each and every visit, things like that. I don't know if the doctors really get the magnitude of dealing with the paperwork in the capacity that it needs to be dealt with in this day and age to comply with Medicare's rules and regulations. Well, I agree. I think most time you see that the latest ones have come out that chiropractic has a 92 % error or failure rate of documentation. Most of that is quite simple. The one thing I do like about Medicare, they're very straightforward. They tell you exactly what they want and how they want. Now, that could be another episode for us to do here for a webinar, but if once you follow those rules, they're actually not hard, you just have to know what they want. One of the things you pointed out and I think this is a [high rate 00:25:17], I would ask every doctor listening to this, how many of you sign your full name at the end of the treatment note on each visit? If you're not saying yes to that you have failed the Medicare audit. Even though your notes could be perfect, because you failed to sign, the Medicare is going to reject them. Now that's an easy one to fix to Medicare, but again it's little things like this that often are just misled or doctors misheard that. They thought, “Oh I thought, initials were okay,” not for Medicare. Remember, f electronic signature is fine also with electronic health records, but there must be at the end of each visit, a signature or a statement that these are your records electronically. Can we also interject something that you and I have spoken about to and I know this is in the middle of trying to share some of these codes, but I think it's an appropriate time perhaps. When I talk to doctors, some of them don't even want to participate with Medicare. As you said, “If you learn how to document properly, it's not going to be a big deal, it just needs to be done.” However, doctors think that they can opt out of Medicare or they don't seem to understand being a participating provider from non- participating. Would you mind sharing a little bit of the difference with us? Oh absolutely, it's something I think is a common confusion among chiropractors and it's because the way Medicare words it probably. First off, chiropractors if you want to treat Medicare patient, you have to be registered with Medicare and when you register with Medicare, you can register as what's called a participating provider or you may register as a non-participating provider. In both cases, you're part of Medicare. Par and non-par doesn’t mean you're in and out, it means the designation when you're in, what type. The differences here are par provider bills Medicare and gets more money on claims they accept [inaudible 00:27:16], which they always have to do. A non-par provider though has the option of having the patient pay up front and they get to charge the limiting charge, which allows them to get a little bit more money when the patient pays upfront. However, the downside to being non-par is that you get less money when you accept assignments. It's really an issue of if patients can afford to pay up front, it's better to be non-par. If you have most patients who are accepting assignment, better to be par. In either case though, you must be registered with Medicare. If you are not registered with Medicare, you can't treat a Medicare patients and here's why, Medicare federal law requires that covered services performed to a Medicare patient must be billed. The only provider who can bill these covered services is a registered provider, so if a chiropractor chooses to not be part of Medicare, they can't bill, which means they
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