five to 15% for your federally funded patients. Always make sure to see if your state has a more strict role. Whichever is most strict rule, real rule and be the one that you’ll have to implement for your office. But when you find the state may be more lenient that may apply towards those outside those federal programs. So charge a reasonable time of service discount. Five, 15%. For me personally, I would not want to think about this as federal. You get 15, this is you. You get there. I would pull out my hair. I would either do five to 15 based on my bookkeeping savings and or do something like Kira health. Make it simple.

Don’t complicate it for your patients. We’re already in uncertain times with money and they don’t want somebody feeling like they’re jacking around with their money. They want to know this is what it is or this is what it is. You can pay our full fee. You can join this discount medical plan, and this is what your fee will be. Which one would you like? Let them make the choice, give them a choice. You could use a network-based legally discounted fee of choice ups, Kira health. And then you have those legal options with the hardship indigents policies for those patients who qualify. And I did say qualified. So these are the ones we’ll look at Cairo health, a little bit hardship, professional, and then billing for family members. I’m not going to cover a slide specifically on billing for family members. I just want to cover it verbally with you today.

Please know that with Medicare and many payers, they restrict you from billing, your immediate family members, and they do give you a list of what that is defined as they saved your mother, your father, brother, sister. And they go on. It’s a list probably if you’re looking at the page about that long, that tells you who you should not be billing to the payer. A lot of times we find family that I’m kind of tempted to help exhaust a deductible for their family members, or I’ll just send it in. I need a little extra cash family’s demanding to pay. Please look at these rules, please make sure you’re dotting your I’s and crossing your T’s. So the compliant time of service discount, it is based on viable bookkeeping savings. Pick one of them. What does it truly look at your overhead? What does it truly saving you to not have to send the claim, chase the claim, get authorization for the claim.

Go back and get authorization again, to see them for five more visits, chase your tail, wait, uh, appeal. Do all that. Send a statement. What are you really saving? Are you saving 5% great? Are you saving 15% great. Write a policy. There’s your time of service discount? It’s often, um, found that a lot of people are using something that’s not within those guardrails. And it’s unreasonable when we get up into 50% or, Oh, I just have a flat rate for cash patients. Can I ask you what you’re billing the insurance? Well, typically about $180. Okay. What is your flat rate for your cash patients? Oh, it’s 50. They just come in whenever. And the other one I hear that makes me want to scream is, Oh, well when they’re with their insurance, we just always use the nine, eight, nine four one. And when they’re cash, we just use the nine, eight, nine, four.

Oh, I’m like, Oh Lord, you can’t play with your codes. You can’t play with your fees to make it fit what you need. So you gotta find what you need and get it to fit what you have to have. So understanding again, that when we’re using these time of service discounts, there are guard rails, and they really should be because it’s a time of service be paid in full at the time of service, maybe lingering just a day or two after, but it’s got to have some parameters on it, not loosened it. So that relationship, when we talked about Cairo, health USA kind of works like this. I love them. By the way. Uh, before I came to KMC university, I said there were a couple of things I wouldn’t live without and practice. And that was Tusa Cairo health and KMC because they helped me to get to, you know, to the knowledge I have today.

They a part of how I got here. And when I joined Caro health, what I could do was now legally offered discounts. So at the office I served last, we were a specialty clinic. Uh, I know a lot of you say, Hey, all of us are specialty clinics and we truly are, but we did something that no one in a very large geographical region did here. We have pizza. People travel in from thousands of miles away. We have people that traveled in from States. We had about a five state surrounding area that came to this practice. And, uh, so we needed to make sure that we had some way to compliantly offer them a discount. So we looked at Kira health USA, and here’s in that specialty niche. Our typical first visit was $565. It’s just what it was. We knew when we bill blue cross and blue shield for those services, that would qualify that generally we could get back somewhere around three 70 when we build Aetna and we’re coming down closer on two 25 and we’re like, number one, we’re not chasing it.

We’re not having to get authorization. Um, that’s we want to just count more than 15%. What can we do? We went with Cairo health and how it ended up being that $565 visit came down to $200. All the patients had to pay that day was $249. They’d paid 49 to Cairo health. They paid 200 to us and they didn’t pay five 65. And they kept getting all the discounts that we made available through Cairo health. From that point forward through the rest of that year. So doctor joins, he sets his own fees of what he wants it to be. You can do discounting for multiple family members. You can set it up that, Hey, I want to cap these visits here. Or, Oh, I want them just to be this percentage off, or I want this service to be that don’t include that in my cap.

As you see, I’m telling you all kinds of things you can do. You can’t do that with Medicare. You can’t do it that with a payer where you can order it and have it your way. But with Kaiser health, in many ways, you can have it your way compliantly and your patient has an option. If they don’t want to pay 55 and they want to pay 35, then they join Cairo health. If they say no, then they really said, I’ll pay 55, no problem cash check or credit card, but the patient joins. And again, they, and all their dependents are covered. This relationship is about between that doctor and the patient. And we have compliant discounting. I cannot tell you and stress to you enough. This is a huge Savile. When you’re looking at discounting in your practice, the other one may be that professional courtesy.

Did you know that you actually need a policy when you are treating your staff members for free? Please don’t play that game. If I’m going to help them meet their deductible, please don’t do it please. You can’t waive the deductible. Their insurance is banking on you to collect that this is part of the plan they chose. But if you’re going to treat them in your immediate family members for free habit in your professional courtesy, um, what about others in the community? Maybe it’s all the first responders. Maybe it’s ministers. Maybe it’s all other doctors define that, put it into policy. But for the love of the Lord, don’t be like what that doctor asked me to do. He didn’t get me to budge, which was no. We offer this service for free. I cannot charge your insurance for something we offer for free to you, nor will I help you meet your deductible.

The only way I could have done this was told him you are going to forgo our professional courtesy. And when that bill comes in and it tells us what your deductible is, we will have to assess that charge to you. So keep in mind, this is one legal way. You just gotta make sure you’re dotting your I’s and crossing your T’s and no isn’t for all your friends. And the quick way, we’ll just do a bunch of professional courtesy. No, they’re still dotting of I’s and crossing of T’s that need to take place. What about hardship first visit, take their word. I can’t afford it. Okay. Well, we offer hardship for people who can’t afford service, and we kind of can get by with taking their word the first time, but not after that, we actually have to verify don’t just take the word and my office.

I had one way you could qualify if you were on government assistance and you could show me proof of government assistance and I checked it on a consistent basis, then I would qualify you. I did not think about some of these other things to implement. Ours was just pretty short and sweet. We had Cairo health and we knew we could fix most problems and we have payment plans. So we knew we could fix most financial considerations for patients, but that was one consideration. And when I did it, it’s like, you can come for $25 a visit. If you’re having an exam, it’s another 25. If you’re having x-rays that’s another 25. So the most they ever paid was 75, but that’s the way my hardship was set up, but I couldn’t just offer it because they said they did, especially if they’re coming in with their Prada shoes and their Gucci purse or their nails are always done.

I’m not disqualifying those people. I’m not saying they’re in a financial hardship, but I’m saying we have to use a systems of measure to verify this. Or then this is not having an I dotted and T crossed. We do know that those federal poverty guidelines are about to come out. They’re just right out of. They’re always a little slow for some reason, but once they come out, we’ll be able to see what those federal poverty guidelines are and what percentage that particular patient falls under. You have the ability to set that up down. You can see this as one of our forms, by the way, that’s in the library. If you’re a library member, you can find this in the office management section one, and that’s going to be in less than three. And you’ll be able to go in there and tweak. You can see any of that great out areas, something they can do, but you can set what your fees will be.

Put your exclusions in there and make sure that you’re able to just do this appropriately, going by those guidelines. Again, a little bit of leeway with you on what you want to set up. There’s any questions on this? This is a bigger topic than what I’m able to cover here. Definitely let us know. And just a little bit of role playing. So let’s say you treat Medicare part a and part B patients. So are you enrolled? No, we already talked about it many sessions ago. We can’t see the Medicare part B patient. If you are, you’ve got to charge the appropriate fee for the excluded services. Even if they’re a, QMB a duly eligible, you still on the excluded services have to, you’ve got to bill on behalf of them. Your collections will be based on their co-pay, their co-insurance deductible, figuring all that out.

There’s one of your regulated then what about the part C if you’re not enrolled, we fill, these are cash patients to your office. You can see down at the bottom that we have cash paying patient, not insured. We have actual fee, um, or that discount medical plan. They get a super bill. Make sure if you’re giving a super bill and you’re doing discounts that there’s a line item that shows what that discount is. Don’t send that patient out the door with, Oh, it was a hundred dollars and you only charged them 50 because they’re going to get paid to come in your office. If their insurance, as an allowable higher than your 50, they will actually make money coming to you. So it needs to have everything listed there that shows that actual financial transaction that you have. What if you’re not enrolled with the insurance plan, then you have that cash play game that you can do again.

But over here on the other side, you’re going to be abiding by those contracts, looking for deductibles, obeying those rules of medically necessary and active maintenance and all that type of stuff. But you’ve got to bill, according to them, you sign the line. You’re there. You can see a little bit with the non par and the par there at the bottom. What about worker’s comp? Well, with some worker’s comp, you have to be enrolled in order to treat them. So please make sure there’s a lot of rules in my state alone that you got to jump through hoops. If you weren’t the first person who saw that patient a little bit of here that you can look at, but if you’re one option with PI patients, if you feel like you’re always getting stung by it, make them cash patients. When they get paid in their settlement, have the lawyer incorporate what they already paid to you.

That’s probably one of the most simple ways to get rid of the problem of lingering bills. So this is what it looks like when you’re done setting up your fees. We’ve got the doctor’s actual fees up here. Next rainbow down is our contract and fees are regulated fees in our hardship fees. And when it all starts coming together, we can see that Cairo health USA, that legal way to do a discount gets the fall in the green it’s right there. It’s part of our contract. And we got to pick what it looked like. Imagine that it wasn’t $9 for a therapy, unless you want $9 for a therapy. I have seen reimbursements be that low or say, Oh no, that’s bundled. Oh no, we don’t pay for that. On the same day, Kyra health USA is a great work around, especially with, for high deductible patients.

You can see that you’ve start piling in those other things with Cairo health, you’ll have those cap fees or your discount and name it. What you want it to be, make it that way. It includes everything. Oh, no includes everything. But this, this is you. It’s an elective discount. You get a set, a lot of it up. Then you’ve got some of the other things that come down in there where you’ve got this hybrid of Medicare and Cairo health. What the same service cannot have medic cannot have Cairo health, but we know Medicare only covers spinal CMT. So there’s a bunch more, we could apply that to. So it makes a very beautiful product for those patients. And then down at the bottom, we have our hardship fee schedule. This makes it all look beautiful. One pretty rainbow everything’s in there. Everything’s compliant. Nothing’s out here on the perimeter.

That’s kind of not okay. We fit all of our discounts nicely into this beautiful rainbow to where we can rest at night and be compliant. So you’re free to choose, but you’re not a free free from the consequences of your choice. So be careful when you’re doing fee changes in your office, making sure that you’re doing it by dotting I’s and crossing T’s. If you’re a member, if by chance you didn’t have this in your, a member, we do free schedule a fee schedule consultations, either help you, uh, get Kira health USA put in place at which we will. We’ll take you all the way up to it. Almost being implemented, just what they have to do at the very end, or if you’re not interested in that we still do. If you’re a member, that’s something we did. So it’s free for you as a member.

Um, the very next thing I want to show you are hot topics. And then we got to go hot topics. One, one that ABM form had to be implemented. Look at the bottom of your form. If you’re an Anon version, six 2023, starting January 1st. If you’ve got more questions about what you do about the one signed in December or November, you’re glad to give us a call. But as far as the new ones being signed, ABM must be implemented. When you’re looking at box D your mandatory is spinal CMT only don’t have anything else on it. And know when to issue it, big issues going on misconceptions, going on in this industry regarding how to use an ABN appropriately. And it can get you in big trouble because when they pull your records, they pull the ABNs in M coding went into effect. January 1st one code is gone for the new patient.

Do you know which one it is? You should never be using the nine nine two one one. That’s an established patient, but there’s one of them went away. The change in the coding methodology, how you’ll get to it is all lining up over on the medical decision-making. And although the AMA and all those rules have come out and said, Hey, history and exam, you can do it. If it’s warranted for us as a profession, it is warranted because that’s how we establish the medical necessity. Everything is built off the history and the exam next down Medicare fee schedule update. We had a big 10% drop this year. It was a huge disappointment and the middle of COVID and everything’s shutting down practices. It shocked everyone. However, we saw about as quickly as those one up on the website, they got pulled back down because the COVID relief came a bias about sort of bipartisan act that removed the full 10% gave us back 3.7, 5%.

The reduction is still sitting at six two five. And I’m just telling you if you want to be a part of the solution and not have to sit back and accept the problem, contact your state representatives. Remember it’s time to verify benefits again. And if you don’t remember why I go back and listen to a couple of my sessions a little bit ago, one more thing. If you are a KMC university member, please keep in mind. You’re going to be seeing a lot of stuff coming from us. Go in this spring, don’t put your head in the sand or not look at an email cause there’s a new website launch. You’re going to go to the, our website. You’re going to, uh, what happened, make sure you’re paying attention. And if you have any questions with what we’ve discussed today, feel free to give us a call. Uh, we’re always here to help. We’ll be more than happy. That’s (855) 832-6562 or info@kmcuniversity.com next week. Make sure you’re here because Janice Hughes will be presenting again. It seems like she follows me up a lot, but I think that’s really great. And I’ve watched these people and they’re wonderful if you miss these, just let us know we’re here for you. Good to see you. Thank you for spending some time with me again today. Bye-bye

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 – Client Case Management – Leadership to increase your impact!

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Disclaimer: 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.

Hello and welcome to this week of growth without risk. My name is Dr. Janice Hughes, and I’m excited to be one of your hosts for this week’s show. Um, my role is to support ChiroSecure and particularly to bring cargo secure, some ideas input, and you as the listener, some concepts related to practice management, you know, or an essence growth of your practice this week, coming up to the end of the year, already thinking about our goals and looking into 2021, I really want to support you to have potentially this incredible year. Now I say potentially, because what happens is if we keep doing the same things we’ve been doing, we’re obviously going to get the exact same things, the exact same results that we have now for many of you, if those results are excellent. Terrific. The issue though is if you don’t continue to grow, if you don’t keep expanding, what tends to happen is even doing the same things.

We often, suddenly aren’t getting as much impact, but for many of you, I really want to focus this week’s episode on the fact of how do you lead a patient? How do you guide a patient? We might call that management of a client. So client management, and how do, how do get them through what we know is the full potential of their chiropractic care, because I know what happens after coaching thousands of chiropractors for years, I know that unfortunately, in North America, as an example, that we still tend to have a very low PVA. Some years we statistically see that is that a typical PDA or patient visit average is eight visits. So what that is telling us is that a lot of you, you start working with a patient. In many cases, you do really, really excellent work. And yet you’re not really sharing with them or guiding them through all the opportunity that chiropractic can provide them.

Now, what are the ways then that we do? So I want to share with you today, what I consider our three different pieces or categories of this patient management, or I would prefer to call it even patient leadership. So, number one, I like to call that your education number two is multiple scheduling and number three is consistent and regular re-evaluations. So let me go through those and break those down. So number one, talking about this concept of education, a lot of that, and there’s lots of different, phenomenal practice management groups and coaches and educators out there. And what I want you to know is that all of the different systems work, actually, it’s really finding what works most authentically for you. And because I prefer to say, what are some things we can work on right now? The one thing I want you to understand with this educational piece is share why, why chiropractic?

What is your objectives over a certain care plan? Where are they now? Where are you trying to move them to? So that’s a key piece instead of this going week to week to week, or let’s schedule you for a couple of weeks and see what happens. You know, you’re not languaging it like that, but in essence, I want you to see that that’s what happens if we don’t really educate someone, you know, if we don’t say, look at, you know, working with us, here’s our objective. And here’s the timeframe, the period that we’re going to work on that for some of you, it’s as simple as starting with things like the language that a typical case like yours is going to take anywhere from two to four dozen visits. Having people understand that it’s not a quick fix. Now, I’m not saying that you have to suddenly run a practice where you schedule all of those appointments.

But what I want you to know is if you don’t share from a leadership perspective, really where you’re going to try to take them through their care. You’re not even going to get them really being congruent or consistent with six, eight, 10, 12 visits. So it’s really imperative that you start to share what you’re doing and why you’re working together. Almost like, you know, in a business world, we call that kind of your, your objectives. And then your review of have you hit your objectives in practice. That’s kind of the same thing. You know, why are you working with them? What are you looking for? And then how will you measure that? Now it comes time that you’ve shared this idea, this plan, and then we now want to take them out front. So part of, for you as the doctor, your report of findings includes and frequency of care so that they understand the necessity of the repetition.

So I asked you, you know, why can’t you just get adjusted once or twice and have that all change. Now, I’m not gonna say it has to be set in a certain way, but you really want to make sure that you’re having that patient understand that sometimes we talk and talk and talk in a report of findings around a whole bunch of issues. But the reality is, is that to make change from where they’re at and you clinically have gone through that, here’s where they’re at to get to a different place. What’s that going to take? So the consistency and the repetition of the visits is imperative to make that change. So I want you to make sure that you’re really defining and helping your support team, your amazing chiropractic assistants, that someone walks out of the report of findings up to the front, or you’re taking them up to the front and that they even understand why they’re here for a series of visits.

So let’s talk about now we take them up front or you’re trying to schedule them, or you’re asking your team to multiple scheduled them. Let’s face it. If you are in a full active clinic, a lot of times the front is saying, well, wait a minute. I can get there next couple of weeks, nailed out, but that’s sort of it well that if we’re not careful has us go week to week to week, or we’re now showing a patient that we’re not even really taking serious, the recommendations that we’ve just made to them. So I would prefer that we all learn some strategies around the second point, which is how to multiple schedule people. So the same thing, I’m not suggesting that you need to schedule out a year of care or even those two to four dozen visits. What I’m going to suggest though, is that you think about that first piece of their care plan and make it more than four or five visits, because what honestly are you going to completely change in such a short period of time?

So let’s take this idea of even moving from eight visits to 12 to 15 visits, because we do, we need the consistency and the repetition of care. Now, many people are going to be out of say pain or challenges that brought them into your office, even before that. So communicate that we’re going to get you out of some of the intensity of this acute phase, and we’re going to move you then into what we call reconstructive. We’re actually going to get to the root of what’s really going on and what has created this acute exacerbation. So now we want to be able to multiple those people out. So I know even some of you, well, how’s my team going to do that, or how am I asking them to do that? Well, there’s things like, again, recognizing that, you know, is this the better time of day for you?

What we’re going to do? I noticed the doctor has recommended that we do three visits a week over the next six weeks, including a re-examine let’s nail down the time of day. And then we’ll get your appointments in for the rest of this week or your next appointment. And then I will have for you, or even email to you the entire list of your visits. So I’m not suggesting that you also need to do that with them right in front of you to schedule out that eight, 10, 12 visits. But I like that they’re in your calendar. Number one, it’s just, it’s more complete. It’s also showing the patient that you’re working with them through that whole first phase. So there’s ways that we can help for you to be able to communicate this in the report, use your education and the report of findings to show people why help your team understand the second point that I’m talking about, which is multiple scheduling those appointments.

This is also so much more powerful for you because then you’re automatically including when you will do the re-evaluation. Now, when I see a re-evaluation again, every one of you runs a different kind of practice. It might be that if you use some technology scans or different, you know, test results from pieces of technology that potentially you’re scheduling them the visit before you would sit and just spend a couple of moments anchoring back to the progress, you could have those tests redone. Particularly if you have someone on your team that does that work for you, then you’ve got that all pulled together on that reeval. And re-evaluations again, they do not have to be a long period of time. You’ll notice in the sessions that I tend to do, or some of the things that I talk about, it’s just a lot more clarity of your communication.

So from my perspective, every one of our re-evaluations is talking about here’s where you started. Here’s where you are now. And here’s the next state. Even if you’re a little hesitant to say, talk about, you know, care for their lifetime, it’s still moving them into what is the next stage of the care and the possibilities for them with their health. This is more imperative now than it has ever been coming out of all the crazy pandemic phase. People are looking for health options. They’re looking for who can help guide me to make incredible health changes. I hope many of you are experiencing the boom that a lot of people are looking for. Great health advice. That’s puts you into a coaching role, you as a chiropractor, not just the physical adjusting, but guide them and lead them through these stages. So that’s where a reeval is so critical.

It’s not about an amount of time or that you have to spend an incredible amount of time. It’s that I want you to think about what is your key objective it’s to anchor the changes that have been made, where they are now and what your recommendations are. Even heaven forbid, someone isn’t going to follow those recommendations. You’re still clear on showing them what are next stages for them. Why is that important? That there’s next stages. So then point number three, I’ve kind of encapsulated into all of this, which are though consistent. Re-evaluations, you know, so remember the three things I’m talking about and I’m kind of weaving them all in together are incredibly strong. Education is imperative for really good case management. It’s a given from my perspective that each of you listening is an incredible practitioner. You deliver an amazing adjustment. I know you make great changes for people.

A missing piece in many cases is the strength of this education sharing. Why chiropractic plays such a key role at multiple phases of their healthcare plan. So we’ve talked about the education and then literally multiple scheduling people through a first phase of care up to, and including that first re-evaluation it’s interesting years ago, I used to talk with practitioners a lot about how you even move from say that first phase of care into multiple phases. You know, people that are with you for a lifetime care practically is that you then even have to be able to, you know, build in or plot out on paper. What would I do at multiple re-evaluations? So let me ask you this question. What would you still do or educate me on if I was going to be with you for 60 visits this year, just take a little time and think through, you know, instead of overwhelming people in the very beginning with almost too much, because I know how much expertise you have, but could it be that, that first phase that I’ve just talked about is really moving them from acute care into reconstructive care.

Then during this reconstructive, which is a big opportunity of care, can you start to talk about the other things that you love that you’d love to expose them to is that stress factors is that impacting their nutrition. Some of you have products or other services that you could include and then engage in those care plans. So what are the things that you would do through say six or seven or eight days as of care, so that you could almost have a better plan, a better structure to the kinds of care that you’re delivering and it’s those kinds of things then on a re-examine that you can also talk about the next piece or over the series of the next few phases of care. Here’s the pieces that we’re opening up still a big challenge for us chiropractically is what we’re often doing is still talking that pain, get them out of pain, dysfunction, and we’re not finding the language to communicate or educate about all these other opportunities that are available.

You know, it’s interesting because for another project I’ve been working on a book project with some great chiropractors, we’ve really been talking about the sort of whole industry, the longevity industry, and already, currently there are 1 billion people on the planet that are in retirement. And it’s interesting to start to study, you know, what are those people looking for? They are honestly looking for health and wellbeing. They’re looking for the kinds of things that you as a chiropractor offer and provide think about over the next 10 and 20 and 30 years, how many more people are coming into this retirement. You know, people are looking for longevity, not just, how do I get myself out of pain. I’d really love that we help you. Chiropractically position yourself more for that. Now in the short term in 2021, I’d love you thinking about this case management or leading the patient, guiding them through this initial phase and then into the subs, subsequent phases of a care plan.

So again, number one was great. Education. Number two is even working in getting your team support to multiple schedule people so that you’re not having to every week at the end of the week, talk them into next week’s care or after a couple of weeks set up the expectation that now they’re out of pain. We don’t have any other visits scheduled and we don’t have any further plans for them. And then the third piece was the regular consistency of these re-evaluations. I share a lot of this because let me give you an example that myself, even in practice, I was a really strong educator and communicator, but I made a lot of mistakes where I even forgot with some of my incredibly long standing patients to build in some re-evaluations people who’ve been with me for a number of years. You know, I use scan technology, the insight millennium people who had great clear scans, and now we’re still under what you would call really, you know, that wellness phase of care.

And what I started to find is all of a sudden you lose those people. And it’s like, well, where, how did that happen? If they’ve already been under care for several years, what am I not doing? How am I losing them? So I did a little survey. I called up a couple of my previously phenomenal patients and, and really asked that question, you know, how could I have served you more effectively? Why were we all of a sudden not having you in the clinic? And what I found is that a lot of them were languaging it in different ways, but sharing with me that I’d stopped sharing the vision with them. I hadn’t done a rescan. I hadn’t done re-evaluations after someone was under care for a couple of years, what was I doing? I guess in my mind, I thought that going back to some of the basic baseline tests was actually pulling them maybe more back to symptom care.

But what they were telling me is that I was losing them because I was no longer sharing the vision. So I want you for 2021, you know, growth is already available to you even within your existing patient base. How do we maximize that by multiple scheduling people and reevaluating your people? You know, the new year is a great way to talk about what are their health goals? How could we help you have that conversation about new goals for 2021, even asking a patient to on their next visit, you know, talk about their goals, have them go away, think about it, write down two or three goals and bring those back. Another thing, right, even in your visit is saying things like looking at this whole upcoming year, would you prefer to do the next simple kind of change that we’re going to talk about in the area of your physical health, your mental health, you know, nutrition, what area can I help you the most with?

It’ll be interesting for you to see what patients say because you and I both know you have a lot that you can be sharing with people. So growth without risk is that you already have people in your practice. You don’t have to go out and always think about the next new patients. Let’s help you educate within case management is actually case leadership. So I want you to think about that. And I want to just take this opportunity at the end of our session today to say thank you again to ChiroSecure for the opportunity of being one of the hosts Dr. Hoffman and his team support myself, other leaders in the profession, but more importantly, they support you. They provide phenomenal services and resources like these shows. So please don’t hesitate to reach out my wish for all of you is an incredibly happy, healthy, you know, holiday season with your family. No matter what way that you celebrate, please celebrate in great health and let’s look forward to an amazing and incredible 20, 21 have a wonderful day

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 – Upping Your Game in 2021

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Disclaimer: 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, it’s Yvette from KMC University. I’m glad to spend some time with you again today. I know a lot of us have wanted to say goodbye to 2020 as quick as possible. So we only have 30 minutes today kind of like usual. And we’re going to be talking about upping your game in 2021. It’s going to move fast. We’re going to cover several topics, but hopefully today is just something that’s going to help you to, uh, kind of seat in into some things that you may want to consider doing for your practice. Maybe generate some thoughts, maybe, uh, caused you to pause and say, wow, I never thought of doing that. That’s what all this is about. We’re going to go ahead and jump straight to the slides today. And like I said, we’re going to cover upping your game in 2021 saying bye-bye to 2020 and just getting this all behind us.

And I know we’re all looking forward to a fresh new start. So what we’re going to cover today, we’re going to talk about the importance of verification on that very first visit, which we covered several times ago, but we’re going to talk about it again for the beginning of the year. I know, I know not enough time in a day to do all that you vet great thing is, as you saw, we’re going to talk about some time management too. Um, we’re also going to talk a little bit about the importance of team training. So if I’m going to tell you, you have to add in all of these verifications all over again, I’m going to definitely stress. You need team training and some time management. And then I’m going to give you just a little snippet at the end of some high, very high points.

I’m telling you a little snippet at the end about what’s coming on January 1st with those ENM code changes. It’s huge. It’s massive. Nothing’s been done since 1997 and here we are 2021. Imagine that, and there’s a lot of changes. So let’s go ahead and jump straight in to what we’re going to cover. And you’re probably saying, Oh gosh, why in the world is she going to talk about verification again while I’m coming from a different angle? Last time I talked about it, we talked about how important it is, um, when establishing a patient to the practice. But it’s also important at the beginning of every year. Maybe even when a patient starts a new episode of care. And the reason really is simple. It’s called being proactive and making sure you get all your little ducks in a row, I know doing the same thing over and over expecting a different result is insanity, but I’m telling you in this environment, we’re in right now with all the changes that’s happened with company and just in general should have been doing it.

The first of 2020, any of this had happened 2019. It’s needs to be your model moving forward and a proactive stance because you don’t want to go in the hole. One have to be reactive where you’re paying somebody three times to do something, pay him the first time, second time to fix it. And the time lost while they were having to fix it. So we really want to be cautious and utilizing our time to the best of our ability and proactive. Um, uh, being proactive is probably one of the best investments you can make. Now we all know, again, like I said, the definition of insanity is doing the same thing over and over and expecting a different result and it can feel that way with verifications, but can we think of it a little bit of a different way today together? That would be, what about this?

An ounce of prevention is worth a pound of cure. Uh huh. So it’s a little bit of a different way to spin it and maybe create some optimism. When we have to think about taking on another task. Sometimes it’s dreadful because we have to sit there on the phone for so long, become the master at master tasking. I’m going to tell you that now because it’s multitasking because that’s just the catalyst to be enabled, to do verifications by phone because remember KMC university doesn’t think that we do them by the portals. Those are eligibilities and not verifications. So the answer is quite simple about why we’re going to do it again. We have open enrollment period going on for both the patient and some change time for doctors Medicare right now we’re in that open period until December 31st, where a doctor can elect to change their participation status.

Now a chiropractor can never let to not be enrolled. So enrollment’s not a question with Medicare. The chiropractor has to be enrolled that’s in their guidance, in their regulations. You can’t argue with it, but what you can do right now is say, I don’t want to be par anymore. I want to be non-par Oh, I don’t want to be non-par anymore. I want to be par and I will tell you that right now, if you’re needing to enroll, what’s probably the perfect time, but you got to go in par for this to happen. So not trying to influence your decision, but during this public health emergency, some people call it a PAG. You can do a rapid enrollment with, uh, with Medicare, if you’re going in as a par provider. So do keep that in mind, if that’s something you’re needing to do, um, definitely get on that as quickly as possible.

It was extended until sometime in January. We don’t know if it’ll get extended again, but things are changing. We’re in open enrollment period, not just for providers with Medicare, but we’re also an open enrollment period for a lot of employee. Um, employer driven plans. My husband comes home every year and he knows I’m the expert on it. And he wants to know which plan should we change plans. And it’s like the plumber that has the horrible plumbing that don’t want to talk about it anymore at night. And I’m like, do I have to talk about it? Because I don’t just check a box and do this so quickly. I want to do the math. If I stay up here and they give me HSA and I have this and my copays that on the average of what we spend, where everybody’s sitting at that, I mean, you’ve got some employers that they’ll do it at the end of the calendar year.

Others will do at the end of the fiscal. Lot of fiscal years are usually that ending in June, starting new in July. I have seen it March. It could be anywhere because that company picks their fiscal year. But those are your kind of your common places. You’ll see it. So open enrollment for employees to select new plan options. Maybe they can’t afford something. Maybe they found out that they’ve got more illness and they want to have less payment out of their pocket and just not in a position to do it. Otherwise. How about the open enrollment for Medicare patients? Of course, Medicare patients can get in. And when they turn 65 by a couple of other qualifiers, uh, throughout the year, but I put this here because we have to think about the Medicare advantage plans. They can switch they’re in that period right now, where they can switch.

I don’t want traditional Medicare anymore. I want this Medicare advantage plan. Um, I don’t want, uh, this Medicare vintage plan. I want traditional Medicare right now is their time to make that change. Why do you think all the commercials are out there about this Medicare advantage plan? We’ll give you this medical drug coverage, all of this. Everybody’s trying to vie for business right now. So we’re in open enrollment with Medicare. So we need to figure out who did they pick? Because it inevitably, if they decided to go to a Medicare advantage plan, when you get the claim back, if you send it to traditional Medicare and didn’t do your due diligence of verifying, because the Lord knows they’ll hand you that red, white, and blue card, no matter what they really have, you’re going to get something back from Medicare, a and a denial saying this is not covered.

It’s covered under a capitation agreement, which generally means, uh, they have a Medicare advantage plan. So there’s another reason. And when we think about being late on, then submitting to the right payer, you’ve got to think some of these payers have a very short, uh, very, very short, timely filing some 90 days. So by the time you would expect to get any OB back, maybe from, let’s say, blue cross, and you just sit there and wait and you wait and you wait and maybe you don’t have great. Follow-up maybe you’re too overwhelmed, short staff by that point there when Aetna’s timely filing. So this is why this is such a pivotal year. Every year is pivotal, especially when you think of all these things, but especially this year. So maybe the employer needs to cut costs. They may do that a couple of ways changing a plan, or they may switch the third party administrator.

They may have always used blue cross, but Cigna came up with a better offer. They may have always used Aetna, but blue cross came up with a better offer. They have been impacted by the public health emergency this year and just impacted by increasing expenses. Overall year after year, you will see employers change a different plan. So what if they keep the same? Let’s say the same third party administrator. They keep blue cross, but because they need to cut costs, they decided, well, we’re going to exclude this now, or we’ll only cover this many of this. And before you get headlong and telling a patient, well, you owe 40 a visit not to realize the employer changed it. Patient didn’t realize cause they were paying attention. So many reasons why this is so important. What about those patients on the affordable care act? The Obama plan marketplace plans, where they have the option to change.

I know that my daughter’s mother-in-law, she just changed her product because another one had raised its rate. So she selected on the marketplace to go a different route. So if somebody didn’t verify again, not just asking her, but verifying what does that coverage? We would have told her that she, the doctors would have totally missed it, build the wrong payer. And I believe she selected one of those plans that had a 90 day timely filing. So look how much that’s going to impact her caregivers. If they’re not paying attention. What about job changes? So I have a child that works at a particular, a place, although the building is the same. There’s several contractors inside that building. So maybe as a job assignment ends with this contractor, they then get hired by another contractor. And then that contractor has a whole nother different plans. So we can see the necessity.

These are just a few of the reasons why you should obviously, uh, you’ll have better reimbursement. I mean, we can go that direction on talking about the positive impacts of your office. I think we can all see right now we can’t afford to get behind. We can’t afford to build our own company. Money’s tight for everybody. Everybody just stay on top of it, take a few extra miles. It’s like if I had to let people go with COVID, we just don’t have the time. I’ve got a few employees left. I used to have this many, you know what? That’s the reason you do good team training. So instead of this taking one employees, 80 hours, you divvy this out over the employees because they’ve all been trained well cross-trained we had a situation the other day when somebody came to KMC university and said, I believe they were one of our members.

And they said, can you help us? Please said our biller has been out with COVID and we don’t know how to set up billing. We can’t set up billing. She’s still in quarantine. Won’t be back. Any time soon, money stopping up. They were dependent upon that. They have been that impacted by COVID. So with that, without the training and the cross-training money came to a screeching halt, that’s why team training to increase training is so important. If something changes, if somebody wins the lottery like Kathy likes to say, or, you know, a health challenge or even death comes about and can your office function, if not, there’s a problem. So we look at what has been published by this Michael at [inaudible] where he talks about, if you believe training is expensive, you truly don’t know the cost of ignorance and how true that is. I did an onsite back in October and this became very real to me.

I already knew the impact of not training, but I saw it. So plainly in front of me, when I stood up in front of a room of CAS doctors and trying to find the common ground in that room. And I couldn’t even say nine, eight, nine, four zero. I couldn’t say CMT. I barely could say the word adjustment. How in the world do you expect your patients to know what’s going on for you to get scheduled for the right type of visit for you to get collections in for you to build right for you to do anything, right? If your team has not been trained, you are setting yourself up for failure. If you are skipping the most important element, and that is team training, don’t leave yourself, sitting there empty handed. If you’ve got a staff member wanting to control everything, you got to break that barrier.

What if something happens? I at one time was a hoarder of information in my head and I realized the impact that I likely left when I walked out with all the knowledge in my head by no means would I ever want that for anyone? And I’ve been the recipient of walking in on offices like that. Actually one, the office manager suddenly passed away and nobody knew what to do. Uh, you can’t leave yourself that vulnerable, but we can see that ineffective training costs money now for bigger companies like about a thousand people, that’s about 13.5 million a year. If you bring that down to your practice of five, you’re talking about 5,000 a year in a cost for a small business, and you’re going to have high turnover. So really I think the costs would go up significantly when you really have to factor all things.

But according to the HR magazine, if you invest about $1,500 on training for your employee, you’re going to probably have about 24% more profit. This office that I went to in Pennsylvania was a disaster with their collections, absolute disaster. And until they allow the training to get in there and get out of their own frenzy, they’re going to continue to struggle. Now, the minute that we get training in there to learning in there, to understanding in there, we can not make a change. We have to get understanding. So let’s think about the old story. Everybody tells it a little bit differently, but it goes a little bit like this husband and wife sitting down for dinner, she decided to cook a ham ham and potato dinner for him. And he loved him. His mom always fixed it for him, seems similar in its taste. But something very odd happened in the process of preparing it.

The wife cut off the ends of the ham and she stuck it in the oven. Just like she has every time, just like mom did just like grandma did. She’s going to follow that family tradition because it’s mouthwatering great. And husband’s kind of sitting back perplexed. Like, did she cut the ends off the ham? There’s plenty of room in that pan on the one in the world was wrong with her and it gets the best of him. And he’s like, Hey, we have got to call your grandma and ask her what the secret is behind it. Does it allow more juice in, what does it do? Really? What happens when you cut the ends off to the hand? Cause it really kind of say something my mom. So, you know, maybe, maybe we all need a cooking lesson together. Just picks up the phone. Hey grandma, it’s me.

I just wanted to call you. I fixed the hand today. My silly husband wants to know why we’ve always cut the ends of the ham off. She goes, well, did you use a good size pan? Oh yeah. There’s plenty of room in my pan leftover and the whole thing would have fit in there. But I mean, once I kind of done, I had plenty of room and she goes, Oh honey, honey, I guess the training that you needed, you didn’t really get, you only heard it by experience. I am so sorry, baby. You probably just threw away a good amount of money because the only reason I cut the end off to the Hamm was because my pan was too small. And so we have gotten to leave the ends on the bacon, some on the end of that thing and bring home the bacon.

We can’t keep leaving money on the table because maybe we had a staff member. We thought knew it all that didn’t know it all. That’s what I ran into in Pennsylvania. Um, maybe they’ve only had training because of what they saw in the software. You’re going to merge to a new software. This is where we see a lot of issues and we have to step in and fix fee schedules and fix all kinds of stuff here. We actually have a protocol for one particular software where we go in and fix fee schedules and have a whole training protocol around it. You can adapt it to any of them. But, um, but when we’re talking about the training that comes from staff to staff, you’ve got to ensure that it’s correct because it could be costing you money. And what you thought was a good land of profit, maybe much less than what you could be getting.

So make sure that your team is properly trained and not just because they saw it, but because they learned it and then it got from a different place of learning it. And it went all the way to an understanding. That means if everything falls apart in this world and we leave being able to submit claims electronically, you can pull out one of those good old CMS, 1500 forms, no cheats in the system. The system died, everything went away. And, but that’s where our model, Oh, God money stops because we don’t understand what it took. You could change to any software in the world. You could go to being on any piece of paper. And as long as you understand what it takes, it will happen. We see that this with doctors, with the anamar systems, they don’t have an understanding of what it takes. If you told them to put it on paper, or we look at their paper, we realized how wrong the paper was.

How would the world do you ever expect them to get it right in the EHR? It’s because there’s no understanding. Anyway, you go be it going from paper to EHR or back and forth. You have to have the concept down of what it takes to document what it takes to bill, what it takes to modify what it takes for this code. How you have to point here, how you have to do that, how you have to schedule for all their appointments, how you have to schedule this much time. You see what I’m saying? How it can so negatively impact your practice. You can afford that. No one can afford that. So the, the ends on the ham and bring home some more bacon and get the right kind of training to this tape. I sat in on the day and I thought, you know what?

I’m just going to throw together a few ideas of why I think this is just off the top of my head today. I didn’t pull it from anywhere. I just thought, you know, how important is team training to me? How often important is it? Or should it be to offices? Now, those of you who are KMC university members, you fully recognize that little purple cube. That’s the one. When we’re doing an orientation or, or guiding you in the library to something with a new employee, we’re like, do not pass, go do not collect $200, go straight to basic CA training. Let us know when you’re done and tell us what their job role is. And we can tell them where else to go work. You know, we can work with them one-on-one and a lot of times we take brand new staff members and train them.

But let’s think about how this works. So team together, each achieves more. We don’t want Sally being the lone ranger, everything in her head, but we also don’t want Bonnie having to do everything because no one else has been trained. So when we do proper team training, it fosters team spirit. It’s a well-oiled machine. We have accurate and effective outcomes, things that are positive for this office, for the patient, all around things are just brighter. We’re all working toward a common goal. We’re not scattered everywhere, just thinking, okay, I guess I have to do it this way. And this one over here does it the other two hours of the day. And she does it the other way. And so they sit and they pull at each other, no, be consistent. So we’re all working towards a common goal training to learning, to understanding. I, it was just an eye opener for me recently, with those I can train you, but if you never learn it and then if it doesn’t go to understanding, it’s a waste, make sure they understand that there’s nothing wrong with that.

Like even in our basic CA training and throughout our library, there’s a lot of self-assessments where as an office manager, you could go back and look not to say, I can’t believe you don’t know that, but to say, Oh, okay, she needs some more training there. So just realizing opportunities for training you’ll have increased productivity. They know what they’re doing. They’re not sitting back, scratching their head, trying to make it up or figure it out. You’ll have increased profits. Uh, one, because you’re not going waste so much money on payroll and there’ll be more productive and they’ll know how to chase that down. Better increase patient retention, increase patient satisfaction, which then generally moves run on over into the land of referrals. They’ll all have the same basic knowledge with cross training. They’ll have jobs, specific training for what they have to do through cross training.

They won’t be the only one you’ll have much less staff turnover. People would just want to know what they’re doing. And if you don’t have your stuff together, don’t expect them to have their stuff together. Don’t expect somebody to come in and be your miracle staff. Because if it’s that, man, you didn’t have it together either. And I, I generally don’t become that harsh, but that is the truth. And we see it every day. People relying on a staff member that they hired from off the street. I’ve walked into offices where they’ve hired from maybe just a local bar. Maybe they’ve hired from a restaurant, maybe from a gas station, just because they like personality. Be very cautious unless you’ve got a lock type training program and compliance in place, know what you’re doing. And also because you’ve got to satisfy this compliance requirements through HIPAA OIG, OSHA, CLIA, all of those that apply in our offices, we’ve got to have our real structured plans and they need to be trained.

And it establishes your practice culture. Not everybody. If we’re having a very somber practice, not everybody’s chip here. And for having a very chipper practice, nobody’s looking a bother. Everybody’s matching that practice culture because they’re well-trained and they’re on that target together. And all I could do is put an, because I ran out of room, it’s pretty simple. You can see the value in what it will be and what does it really isn’t for you? So let’s look at this together. We got 50% increase in efficiency. Oh my gosh. We all could use that. We have a much faster turnaround time on a claims. Our reimbursements are up significantly and we’re getting paid for what we do because the staff knows what to do. When the insurance doesn’t cover this, they know how to behave. If they bundle it, they know how to use the CCI, edit modifiers.

They know how to diagnose these points and we can be so proactive. Of course we have insurance companies that get a little crazy on the side, but you know, but we know how to deal with it. Right? Absolutely. And the best way to do this is through time management. So we talked about verification, doing it at the beginning of the year. You bet that’s going to be burdensome. Okay. Then train some other staff members. Okay. Then what about the time factor? Schedule it, manage it. If you’re doing an app passively, then time is managing you. Nobody has time for that. As the lady said on Facebook and nobody got time for that, we want to make sure that we’re managing time. So it’s not managing us because one thing you don’t want to do is, well, Patrick, Leah Lynn Lencioni. I’m so sorry. What Patrick Lensioni said.

If everything is important, then nothing is quit. Making everything important. Uh, often had to tell doc, he’s like, come home and change the furniture. It was almost weekly. It was at least once or twice a month. I said, you know, if I come and help you move the furniture that you’re going to be losing money because we don’t get paid for me to move furniture. We get paid for you to work claims. And if everything’s important, then realize that there’s a lot. That’s going to have to go by the wayside. And more than likely it’ll be in your back pocket. We also know that interruptions all Deere. I threatened at that last office. I said, okay guys, I’m changing my name. So if you can guess what my name is today. Then I’ll answer you. My name is not your vet. My name is not Mrs.

Noel. My name is not, Hey, you mom, whatever. It’s not that if you can guess what my name is and you can interrupt me otherwise, I’m not going to, I’m not going to hear you. And really all I was saying, Hey guys, please cut down the interruptions because everybody, it wasn’t just the staff. I had a window right by my door, Vic slender window. And our check-in area was right there. And people love to talk with me. I love to talk with them, but I didn’t have time. So everybody you’ll find everybody wants a piece of you. You just cannot, uh, take the protection off your time because time is of the essence and it takes more time to do things and we can’t let those moments be stolen. And doesn’t mean we become cold and insensitive, but we guard those. So a person generally gets about seven interruptions per hour, generally takes about five minutes per interruption.

I’ve never known one to take that small of amount of time. Then they end up spending about four hours a day in interruption. So they work eight hours for you. And you’ve done interrupted them that much. That’s four hours. Maybe you interrupted so much today. It was a whole eight and 80% of the time. And so little or no value. And we find out if we really start saving those things that are truly important, maybe setting up communication Benz. I had to do that at that recent onsite, up in Pennsylvania, where I set up communication bins. And we used a piece of paper to communicate. It’s not that I don’t want you to talk, but don’t for that. We’re a doctor run toilet paper.

Oh, combin. Or

I told them, I said, I want a white board. I want something up on the wall. That’s the wishlist. That’s right. The order list. And if you know where on toilet paper, if you know we’re on a paper towel, if we need post-it notes, stick it on the board, quit interrupting people. Be smart about your time, these smart about what you’re giving your time to make sure that you’re managing the time and it’s not managing you kind of look at this here. When we think about those things that are urgent, not urgent, urgent quad, one urgent quad three, a non-urgent quad, two quad four. You can see that there’s some, that’s super important. The building’s burning down, go get everybody out. And some that maybe aren’t that or broken, you know, things, maybe a short-term focus of something. Maybe just somebody called on the phone.

Uh, his doctor, I need to talk to him. Actually. He’s seeing patients right now. Could I take a message or I can have him call you back on a break that was wife calls. I had this happen. I need to speak to him right now. One of the kids has swallowed paint center. Um, I immediately, I put him on the phone. You have to know and manage their time also and not let everybody get to them. I commonly would’ve saw, I saw somebody going towards Doug. I’d say he’s with a patient. You’re going to have to wait. Actually, if you could schedule a time, people come in and want to market this. You will need to schedule a time to talk to us. Um, we have administrative time set aside and that’s, what’s really important is to really figure out what’s important. What’s not important.

What can wait and what can’t wait and really managing that through a process of managing, focusing, avoiding, and then limiting, uh, really find out from each other. Is this truly important? And it needs done right now or by when do you need this? Tell me when you need this by. I don’t, don’t just tell me you got to have it right now. And if you said yesterday to them, can I tell you that could be a lack of planning on your part or a lack of follow-through holding their hand to the fire and saying, get it done, but be cautious that you’re procrastinating, which causes havoc, which pulls them off of their task. Try to keep a calendar going or something that always keeps something in advance abuse so that you are aware, keeping tickler files going, um, keeping things in outlook. However you keep your calendar, keeping it somewhere to where it doesn’t sneak up.

Maybe get alerts. I use my phone sometimes pay your car payment five days before it’s due. So if I don’t want to do it that day, I hit remind me tomorrow, remind me tomorrow. And I never go past, but it lets me know it’s coming up so I can be prepared. And we always want to make sure that we ask by when do you need that? That’s something we’ve learned very valuable here at KMC because there’s a lot of times we can think it’s an emergency to us, but when is the do or die and be ready to give those answers to your staff. So time management and really getting that into play really starts before that patient calls goes to that whole cycle for reimbursement, you can see this is a lot of reimbursement stuff. And if you aren’t keeping the cycle going and you’re constantly just getting caught up in one of these or another, it’s going to blow the cycle and you can’t afford it.

Because look over here, you’ve got the receiving and posting of payments at about the seven o’clock and one, if you need to appeal it that whole side, if it’s lacking and you’re lingering too much on the right, you’re going to completely miss your money. So some of the important things to remember are time will not change. Time goes on no matter what you do, as much as we’d like to stop it. I commonly say I went off of this life, uh, life cycle I’m on right now, this, so I need to let me off, let me go do something else. That’s sometimes I feel overwhelmed by life in general. Find out are you wasting time? I do. Sometimes when I feel very overwhelmed by it, I find something else that needs my attention. Um, that’s just transparency set a time related goal. Uh, Kathy told me one time, she said, think about it this way.

What can I do in one hour? Don’t set goals. I mean, you’ll have longterm that be realistic in them implement a time management system use tools that you can to help manage that time. Buzzers alarms, nothing to go off loudly, but something to remind you, Hey, you said you were doing this for this timeframe. It’s not done. Put it back where it was with all your notes. And then when it comes back up on your schedule, you’ll do it again. Prioritize, prioritize, prioritize, just like with a real estate location, location location. When it comes to time management, it’s prioritize, prioritize, prioritize, delegate. When you can install proper routines, set time-related tasks and then be, uh, be systematic about that. Always make sure you’re saying aside of administrative time, doc, they do need to talk to you and to put your head in the sand and never talk to them and never asked for followups.

Never still have your hand in that practice is a disaster set aside times where they can ask you set a time aside times that they know you’re going to go to that convent and get those things out that they need you to address. Have a time that everybody can set aside for training to handle tasks that are out of the norm and things that just eat things away, but things that are not part of the business itself, like I’ve got to touch patient like that. This is the followup that prevention know that that staff member, if you think that she has a lot of time in a day, I will tell you, they usually don’t. Especially if you’ve got a one CA office, this is a list of just some of it. Very minute, that phone rings and you never know which hat you need to put on.

Um, a lot of different things that they have to go through and having systems and training in place, speeds it up for them. One great way to manage this is to identify all your tasks that you have to do daily, weekly, monthly, and then as needed. Put those in columns. If you’re KMC university member, this is in the third party billing and collections, the follow-up system, the very first lesson. This is a time management tool kit, but you can see daily, weekly, so forth. You spread them out. Then you get your calendar up there. Again. This is part of that same tool where you start saying, okay, all those are on that weekly. I’m going to, or daily, I’m going to put them on Monday, Tuesday, Wednesday, or they have to be done weekly. So I’m going to put that on Thursday and then you list out everything and put it into a framework.

Then when you go onto the next piece of that, you’re going to then say, well, my reactive calls and my proactive calls go here. I’ll do verifications here. And when my time is up, my time is up. You’re going to be efficient about it. You may be able to say, well, I’m going to do insurance verification and posting, uh, because I can multitask while I’ve got the phone on speaker, until they up, I can do this. Always make sure you’re not just sitting there and stay hot. It’s insurance verification time. I’m not going to do nothing for 50 minutes while I went on to pick up the phone. No, no, no, no. Make sure that you’ve got things in there that will keep your time moving. Finally, I told you I was going to cover just a couple highlights, uh, of M coding. Obviously we don’t have the time.

Uh, just so you know, KMC university is doing a training tomorrow. You’ll need to call us to get set up for the ENM. Coding changes. Massive, massive change. First one, since 1997 coming about January 1st, right along with that new ABN form, make sure you were aware of it. I put this year here because there’s some things I don’t want you to hear, uh, and take it as that’s how you’re going to move, but let’s talk about those. You will hear straight right out of the way it’s coming out of my mouth. It will be effective January 1st, 2021. Everything changes. It’s the first time since 1997, uh, then we go to the nine, nine two zero one is going away as a chiropractor, nine, nine, nine two one one should have been gone a long time ago. The minute you walk in the door, you’re already at a nine, nine, two and two, and the old model. Um, now what I don’t want you to hear, I don’t want you to hear, what’s not being said here.

A lot of the code

Selection is going to the medical decision-making and time component. So while a lot of us may jump up and down and say, if I just say what I’m going to do, if I’m, and this is my thought, and I ordered this test, Ooh, look at that. Where did I get? And I spent this much time with them and afterward claiming all that up, right?

There’s my code, please.

If you’ve heard nothing else I say today, you have to hear what I’m saying. I don’t want you to hear that. I said medical, decision-making focus there and how much time you spend with them and you’ll make more money. They’ll tell you what code to pick. Listen to me, chiropractors, physical therapists, whoever’s listening today. You still have to support medical necessity, which is still going to come out of that chief complaint out of the dysfunctions, out of your written treatment goals out of the exam, that’s how you’re going to support medical necessity for the long haul. A lot of this really made probably just general medical doctors, where that’s all, they do feel pretty happy. It pulls some of the burden off, but it didn’t say you don’t have to have it. It said, when it’s medically necessary, you pull the during the exam. Let me tell you something right now, chiropractors.

It is medically necessary. Every time you do one, because you have to establish the medical necessity for this, uh, this, um, span of care that we’re doing this episode, please do not hear that and go running and think you’re scot-free on having to do the exam and the history. You’re not because that’s how we, as a profession, support the medical necessity for the continued care. Um, and the medical decision making and time again are going to be a lot of the components, but you can’t skip it, even though it says only if it’s necessary. It is for medical necessity. So hot topics. I want to leave you with these, the ABN form. We discussed that my first couple of times I was with you has to be brand new. You should be on version a for 2023, six 2023. Um, make sure that you’re doing it appropriately.

There’s a lot of people still doing it wrong. If you’ve got everything on your ABN, if you’re doing it once a year, you better give somebody a call and we’re a good place to call for that. And I’m coding effect. Medicare open enrollment deadline for you to change from par to non-par is going to be December 31st. If you thought you wanted to get in on that, you’ve already do that. Now, Medicare new enrollment, uh, COVID emergency only valid. As long as this public health emergency is going on. You’ve gotta be willing to go in as par. And if so, um, it can, um, speed that along. A lot of people were getting in. And just a few days time, you still have to go through the process of getting everything into them for the, uh, permanent enrollment. Um, but make sure that you’re doing that upcoming events tomorrow, KMC university, doing the last minute, waited on some of these last minute things to change.

Are you ready for that? January 21st, um, the January, 2021 eight coding changes for more information, (855) 832-6562. And then if you have any questions, just feel free to reach out to us at any time. Uh, we’re here. Any questions that came up today? If we brought up a thought or if something just comes up for you organically, let us know, uh, Connor skier next week. Please join them as, uh, Janus shoes. We’ll be presenting. I’m sure that’s always a great time for you guys. I definitely appreciate you letting me join you today and we’ll look forward to talking to you and next time I’ll be with you again in the early part of January, have a great day. Bye-bye

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Empowering Women in Chiropractic – Cathy Wendland-Colby

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Disclaimer: 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. 

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. Now. Join today’s host Dr. Cathy Wendland-Colby, as she talks leadership community and juggling it all. And now here’s Dr. Cathy.

Hello and welcome to empowering women in chiropractic. I’m your host, Dr. Cathy Wendland-Colby. And I am super excited to finally connect with you because in this crazy world of Corona and COVID and lockdowns and pandemics and media frenzies, and disinformation, intentional misinformation, you are still in practice and you are still trying to help people in your community, run a business, feed your family, and take care of your staff. So there’s a lot going on. And some of you may be homeschooling your children for the first time ever, or perhaps like me. You went the opposite route and went from homeschooling your children and sent them into public school for the first time in their life. Because you know what, for me, I said anything that’s more routine and more exposure to other children and more normalcy. I want to put my children into that.

So I went the opposite direction as most people in this country going, but let’s talk about you because right now your practice may be doing great. It may be doing exactly what it was doing before March. It may be doing better than it was doing before March, or perhaps you are still kind of in the weeds and just existing on what’s coming in by accident. And I talked to a lot of doctors and a lot of doctors are saying similar things that the patients that are coming in are still coming in, but the ones who dropped off either because of their fear or because of finances or because the loss of a job, or because they’re now carriers those people 72 phone calls later, they’re still not coming in. They love you. They miss you. They want to be part of your office. They’re just not ready for one reason or another.

Whether it’s finances or fear or family, they’re just not yet ready. And you know, the people I’m talking about, maybe you have someone who has a family member who’s on chemo or a family member that has a chronic illness or heart disease. And they’re just too scared to leave the house. Or you’ve got elderly patients who their family members won’t take them anywhere. So whatever you have going on, let’s really dig deep. Because today I want to talk to you about your foundation, your platform. That’s your principle, that’s your philosophy. That’s what needs to sustain you through this entire thing, because as the saying goes, and I know I’m going to misquote it because it’s a Thursday and it’s crazy. But as the saying goes, do you have more faith in a pillow powder or a potion than you have in the universal intelligence that animates your living body?

I hope not. Because as chiropractors, we know that everything that we need is inside of us, it’s within and innate intelligence within can provide every chemical, every up, every down, every drug, everything that we need naturally without having to take anything from the outside and bringing it because we as chiropractors live that inside out mentality, but our communities don’t. So how do you lead in a time of mass chaos, mass confusion, intentional fear. Fear-mongering how do you lead in a time like this? Where people are just inundated with false information, scare tactics and inaccurate numbers that are designed to keep them scared. Well, first and foremost, think about yourself, your health and your family. For me, this is really easy looking at this COVID ridiculousness, because we were fortunate enough to be the early adopters, right? We had COVID back in December and January, my son and my daughter on Christmas day were too tired to even open their presence.

And for the next 15 days, my son costs and slept. What do you think he had? We don’t get tested, but it’s pretty obvious. Right? And if you think back to this time last year, you probably had a lot of patients that had that three week nagging, cough. I specifically remember saying to patients, wow, I don’t know what was in that flu shot that your coworkers got, but they must be shedding something really bad because you’ve been coughing for three weeks. And every person that I had coming in that had coworkers or family members that had gotten the flu shot, they had the cough, not that people got the flu shot, but the people around them had that three week long cough. So something was going on. So by the time my son got this 15 day, knock him on his butt, sleep and cough and sleep and cough and burn up thing.

We knew something was up, but we just talked it up to, there was something bad in the vaccine that year, because I relied on my philosophy. He didn’t need a test. He didn’t need a drug. He didn’t need a shot. And either you, you and there does your community. What he needed was an adjustment, some sleep, some good nutrition and just time, because all processes required time and he needed time to heal. His body needed time to just fight off whatever was going on. And because we were able to rely on our philosophy, then I’ve been able to rely on my philosophy. Now it’s a lot harder when it’s yourself and your children than it is when it’s a stranger or a patient or a community member. Right? Because then you have that mom guilt that might come in. We say, am I doing the best thing I can for my kid when they’re burning up? Yes. You know, you are because the best thing you can do

Do is nothing. Adjust him and leave,

Leave it alone, detect and correct the red table subluxation and leave it alone, move the bone and let God do the healing. And that’s what we did. And so that faith in our philosophy, that structure, that foundation, that solid principle carried me through with my son, with my daughter and with our patients. And I know that most of you have probably had numerous patients by this point that either have called you because they’re quarantine because their children’s school or their job, or have called you because they were just in your office and then went and got a positive test or have been hospitalized and been in the ICU for this and have come out or are just staying home because they’re elderly or they’re immune suppressed, or they’re on chemo or something. That’s preventing them from leaving their house. So whatever you’ve been exposed to, and I’m sure you’ve been exposed to the whole gamut, understand that this unfortunately is not going away, but how we approach it as chiropractors, our mindset, our mentality, our fortitude, what we believe in, what we stand for and being able to walk.

The walk that we’ve talked for so many years is really, what’s going to lead you and separate you and help you reach your community members right now. So they lock us down again. What are you going to do? If the world starts turning in a different direction, great, what are you going to do? And what are you prepared to do in your office right now? So let’s get your mindset straight, because if you keep your mind on the fact that the body is brilliant, there’s an innate intelligence that knows how to handle everything that comes our way, especially when we provided everything that it needs. Meaning making sure there’s no interference to the function of the nervous system, making sure that we’re supplying it with good food and good water and lots rest and lots of positive mental attitude and moving that body to keep everything going.

Then the body is better able to handle whatever comes its way. So leaning on our philosophy, how do we stay mentally prepared in this time period? When there are unpredictable moments, when you don’t know if your office could get shut down or your state could have a lockdown or your children’s school could quarantine, or you’re told that you have to close your office because you had a patient test positive. So how do you prepare yourself? First and foremost, you need that financial aspect because let’s face it. You have bills. You have to pay and staff that you have to keep employed. So you’ve got to have your finances, right? If they haven’t been right, now’s the time I know you’re thinking now’s not the time to get my finances, right? Well, yeah, actually it is because guess what? Most things around your clothes. So all of your normal spending, not on your bills and utilities, but all your normal spending, you’re going out to eat, going out to drink, going to seminars, traveling a lot of that’s been curtailed.

So put that money aside so that you have the finances to handle a lockdown, and you have to have the mindset that this is all temporary. This too shall pass. This is temporary. And be that voice of reason for your community. Be the one who’s able to say, listen, I understand that you’re scared, but let’s look at facts because numbers are numbers and facts, facts, and scare tactics. While they may have worked. When you look at the numbers and you look at the facts, it’s not as scary as they’re making you believe the numbers just don’t add up. The, the people who are succumbing to this illness were immune compromised, elderly, chronically ill. It’s not your average. Eight year old, 10 year old, 16 year old, 25, 35, 40, 55 year old, 70 year old patient that is succumbing to this. And if that just kind of ran the gamut of the majority of your patients, then you have a lot of leeway there to explain to people, look, stop being fearful because that’s going to put you into fight or flight, and that’s not where you need right now.

Start being more purposeful, start being more dedicated to your health. Start being more grateful for the abundance that you already have. Start being more aware of the life that you’re already living and the choices that you could make to improve your health. Right now start having that conversation in your office. Take a little extra time, because if your office is a little bit slower or you’ve got your patients spread out a little bit more than while you’re doing whatever precautionary measures you need to do in your state. And there’s a patient there use that as an opportunity to talk to them about things that are going to put their mind at ease. Not about the weather, not about sports, not be played school, but about things that are going to put their mind at ease. Remind them that you have an intelligence within your body that is constantly giving to it.

All of its properties and characteristics. That’s maintaining you an existence, meaning your body is brilliant. It knows what to do, make sure that you’re giving a good quality food drink and plenty of water moving, resting, having positive mental attitude. And what you’re doing right here in this office is the most important. And that’s making sure that your brain and your body can communicate effortlessly without interference. So mrs. Smith, I’m so glad to see you here for your adjustment because you’re doing one of the top key things that you can do to keep yourself healthy. Now let’s make sure when you leave this office, you’re staying in the right frame of mind and not getting sucked into all the negativity and all the fear and all the news and all the media. That’s trying to scare you into not living your life. Mrs. Smith. When you leave this office, I want you to go out there and I want you to live to the best of your ability.

Sure. That images may have changed and the places may be different than the experiences. Maybe a little bit smaller or more spread out, but you still get to live. You can still go for a walk. You can still go for a bike ride. You can still make healthy food with your family. You can still bring your friends and coworkers and family members in here to get adjusted. And you can continue to live your best life, even in the pandemic. So have that mindset that you are the voice of reason, have that attitude in your office, that this right here is a safe space for conversation, for healing and for empowerment, where we’re going to teach you that your body is brilliant because let’s face it. Everything that they’re seeing on the news. I mean, this is, to me like an, an exponentially amplified version of what they do to pregnant women during their 40 weeks of pregnancy, right?

Fear-mongering scare your body’s not smart enough. Your body’s not brilliant that baby’s going to be too big. It won’t know when to come out. Your body doesn’t know what to do. You need our help. You need this, you need that. You’re going to need an epidural and a shot and a PZ tummy. You’re going to need all this stuff. Cause you can’t do it on your own. That’s 40 weeks of a woman’s life. Every time she gets pregnant. Now take that and multiply it by the world of where they’re telling us for the last year, almost that this is not going away. This is not going away until 2022. And they’re telling people that, you know, you’re not going to be able to walk out of your house without being gagged without that gag mask on. And you won’t be able to take that gig mask off until every person in the world has a shot that hasn’t fully effectively been tested.

And obviously there’s no long-term studies, but we’re going to make sure we give that to everyone. Anyway. So for your people who are really getting sucked into that and scared, remind them about the movie I am legend with. Will Smith where all the people turned into zombies, except that the very beginning of the movie, which most people don’t even is the reason everybody turned into zombies was because of a vaccine. Hmm. Right. Vaccine that was going to save the world, turn them all into zombies. So look, I just want to have a little fun with this topic with my patients, because I know that it is so stressful and some of them are so tense and some of them are so scared about their family members or themselves or bringing something home. When they go out to the grocery store, I had patients who were literally leaving everything in the garage, spraying down, leaving there for 24 hours before they bring it in and then doing the same thing.

Once they got inside, they were talking on the news, how you had to have airtight chambers for any of your packages and how you had to undress yourself in your garage and put all your clothes in a plastic bag for 24 hours, and then go right inside to a shower. I mean, that’s just insanity because that’s an outside in mindset that the boogeyman out there is going to come in here and we need to put a protective barrier for the boogeyman. Well guess what that protective barrier is already inside. It’s called your immune system and have that conversation with your patients. You know why the nasal swabs are so bad because you’re bypassing the protective mechanism that nasal mucosa, the hairs that are trying to stop and catch everything before it gets inside. But then we take this nasal swab and we shove it up into the brain, right?

As everybody’s saying, so we’re bypassing the protective mechanism. So let’s use our common sense, your brilliant remind your patients, that their body is brilliant while they may not fully understand science, their body doesn’t need to understand science to work properly. So have the mindset that look, your body’s capable of fighting this off. And for most people under the age of 75, if you get this, you might cough. You might sneeze. You might lose your sense of smell. You might not want to eat because you’ll have no real taste going on, but you know what? You’ll be fine. In a couple of days, maybe two or three weeks, you’ll be back to business. You might’ve lost a little bit of weight, but you’ll get back healthy. You might’ve lost a little lung capacity, but you’ll get that back. But the fear that you’re living in right now is so much worse than the virus itself, because that fear is stressed and it’s eating your body apart and it’s not good for you.

So let’s get you on the table. Let’s get you adjusted. Let’s get your body functioning at its best level. And then I want you to go back out there and start living again. And that’s going to make the difference because look, let’s face it. We can not control whether your state is going to lock down again. We cannot control whether your municipality is going to shut you down again, for those of you that have been shut down and we can’t control whether or not your patients are going to buy into this and stay home or getting your office. And if they get in your office, that’s where we can control things. Because once they get in your door, you have the gift of gab. And I hope you use it to share with them, all of the things that they could be doing and remind them that the number one thing they’re doing is being right here in this office, getting your spinal line, helping the nervous system to function freely, without interference, connecting with the spiritual, keeping the brain and the body connected, whatever words work for you, make sure your patients know that this way of living, that we do is an inside out mentality and what the world is trying to scare you.

That’s outside in, let’s not be worried about the boogeyman coming in. Let’s fortify the inside so that we can withstand as many boogeyman as they can throw it our way. Right? And that mentality, that’s going to get you prepared. If your state shuts down, listen, please just try to do your best financially to put yourself in a little bit better position each week. So that if there is a shutdown, you’re okay, you’re not stressed. You’re not freaking out. You’re able to keep going. And then if you need to diversify by doing some virtual calls with your patients or some virtual coaching with your patients or your community, then diversify so that you have an additional income source that could kind of help sustain you in the event of another big lockdown. But in the meantime, listen, let’s just have faith. Let’s put our faith in man.

Let’s put our faith in the system. Let’s put our faith in the fact that people are waking up and they want to go back to life. And let’s put our philosophy as our foundation so that we can lead from a strong mindset that says the body needs no help. Just no interference. And whatever comes at us, we are designed to adapt. We are designed to recognize and to overcome. I know you can do this. I know you’ve been doing a great job in your offices. Whether your practices is booming right now, struggling right now or staying the same. Listen, you’re doing the best in your corner of the world. Just keep doing it. Just stay positive. Keep that positive mental attitude. Remember that those tips of staying healthy apply to you and your family as well as your community. So make sure you’re moving your body every day.

Make sure you’re eating good quality nutrition, getting tons of water in there. Make sure you’re keeping that positive mental attitude to stress is going to eat your way and make sure you are getting adjusted, checked and adjusted on a regular basis so that you can stay on your a game and help the people around you so that they can stay on theirs. It was so great connecting with all of you. I know it’s been awhile. I know we’ve got another great show lined up for you next week. If you ever have any questions, please don’t hesitate to reach out to me. If it’s something, I said, something that touched something in your heart or in your mind, and you just want to have a little chit chat. Don’t hesitate to reach out to me because here we grow and together we rise. And when we come together as women and empower each other, watch out because not only will we empower women, but we’ll empower the men and the children around us to do better, live better and have a greater experience. So go out there, tackle the world, live life to its fullest

And enjoy every minute. I appreciate you. I love it. Appreciate you. Thank you so much to ChiroSecure for hosting, empowering women in chiropractic. And I look forward to seeing you next time. [inaudible] 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. [inaudible] 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.

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Empowering Women in Chiropractic – Are you set up for virtual services? – Janice Hughes

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Disclaimer: 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.Hello, and welcome to another growth without risk show. My name is Dr. Janice Hughes and I’m excited and honored to be one of the hosts for growth without risk. I really am excited to chat today about something that I think is incredibly important right now, which is, are you potentially ready to be virtual? Now? I say that I realized that as chiropractors, we focus on fee for service, you know, and, and when I say that we deliver that service with our hands on, not at any point, suggesting that we completely get away from that. What I want to talk about is some lessons that we’ve learned during this crazy pandemic. And some of you were forced to have your office closed. I think if anything, it’s really brought up that conversation that a lot of people start to have related to. Do you have any other streams of income?

Now, some of you listening, they focused on functional medicine and have an entire division within your facility. Some of you are licensed in acupuncture. So I know one of the things through the growth, you know, sort of the ChiroSecure or this Growth Without Risk network is we have a lot of different styles of practitioners. A lot of this is helping you start to think about yourself, running a business, running a health center, running a clinic that potentially has multiple streams of income. Now, when I say that, I don’t want to overwhelm people. You know, some of you really strong philosophical chiropractors. I was one of those. It was at least beginning a little bit with what are some of the other kinds of products or services that you use? Can you share those with your community? It’s almost like having you, first of all, understand that we’re not asking you to not be the amazing chiropractor you are.

If anything, I want you to become the health connection for the patient. The public wants this, the public let’s face. It is now doing a lot of online ordering of supplements. Well, you and I both know a lot of those are really inferior quality. I would love if you’re ready, that many of you start to think about sharing with your community, the things that you use, the products, the services, the things that you yourself and your family utilize. That’s a great place to start. Now. I like to call these different business units. So thinking in terms of a bit of an organizational design for your entire clinic, you can have your chiropractic stream or your chiropractic business unit, but for some of you that have these other services, I like you to think in terms of what are those business units. Can you think about it like this organizational design and then for 2021, not just setting chiropractic goals or service goals, you know, for you and your team, could it be that if you don’t have any of these other products or services that you think about adding one additional thing into the clinic, some of you actually, our trainers have done personal training background.

Some of you come from the PT, you know, a physical therapy background. I know an incredible chiropractor that began to move and create an entire business unit related to the rehab side of the practice. So it’s critical as we begin to do that, that we think from a business perspective, don’t just build all of the visits in under that same stream, you know, set goals, set targets within this other category. So I want to give you a couple of simple examples, things that we could create a little bit more virtual services. Now, some functional medicine is that really easy fit, turning around and, you know, doing some consultations, even whether they’re in your clinic or virtually, how would you do a questionnaire? How could you start to ask people about other categories of their health and their wellbeing? You know, if you could do that, if you could come up with a questionnaire for that, you could deliver those kinds of things in a Zoot format.

I know that through the pandemic, some practitioners learned to do a report of findings. If you had had a patient come in, right at the very beginning of this, you know, pandemic, you could then deliver the results x-rays results, you know, in a virtual format, starting to think about, could you give some level of guidance? Could you give some of that background and material and information to a patient in a format other than in-person, you know, some of you have gotten very savvy and created some eBooks materials that we always called those, you know, sort of lead generators, but these could be built right into your care plans that you actually share with the patients. And you could do that and coach them and guide them through that. The other facet, I know that there’s a lot of companies out there that offer through their supplements, um, weight loss, weight, weight design, you know, in a health format.

If that’s something that you said, wait a minute, I either have in the clinic and, or I’d like to bring in, start thinking in terms of how would you develop an expand that a lot of times when you have these different business units, it’s almost think about, take a piece of paper and turn it sideways. And then, you know, draw some lines and chiropractic would obviously be one of those business units, setting some goals, setting how you can increase the services that you deliver there, but this idea of a track or a business unit of virtual, what could some virtual services be? Could you subcontract through some of the stress with a counselor or a psychologist? It could be a part of your growing health center, your facility, some of you have acupuncture. That’s not quite as easy, and yet you can modify acupuncture, little easier to do social distancing and or slightly longer visits.

Could you develop an expand that, like I said, if you pick weight loss as an example, what are the companies, do you yourself like certain products? Would you like to put that together through a typical nutraceutical company? Would you like to use one of the existing programs or platforms that are out there? All of these things are good. I don’t, I don’t have a recommendation for you, which company I’m going to suggest though, that you just start to think in terms of, could you put together a webinar as an example, could you then deliver packages that the products that you recommend for cleanses detoxes? You know, again, I’d avoid right now, the, the word immunity, we know we’d all love to boost immune systems, but that really is a trigger word, you know, but could you do these ideas of detoxes that are delivered through a webinar format and then products and services that you deliver?

The key is going to be, if you have nothing right now, besides your hands-on adjusting, is there something you love that you could begin to explore bringing that in as part of your existing care plans, you have your existing database. What are patients asking for? What are they searching for? I know that with the great companies out there that there’s really stronger services, stronger products available. Some of you are probably in States where you actually can’t go into the nutritional realm. That may be more than rehabilitative services. You know, again, subcontracting those, you know, services into your clinic. So a lot of this is you keep hearing me talk about becoming that business owner, becoming the person that drives the business behind your practice, versus it just being the hands-on adjusting so that these sorts of things, number one, add to your bottom line. They provide wonderful care, wonderful services for patients and can some of those literally become in a virtual format.

I think it’s really imperative. You know, we are not psychologists that suddenly began to, you know, turn around and do consultations through zoom. I don’t see that many of us, many of our profession are really set up or designed that well, if you do functional medicine, I think that is a much easier fit into that zoom or virtual format. But I still think it really is imperative. It behooves us as chiropractors to begin to think of those kinds of additional programs or services start with what you’re passionate about. Like I said, passion fuels this. You can’t do this just to say, Oh, I’m going to add something out of fear. If you’re excited, if you would love to add something new, I think that would be fantastic. Then you build, wow, how will I research that? Bring that in. Does it make sense, an example for some of you already using products or product lines, is could you private label that could that come, you know, into a whole new set of business parameters or protocols in 2021, that you private label that, and you figure out some of those lead generators or eBooks or things that help to describe for people how they could have a checklist, you know, a health checklist to determine, you know, again, which programs, which products that you could then consult with them.

You know, also showing how high quality these are compared to something that your patients are buying off the shelf. I know it’s time for us to get incredibly creative. I love chiropractic. I never see us getting away from our hands-on piece. I would just love to ensure that no matter what, you know, where we’re often, if we’re not careful at the expense of the fears of other people. And I think that’s what we’ve learned this year, you know, is that so often we don’t get to control or make those decisions. Obviously the great news is most practices are open. Lots are thriving. The ones that are thriving tend to be ones that they are the health resource for those patients. They’re a health resource within their community. They are exploring products or services that they love. I’m not asking you to start doing things that don’t feel really great.

I think fueling from that passion place, using those products and services, having your existing patients use them and think about developing that into a facet of your business. I think that’s a wonderful way for us to expand and then to always not feel quite at the mercy of what happens based on state mandates, mask mandates, all those things that are in some cases negatively impacting the way we feel about our practices. So a lot of this is number one mindset, you know, love what you do, figure out products, services, other things that you already utilize and start to consider it like a business unit. So you can see that I’ve given you several different kinds of examples. And I just want to review those, you know, it’s the nutrition piece. Some of you that’s a really easy fit. Others. You can’t do that in your state.

You know, I’m also not suggesting that you need to think about going out and becoming a functional medicine expert. If that’s not what you love, you know, it could be things like rehabilitative services, you know, remember muscle work, whether that’s official, physio-therapy functional movement, there’s fabulous functional movement programs that a lot of people can take certifications in. There’s also amazing brain based neurology work. That’s a really strong fit, particularly for some really great philosophical chiropractors. And I’m not saying that you need to go to the route of becoming a diplomat or, you know, really advanced degrees that you could do things like there’s a fabulous brain certification program that I saw. And you know, it’s all about posture. And then delivering, I’ll call it like webinars and information sessions to patients. And obviously you charge for those kinds of things. So I’m not here to tell you what I’m actually here to inspire you.

My hope is to inspire you, to look for products, services, ideas of things that you love, that you can add to the patients that you can use in the format you’re in now adds an extra revenue, a revenue stream, but more importantly, it’s things that are not only dependent on your doors being open. That’s why I think webinars programs, some of the detox, you know, taking a look at those sorts of things I think could be incredibly valuable. So it’s been an honor to talk about this. I’m absolutely happy to answer questions, be connected in any way possible. I’d just like to thank ChiroSecure Dr. Hoffman and his entire team for including me engaging me in things like the topics for growth, without risk. I think practice management, practice, coaching, business ideas. I think it’s really imperative that we keep moving in this direction. So thank you so much for joining. I look forward to your questions and insights and I’m happy to help any of you even just in a conversation to support the ChiroSecure network, have a wonderful day

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/.