Audits, Accounting and Problems
Tuesday, April 13, 2010 at 2:59AM 
R.J. Hammett, DC
Chances are that at some time in your practice life, you’re going to be hassled. An insurance company won’t like you, a fellow chiropractor will turn you into the board, you’ll do or say something stupid. Whatever the case, some “authority” will come knocking at your door. Trust me, it is not a good experience. So what do you do? Well, prevent defense is the best game plan. It won’t solve all your problems or totally protect you, but it may give you a fighting chance. By the way, if you’re doing something illegal or unethical, nothing will save, so quit now and stand up right.
Here is a check list of things you should look over:
1. Are you HIPPA compliant?
2. Do you use informed consent on all patients?
3. Do you “really” listen to your patients and write down what is said and done?
4. Do you re-x-ray or re-exam every patient every 15th-30th visit or so?
5. Do you re-examine those who just ‘drop in’ for a quick adjustment?
6. Do you review your outgoing billing at least twice a year? Do your codes match your documentation?
7. Are you keeping up on continuing education courses?
8. Do you know when to refer a non-responding patient?
9. Are you answering patients concerns?
10. Are your staff members working with you or against you?
11. Do you examine/x-ray the parts you adjust or treat?
12. Do you watch your promotions i.e : “Guarantee a cure” practicing outside your licence law?
13. Are you using outregous techinques or other on the edge stuff in your clinic?
14. Are you keeping up with changes in the laws of your state?
Ok, you have done everything right but someone wants a piece of you? What do you do?
1. Never, ever talk to any investigator from the board or person without the presense of an attorney. Ignore the inclination to cooperate fully until you have legal representation.
2. Do not grant an entry. Do not turn over patient records or other office material, send them to your attorney to send to any requesting authority.
3. Do not allow your staff to be interviewed.
4. Do not allow any authoriziation into your office without an attorney present.
5. Be respectful and polite, and tell the investigator that you will cooperate through your attorney.
6. The investigator is NOT your friend.
7. If you receive a subpoena, verify it with your attorney first.
8. Talk to a lawyer that is specialized in your type of case; NOT a general practice attorney.
I hope this helps, in fact, I hope you never need this information. But remember, bureaucracies are not your friend, nor will they ever be. Their job is to police, let them do their jobs, you do yours.
Til next time. RJH