We’ve all heard of the “social network” by now. I was thinking about chiropractic software for practice management and chiropractic billing software the other day, sad but true, and how web-based software could be used to build, not a social network, but a chiropractic “profitability network”. Then it hit me. I came right back to chiropractic philosophy.
Shared Immunity – One of the central philosophies of chiropractic is that illness is a function of the resistance level of the body’s immune system, not the strength or amount of the “germ”. Medicine still subscribes to the “germ theory”. If you come in contact with a germ you get sick. Chiropractors know that the symptoms, though uncomfortable, are a necessary part of the immune response and ultimately lead to a stronger immune system. Well, could you imagine if we could share one immune system. If you were to get “sick” my immune system would be updated with all of the antibodies that had to be developed to fight your infection. Best part, I would have NONE of the suffering. That would be great! We would all suffer much less as a group. Even cancer rates would be decreased since some immune systems are better than others at fighting cancer. The down side would be someone has to suffer when a new mutation of a virus or bacteria comes along. So what, if anything, does this have to do with chiropractic practice management software or chiropractic billing software? Stay with me I’m getting there.
Chiropractic Software – In recent years there has been a shift for software that you buy and store on your computer (client-server) and internet based/ web-based software (SaaS). More and more people are realizing the benefits of the web-based type software. We’ve seen how web-based software like Facebook has changed the way we communicate. When it comes to chiropractic the web-based software has certain unique advantages that make its value so high that I wonder why anyone would buy a client server software again. To help you understand this from the chiropractic practice management and billing software point of view let’s use an example as a reference point for future discussions.
Reference Point – The Insurance Billing Problem Insurance companies make more then 50% of their profit on the “float”. That is interest and dividends earned on money that is sitting in their bank account because of payment delay tactics when really it should be in the doctors collective bank account. They take that money and re-invest it in insurance audits and make another 13:1 return on investment. So fist they delay paying you and then they take it back. Their methods of delay are many but here are a few; complicated coding, ambiguous documentation requirements, line item denials, underpayments, etc. The point here is they make the rules and we have to keep up. If and when we get them on the phone we are talking to a resource who is overseas and being paid $1 per hour. How can we collectively level the playing field? That takes me back to the shared immune system.
Old Software (Client-server) Vs New Software (Web-based) – First we need to realize that for the greater good, sometimes, someone has to get sick. How does that apply to software? It just so happens that when you are using a web-based software for chiropractic insurance billing you are sharing your information with the other doctors using the software. It is not like the other docs see your insurance claims but the data is shared. Patient Demographics are safe and HIPAA compliance is safe. For example, if/when Medicare changes the diagnosis order requirements in one state. Suddenly they want a 739 code in position one. Since, in theory, all doctors would be on this web-based system in that state their data would be looked at as a whole. A spike in medicare denials would show.
1. With the older type of software, client-server, each chiropractic office in that state would have to investigate the problem independently. This wastes lots of man hours and results would vary from practice to practice. The time it would take would vary from practice to practice. In most cases it will be months before the office realizes a cash flow problem tied to medicare claims and come up with some type of office procedure to make sure it does not happen again. The process is likely a manual one and therefore prone to human error. It is unreliable. The software company does not have access to thousands of claims and probably does not care anyway. They are not going to help develop protection against this billing error. You already paid for the system so why would they redevelop software? In this case you fight against huge insurance companies with powerful technology and unlimited resources as small individual practices. Your immune system is numbered and out matched.
2. With the new web-based software one resource can do the investigation from one location. Fees for web based systems are usually on a monthly basis rather than a one time fee. The software company need to keep its clients happy so they need to constantly update the system. Since there are thousands of claims aggregated from across the state a spike in Medicare denials shows up on the radar instantly. The new 739 rule is discovered with just one person doing the investigation, an expert, not a part time biller. A counter rules is built into the technology (the antibody) alerting the doctor to make the change before submitting the claim. Even if he/she accidentally submits incorrectly the system recognizes it and pushes the claim back to the office for correction before submission. Instantly all doctors using the system are immune to this particular problem. As time goes by hundreds of tactical attacks from the insurance company are deployed. They are all caught and dealt with in a similar manner. Rules and work flow are built into the system to help the doctors using it fight back. In this case we fight the insurance companies as a unified front using technology to create economies of scale and beating the insurance companies at their own game.
Summary – In the technology world the term for the group of doctors using a web based system like the one described above is the “network”. We’ve all heard of the “social network” by now. Well this an example of a “billing network”. What is described above is the “Network Effect”. It is revolutionizing the way we communicate socially and the way technology is developed, especially chiropractic practice management software and chiropractic billing software. In this case it is changing the way chiropractic billing services are doing business as well. The above example focuses on the billing network and specifically using it to defend against insurance company tactics. The truth is the attack on your office profitability is a multi-front war. Documentation, compliance, patient flow, no show management, care plan management, are also areas where it benefits you to be on a network. Without one system controlling and coordinating all of these systems for your practice and at the same time evolving in real time based on user input, you stand to fight alone. Web based system not only function like an immune system but in the bigger picture as the CNS for chiropractic office profitability. In future articles I will discuss each front of the war individually and in more detail.
Copyright (c) 2012 Dr. Brian Capra
