Us older guys and dinosaurs are going to say, "That's not the way we did it in the 60s." I’m sure my dad would be going, "I’m just going to put my initial," because that's what he was used to in the 60s. Now, you learn, "Hey, just sign it." Signing it means they're going to pay you and as Dr. Ken pointed out, there's 10,000 people a day becoming Medicare. That's going to be a large portion of our practice. Therefore, doctors didn’t understand, we want that and it's the only insurance actually that's increased rates. The average doctor now is getting about $40 for a 98941, that's not fantastic but that's certainly a lot better than many of the American specialty health and some of these other PPO plans and, yet, we can still go to patient for their services. I really wanted have doctors be able be able to improve Medicare and Medicare patients, of course, are probably the best patients you have. They love you. They bring you Christmas gifts and they're probably going to bring you the most referrals. At the same token just go back to you're giving someone help that no other doctor actually ever touches them and makes them feel better. A Medicare patient leaves your office and feels better. That's unique. We need to make sure that the patient understands. They'll be seeking out our care more and more and hopefully, Medicare, begins to figure out, you know, when you go to a chiropractor we spend a tenth of what we spend medically. That's the emphasis because Medicare like every other plan has to make sure it's still solvent and they're going to look for providers who can provide as adequate or better care at a much cheaper price and we certainly do that. We just got to make sure our documentation is in line. Thanks, Sam. That's really good. I want to you, Dr. Ken, for a minute about a whole different part of this. When I practiced in Michigan, I tell some stories which I’m not going to get into today when I’m teaching like last weekend, I was at Life University teaching some risk management to the doctors there. When we were practicing there, I was big on our own marketing, on our own advertising and offering people an opportunity to come in and see us and experience what chiropractic can do for them whether it be maybe at a reduced rate or something to that effect all those years ago. Medicare itself has very specific laws. In fact, the federal government has very specific laws about inducement and can you tell us a little bit about what you can and can’t do when it comes to a federal, a Medicare, Medicaid or federal employee in terms of these promotions that so many of the chiropractors around the country have seen to do? You now opened up a major issue on a number of different rules, regulations and opinions. For example, the OIG has put out an opinion number 0803 which is if you're going to give some type of a prompt payment discount to a patient, it cannot be between more than 5 to 15% and has to be documented properly. One of the big things is, of course, there is the anti-kickback and safe harbor rules and that goes from 42 USC 1328 through 7B. Again, you cannot induce the patient to come in such as free exams, free x-rays, things of that nature for, especially a Medicare patient.
Dr. Hoffman:
Dr. Murkowski:
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