The following is an actual transcript of the ChiroSecure Live Event with Dr. Stu Hoffman, Dr. Sam Collins and Dr. Kenneth Murkowski. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. If you have any questions about the transcript or would like to request any transcripts from our previous shows, feel free to contact us at 866-802-4476.
Dr. Hoffman:
Medicare audits are increasing in frequency, volume and impact. Doctors are being told to repay up to hundreds of thousands of dollars in Medicare payments following these audits of their claims and the medical records. This usually begins with the request to review maybe 10 or 20 of their files. The auditors, if they find anything of what they call of interest in those first records, it can and they do sometimes expand the audit to up to a hundred different files and this can stretch out for years affecting your Medicare payments. We know that private insurers always wind up falling in line behind what the government does. It's becoming an increasingly common thing for these record requests and audits to come flying in from all directions which is why, in ChiroSecure Malpractice Insurance, we came in 2005 with audit defense for all of the doctors and some of the other providers have added this into their policy. Usually, it's only for Medicare and Medicaid which is fine since we're talking about. When it's the individual or private insurer, we're still the leader in defending our doctors against these individual audits. In the end, the DCs and CAs must learn about these rules and regulations. The reason I invited the guests today, Dr. Ken Murkowski and Dr. Sam Collins, is to help understand a little bit more about Medicare and how things are working today. The Affordable Care Act, these marketplace plans which are basically subsidized plans that give tax credits and lower premiums to lower income families, are also using these quality improvement organizations to help them credential and qualify to sell plans on the marketplace and be responsive to the centers for Medicare and Medicaid services CMS. Another reason for these increased audits, by the way, audits are being performed by independent contractors. Please understand whose payment is a percentage of the doctor's repayment. The amount they get you to pay back determines how much they make. We live in a world that we have to be understanding that people are looking every which way at the money they sent to us and how to recoup it. The sooner you become confident in your record keeping and the sooner you master the proper CPT and ICD-10 coding, the sooner you can return to concentrating on the patient, good patient care, serving your patient's needs. Let's just jump in and help you with this understanding of the CPT and ICD-10 coding. I want to start by talking to Dr. Murkowski. Ken, I just want to first thank you for being with us. You're always there to be with us, support us and help us in any way necessary. The first question I would ask is the OIG has issued certain contraindications for chiropractic regarding primary chiropractic care. Can you tell us a little bit about this and what that means? Thanks for having me today. It's always a pleasure to help ChiroSecure. Basically, the OIG had issued a report that 94% of the claims reviewed have missing documentation. One of the things that was basically missing was the doctor
Dr. Murkowski:
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