notification to Medicare that it's patient responsibility and simply they won't pay what the patient is then due for. That's a terrific explanation. I hope everybody listened to that, play it back because it is important how to document this in terms of the patient file so that you don't have a problem with the federal government when you're billing. Sam, there was just one other thing I wanted to follow up on from what you were saying earlier. You made a very quick mention that the doctors are starting to receive a letter from Medicare showing their profile and ranking basically. I forgot what the letter is called that you mentioned but a lot of doctors call us thinking that this is a Medicare audit when it's not. Can you explain to the doctors what they're actually receiving and what that means to them? Absolutely. I think most doctors, you get a letter from the Federal government and Medicare you're thinking I'm being audited. Actually, Medicare is required under the OIG to make it what they call a comparative billing report. Every doctor is going to receive it and what it basically does, it just breaks down, to your region not just nationwide but to your region, the number of services you provide on average per Medicare patient as well as the breakdown of the percentage of the code you use, how many patients are 98940, 98941 and 98942. It's completely informational. However, when you look at the report, it's critical to look to see where do you fit. If you have a much higher than average, you're sticking out. That's a bit of a red flag. Medicare is more likely to send you off to get a separate audit simply because you fall outside the norm. Here's what Medicare expects. About 35% of your patients are approximately 98940. Fifty-five percent would be for 41 and about 10% or even a little less than 10% would range, you're probably going to be okay. If you're a little plus or minus on either end, I don't think it's going to be that big a deal. The other areas Medicare looks at the number of visits. Medicare expects on average most patients should not require more than 25 visits in a year. Now, that's an average and we all know what averages mean. I don't have 2.4 kids and I'm pretty sure you don't either. Therefore, that's really just a point of contention. For me, that doctors [inaudible 00:44:44] if you were treating patients for longer periods, can you justify it? Now, what if you treat a very aged population that has significant disk degeneration? I would bet you're going to see patient a lot longer than if you were in area where the patients didn't have as much disk degeneration. You have to look at the comparative analysis to say, "If I'm above what's normal, can I justify it?" What I would say a doctor to do and this is what I tell them when you get this comparative billing report, you want to do your own security risks analysis in your office. Take a look at your files and just pull some files and see when I bill the 41, do I have my 3 regions. If I treat this patient more than, say, 18 times, can I look at and make a graph that shows the patient getting functionally better? What I would say to doctors, don't panic with this report. Take it as a way of self- auditing yourself to see if you're way above the norm, why? I'm not going to tell a doctor he's wrong for being above the norm. You have to make sure do you
Dr. Hoffman:
Dr. Collins:
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