Your Training Checklist for Success in 2013

I n 1983.1 took my first job as a Chiropractic Assis­tant (CA). I never dreamed that it would become my career and my passion. I"m grateful every day for my very first employer in Chiropractic. Dr. John Connors, who taught me that anything was possible. He made sure I knew that I was a valuable member of the team and tliat my work directly affected the patients, even though I was not the one treating them. Weekly team meet­ings introduced me to the likes of Napoleon Hill and " What the Mind Can Conceive and Believe, it Can Achieve!" I was given a "Goals and Dreams" binder and en­couraged to set both busi­ness and personal goals. In 1984.1 was taken to my very first Parker Seminar in Las Vegas, and registered for classes that helped me to achieve Basic Training as a Chiropractic Assistant, a plaque that still hangs proudly in my office to this day. Dr. Connors saw to it that I knew everything I needed in order to be the best I could be. both person­ally and professionally. He knew tliat the better I was personally, the better an employee I would be in the service to our patients. He taught me about a lifetime of learning and keeping with changes in rules and regulations. Most importantly, he instilled in me the know ledge that "he who lias the most information, wins". That has been my mantra throughout my 30 year career in this profession. Unfortunately, not every CAs experience and indoctri­nation to Chiropractic is like mine. Turnover is high in our profession and often, job satisfaction is low. According to a report published by the Bureau of Labor Statistics in September 2012. the median number of years that wage and salan workers had been with their current employer was 4.6 years. However, in the healthcare support sen ices sector, this number drops to 3.3 years. In my experience, this number drops even lower in our Chiropractic profes- sion. The reasons are often lower pay and lack of varied activities that keep one learning and growing. In another report published by the Society for Hu­man Resource Management (SHRM) in October 2012, ■'opportunities to use skills and abilities" outranks "job security" for the first time since 2004. One of the most significant recommendations that came out of the report was to continuously develop existing employees. Frc- quently. employees have skills and abilities or desires beyond the position for which they were hired, the report notes. This is especially prevalent in entry level positions. often found in Chiropractic offices, which rely heavily upon "on-thc-job" training to learn a particular skillsct. Career development is an opportunity for employees to continually take part in more advanced or diverse activi­ties (e.g. training, networking) that result in improving skills, gaining new skills, taking greater responsibility at work, improving their status and earning higher income. The opportunity to develop and enhance our know ledge as CAs has never been more important than it is now. With compliance regulations for healthcare grow ing by the day. doctors cant keep up with it all. Well trained and dependable assistants arc not a luxury . ..we arc a necessity. We're all big fans of the "win-win" relationship. It"s beautifully illustrated in the area of developing an assis­tant's abilities in the practice, so these important skills can contribute to the overall protection of the practice. Having more qualified sets of eyes on the business side allows the doctor to focus on the treatment side, where their passion and energy drives the overall practice operations. If you or your office hasn't kept up with ongoing training and education for every very important team member, it's a great time to set the goal to accomplish that this year. The following is a checklist of areas of know ledge tliat the most effective and efficient practice team members possess. Use it to plan your training strategies for 2013 and to see how you can gain new skills and take greater responsibility in the delivery sen ices and care in your office. General Chiropractic and Office Skills D Mastery and understanding of general chiropractic terminology. D Mastery and understanding of general third party payer terminology. □ Mastery of general phone skills. D Mastery of general computer skills. Front Desk Skills □ Proper handling and completing of a new patient phone call. D Proper scheduling techniques, for NP visits and routine visits. □ Correct handling of multiple appointment scheduling after the Report of Findings, through the first examination. D Mastery of the practice management computer system for the office. D Basic collections skills to keep patient account bal­ances in check. General Third Party Insurance Skills □ A clear understanding of how major medical insurance works. D A clear understanding of how Worker's Compensation in your state works. D A clear understanding of how Personal Injun in your state works. D General know ledge of Medicare, including enrollment. who is covered, your carrier, and chiropractic coverage. D General knowledge of Mcdicaid. as it applies to your state. D Excellent collections skills and techniques when working with third part}- payers. Coding Knowledge D Strong know ledge of all coding used in a chiropractic practice. D A basic understanding of ICD-9 diagnostic coding and how it is applied to proper billing. D In depth knowledge of coding for Chiropractic Manipulative Treatment (CMT) Therapies, and X-rays. D HCPCS coding for chiropractic durable medical equipment and other non-CPT coded items. D Complete understanding of the timed coding rules as they apply to timed modalities and procedures. D Broad understanding of the propcruse of modifiers in chiropractic reporting and billing. D A clear comprehension of how Evaluation and Management coding is used in chiropractic. General Billing and Collections Knowledge The following items relate to Major Medical. Worker's Compensation, and Personal Injun D The ability to properly verify all types of third party insurance, understanding the nuances of each. □ Complete proficiency of both paper and electronic billing techniques, systems, and schedules. D Thorough systems for properly processing incoming daily mail into your billing and collections system. D Extensive knowledge of proper processing and posting inbound third party payments, including line item posting. D The skills necessary to install and properly manage a follow up system that includes proactive, aging report follow up. reactive daily follow up. and. ongoing tickler follow up to maximize collections. □ High level abilities to conduct appeals processes with third party payers, to collect every penny due to the office. D Know ledge of proper patient billing and follow-up techniques, including statements and collections processes. D The ability to record proper statistical management for the billing and collections department to maximize efficiency and reporting to the doctor and management. Medicare Knowledge D Know ledge of proper verification of Medicare. including replacement plans, secondary and supplemental insurance, and identifying other self-insured type Medicare options. D A clear understanding of the special billing requirements of Medicare, including PQRS and carrier policies. D Mastery of special coding requirements of Medicare, including diagnosis. CPT coding and special modifiers. D The ability to master the proper use of and management of tlie Advance Beneficiary No­tice (ABN). D Detailed and specific un­derstanding of the require­ments and elements of the Medicare Appeals process. Compliance Knowledge D Complete understanding of the rules as they apply to patient financial policy, to include proper fee schedules, proper and legal discounts, and hard­ship agreements. D General k now ledge of the applica­bility of the Office of Inspector General (OIG) Compliance Program for small practices, and commitment to follow these rules. D Proper implementation of HIPAA Privacy knowledge as it relates to requirements for all healthcare employees. Obviously, this is not an all-inclusive list, but I do encourage you to take a short self-test and find out if you arc "up to speed" in every area, and where you could use some additional, ongoing train­ing. Since we know that job satisfaction is directly related to the knowledge base of the employees, make 2013 the year that you arc able to contribute more to the practice. AND to your job satisfac­tion. Find out what kind of training is being offered in your area, at your state chiropractic convention, during online webinars or with other online training. Set some goals for which areas you"II work on each quarter of 2013 and watch how it will bring your office more effi­ciency, effectiveness, and success. Don't be surprised when this happiness and success spills over to even area of life. Kathy Mills Chang is a Certified Medical Compliance Specialist (MCS-P) and. since 1983. has been providing chiropractors with reimbursement and compliance training, advice and tools to improve the financial per­formance of their practices. Kathy is known as one of our profession 's foremost experts on Medicare and can be reached at (855) TEAMKAIC or infofqjjaticuniversity.com