Author Topic: Breakdown of Doctos  (Read 5326 times)

shanbull

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Re: Breakdown of Doctos
« Reply #15 on: January 30, 2014, 10:23:46 AM »
Mental health can have low comparative reimbursement for the providers (although it's really not too bad), but it's one of the easier specialties to bill for. I am employed full time by one clinic, and the specialties I bill for are:

- Chiropractic (easy once you know all the rules)
- Acupuncture (a bit harder, more rules than chiropractic)
- Physical Therapy (harder now that functional limitation reporting is required, lots of mutually exclusive procedure rules)
- Internal medicine (usually not hard but once in a while a real conundrum)
- Psychotherapy (easy)
- State Medical Home program (awful, it took a software patch and 6 months to get this billed properly)
- Cardiology assessments (tricky due to diagnosis requirements for Medicare)

Mental health billing is a good specialty to get some experience in. It's not likely to overwhelm you with technicalities. I get paid the same amount per hour regardless of what happens, so I would highly recommend charging a flat hourly or per claim fee. That way what you make isn't directly tied to how much or how little the provider makes.

only one specialty I won't touch is chiropractic. No amount of money will get me to touch that specialty.

 :P Curious to know why? There are so many potential reasons why someone would not go near it.
« Last Edit: January 30, 2014, 10:26:41 AM by shanbull »

PMRNC

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Re: Breakdown of Doctos
« Reply #16 on: January 30, 2014, 11:02:28 AM »
Quote
:P Curious to know why? There are so many potential reasons why someone would not go near it.

It's my own opinion based on experience talking with many billers and chiropractors, the risks are higher of fraud.. may seem like a stereo type but this is just what I've seen. Knowing the rules is one thing.. getting chiropractors to play by them seems to always be a headache.   JUST MY OPINION!!!
Linda Walker
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shanbull

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Re: Breakdown of Doctos
« Reply #17 on: January 30, 2014, 02:47:20 PM »
Quote
:P Curious to know why? There are so many potential reasons why someone would not go near it.

It's my own opinion based on experience talking with many billers and chiropractors, the risks are higher of fraud.. may seem like a stereo type but this is just what I've seen. Knowing the rules is one thing.. getting chiropractors to play by them seems to always be a headache.   JUST MY OPINION!!!

Actually I agree, we just received another letter today getting yelled at for billing too many 3-4 region adjustments compared to 1-2 region adjustments (by a ratio of 9:1). Of course they also just gave this provider their highest rating and don't even make him request prior authorization. So they're both threatening to kick him out and giving him the highest rating they have within the same month  ::)

PMRNC

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Re: Breakdown of Doctos
« Reply #18 on: January 30, 2014, 04:05:15 PM »
I can honestly say I've NEVER had the privileged of speaking to an HONEST chiropractor!  My insurance guy even told me that malpractice and E/O for chiropractors are higher.. gee wonder why?
Linda Walker
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cflorez

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Re: Breakdown of Doctos
« Reply #19 on: January 30, 2014, 04:27:29 PM »
Thank you all for that dialogue. Your right,  when your first starting out there are so many questions whirling in your head. It's hard to know which one to solve know or later. But, you have no idea how helpful these forums are. You all are appreciated. Thanks

DMK

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Re: Breakdown of Doctos
« Reply #20 on: January 31, 2014, 11:36:56 AM »
Just piping in regarding chiropractors.  It is NOT true that their malpractice is higher than other medical providers.  It's among the cheapest.  Don't know about the E/O comparisons though.  There are a lot of dishonest ones out their.  But there are a lot of honest, hard working, caring ones out there too.  The billing shouldn't be complicated at all.  The rules are pretty straight forward.  Unfortunately, the one's out there for the money, not the care, are learning bad things from the seminars showing them how to bilk the system.  Avoid the "cash" practices and the pre-pay practices like the plague.  A good chiropractor should have some result within 5 visits or refer you out.

And shanbull, if the record supports a 3-4, don't worry about it.  If the record and diagnosis doesn't support it, it shouldn't be billed....period.

Michele

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Re: Breakdown of Doctos
« Reply #21 on: February 03, 2014, 08:08:22 AM »
I agree with DMK.  I have had the pleasure to work with many very honest and caring chiropractors.  I have also met some of the not so honest ones.  I don't actively seek them out or market them because they can be more difficult.  They get asked for notes often.  The NYS comp laws have crippled them.  I understand why comp needed to change but they went from one extreme to another.  Now patients are being denied necessary treatment and I'm not strictly referring to Chiropractic.  A good friend fell at work and had a complex fracture in her arm.  She was denied OT under the new WC laws. 
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