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Do your patients pay out of pocket for their maintenance care, or do they just plop down the co-pay every couple of weeks? Click here to find out how the insurance companies figure out how much business as usual can cost you.

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• The Compliant Wellness Practice
• The Bulletproof Practice - Part 1
• The Bulletproof Practice - Part 2
• Saving the Profession from Tyranny
• Do you want to re-define medical necessity?
July/01/2009
BCBS Sees $350M Gain From Anti-Fraud Investigations

June/30/2009
CMS 'Complex Reviews' On The Way By August Or September

June/24/2009
Medicare Fraud Strike Force Charges 53 Providers, Execs and Beneficiaries

June/22/2009
Health Net Will Stop Using Ingenix Database

June/18/2009
Medicare Fax Scam Alert

June/15/2009
Federal Court Says States Can Decide Medical Necessity Under Medicaid

June/11/2009
OIG Reports More Than $2.4 Billion in Expected Recoveries

June/04/2009
HFMA Releases Model Charity-Care Policy for Non-Profits

June/03/2009
Claim Adjustment Reason Code (CARC) Update

June/02/2009
Railroad Medicare Posts Procedure to Reopen Claims

June/01/2009
Study Ranks Aetna, Cigna and Humana as Fastest Payers

May/28/2009
Antitrust Laws Could Limit Efforts to Control Prices

May/14/2009
Clarification About the Medical Privacy of Protected Health Information

May/09/2009
White House Plans Tougher Fraud Control Efforts

May/08/2009
FTC Grants 3-month Delay on Red Flags Rule

May/07/2009
OIG Finds Increase of CERT Error Rate for Chiropractic Claims

May/07/2009
Provider Action Needed For CMS Crossover Claims

May/07/2009
Federal Law Would Further Fight Government Healthcare Fraud

May/06/2009
Ingenix Database to Face More Questions from the Federal Government

May/06/2009
Michigan State False Claims Act Reviewed by the OIG

May/05/2009
New CMS Rule Cuts Enrollement Back Billing Time

May/04/2009
Bill Could Lead to More False Claims Prosecutions

May/01/2009
New HIPAA Stadards for 2012

April/16/2009
New Interest Rates for Medicare Overpayments and Underpayments Announced

April/07/2009
San Diego System Fights RAC Procedures

April/01/2009
United Health Group Face Skeptical Senate Panel

March/27/2009
Florida Senators Introduce Bill To Prevent Medicaid Fraud

March/19/2009
City of Angels Hospital Exec Pleads Guilty to Medical Fraud

March/18/2009
Federal Stimulus May Not Be Enough For EMR

March/17/2009
Wal-Mart to Market Electronic Medical Records Systems

March/16/2009
Medicare Sigature Requirements

March/13/2009
Fraud and Abuse in Medicare Become Part of Politics

March/09/2009
ShopKo Pays OIG $670K For Excluded Employee

March/06/2009
Claim Adjustment Reason Codes Effective April 1st

February/24/2009
Federal Government Nearing 50% of Health Spending Total

February/18/2009
Ingenix Database to be Shut Down

February/18/2009
CVS Pays $2.25 Million to Settle HIPAA Privacy Case

February/10/2009
HHS OCR Posts New Website for Health Information Privacy

February/07/2009
CMS Change in the Amount in Controversy

February/02/2009
Federal Fraud Charges in Private Insurance Case

January/30/2009
Required ID to Call CMS Customer Service Centers

January/28/2009
New HIPAA Frequently Asked Questions for Family Medical History

January/22/2009
When Not to Show Patient Paid Amounts on Medicare Claims

January/20/2009
Bartering for Treatment

January/16/2009
UnitedHealth Settles with NY Attorney General Over Fees

January/15/2009
Obama Announces Plan for Electronic Health Records for Everyone

January/14/2009
Doctors Can Have a Group Practice While Maintaining Private Practices

January/13/2009
Part-Time Employees Also Exempt from Anti-Kickback Laws

January/12/2009
Chiropractor Sues Patient Over Negative Online Review

January/11/2009
2009 CMS Coding & Reimbursement Update

January/10/2009
HHS Faces Fraud, Billing Challenges in 2009

January/09/2009
California Supreme Court Rules Against Balance Billing by Hospitals

January/08/2009
Economic Stimulus May Send $100B to Healthcare

January/08/2009
CMS Claim Status Category Code and Claim Status Code Update

January/07/2009
Seven NY Hospitals Accused of Fraud due to Marketing

January/06/2009
Annual Medicare Contractor Satisfaction Survey

January/06/2009
Health Care Spending in 2007 Increased at Lowest Rate in Nine Years

January/05/2009
Increased Compliance Efforts Required by Employers

December/30/2008
CMS Timely Filing Deadline

December/03/2008
Fraud and Abuse Control Program Annual Report For FY 2007

November/19/2008
Doing Business With New Medicare Carriers

November/11/2008
Justice Department Recovers $1.12 Billion in Fraud Repayments

November/04/2008
New Medicare Physician Guide Released

November/04/2008
Court Blocks White House Push on Medicare Expenses

November/03/2008
HHS Blasts CMS's HIPAA Enforcement Program

November/03/2008
Presidential Candidates Position on Chiropractic

October/27/2008
FTC's Identity Theft Rules get a New Deadline

October/16/2008
California Bans Balance Billing

October/08/2008
CMS Sets Plans for RAC Contractor Expansion

October/03/2008
CMS Policy on Recoupment

October/03/2008
Resolving Common NPI Problems

October/01/2008
Cracking Down on Medical Identity Theft

October/01/2008
2009 OIG Work Plan

October/01/2008
2009 Medicare Part B Deductible

September/18/2008
New HIPAA Release on Communicating with Family and Friends

September/17/2008
NY Hospital Pays $89 Million Due To Whistleblowers

September/05/2008
Preparing for the RAC Program

September/02/2008
Whistle-Blowers Help US Recoup $9.3 Billion

September/02/2008
Examining the Practice of Balance Billing by Medical Providers

August/27/2008
Implementation of New ABN Postponed

August/25/2008
Expect Tougher Medicare Reviews

August/21/2008
Medicare Fraud Cuts Disputed by OIG

August/19/2008
California Court says Physicians Can Not Discriminate

August/18/2008
HHS Proposes 2011 Deadline for ICD 10 Code Adoption

August/11/2008
Majority of Patients Want EMR

August/09/2008
Denied Services Contribute to CERT Provider Compliance Error Rate Percentages

August/01/2008
Beneficiary Submitted Claims

August/01/2008
Medicare Signature Requirements

July/25/2008
Requests for Medical Records from Medicare

July/24/2008
House Committee Approves Bill Aiming To Promote Electronic Health Records Nationwide

July/23/2008
Notice of New Interest Rate for Medicare Overpayments and Underpayments

July/21/2008
CMS Therapy Cap Exceptions Extended

July/16/2008
CONGRESS OVERRIDES PRESIDENTIAL VETO

July/16/2008
Providers Lose Almost 70 Percent of RAC Appeals

July/14/2008
Medicare Auditors Recover $700 Million in Overpayments

July/08/2008
OIG Gives Opinion On Offering Patient Satisfaction Gift Cards

July/08/2008
HIPAA Prosecution Targets Arkansas Clinics Employee

July/08/2008
HIPAA Prosecution Targets Arkansas Clinic Employee

July/02/2008
CMS Posts a 10% Error Rate for Chiropractic Claims

July/02/2008
More Than 500 Backlogged Whistle-Blower Cases

June/26/2008
Update to CCI Edits - Effective July 1, 2008

June/25/2008
Consortium Formed to Fight Medical Fraud

June/24/2008
CMS Selects Pinnacle Business Solutions, Inc., in 3 States

June/18/2008
CMS now says NPI must match IRS data

June/17/2008
AMA Releases First Insurer Report Card

June/14/2008
Dr. Terry Rondberg Comments on Article By Dr. John Davila

June/13/2008
Audit Finds That Illinois Medicaid Paid Providers Late

June/04/2008
IL Considering Bill Limiting Charges to Uninsured

May/29/2008
Aetna Ranks First in 2008 Pays Medical Providers the Fastest Among National Commercial Insurers

May/23/2008
OIG Gives Thumbs Up to Prompt Pay Discounts

May/23/2008
Modifier 52 - Clarification from CMS Carrier

May/21/2008
The Medicare Remit Easy Print Brochure

May/20/2008
CMS Releases Top Reasons for Denials

May/20/2008
UHC Releases NEW Claim Reconsideration Request Form

May/19/2008
CMS Rules Change for Therapy Personnel Qualifications

May/19/2008
Free HIPAA Brochures in Eight Languages

May/15/2008
BCBS of NC Maintains NCQA Accreditation

April/01/2008
Hospital Settlement for Employing OIG Excluded Staff

SAFETY INSURANCE PREVENTIONS

As you suggested, we have been taking our patients from passive modalities to active rehab during the second phase of their treatment plan. 
As a result, we have been getting paid on average $27 as opposed to $9 for each 15 minute session, tripling the reimbursement for therapy. 
At the same time, it makes us more compliant with the insurance company's policies. 

Thanks John, your company is worth it.
Dr. Charles Copeland

 


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I want to express my gratitude for your help with my BC/BS audit. Due to your expert knowledge of the situation I came through the audit with flying colors.
No money was owed and I received this news within thirty days of my response. I would recommend your service to anyone who is facing an audit.
Once again, thanks for your help!
Dr. Mark Escobedo


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Thanks for the great Webinar today!  I was the only one able to attend today, but will pass this info to Dr. Tim. Can't wait for next week!
Charlene Carter
Compliance Officer
Kosterman Chiropractic Center

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These are wonderful for us and I really believe that both the Doctor and staff need to be involved.
Thanks,
Jan Coplen

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It has been a tremendous benefit to me, so I'm very glad I got it!  I especially like using this as a tool to show the phase changes of care, as well as from insurance to cash and back, as called for. 
Kimber and Dr. Adrian Nohr


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You always seem to find the things I need and are remarkably pleasant about it.
Dr. Lisa Prusinski

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You need to contact CSSi, with the current status of insurance enforcement; it is the best insurance policy and peace of mind you could ever purchase.
Steve Willen, DC, CCSP 
Former President of the NCBOE & NCCA
Former Chairman of the Board of the FCLB and NBCE


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If you ARE being reviewed by one of the audit companies contracted with CMS/Medicare, or some other payer and you don’t want to go it alone, contact Compliant Services & Solutions! Their website has lots of free information on how and why you should consider putting a compliance program in place in for your clinic before you are reviewed.  
Ray Foxworth, D.C.
President, HealthNetUSA, Inc.

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Thanks so much for starting this program.  We have learned a lot of valuable information to help us better manage our patients and doctors.
Melissa Alvarez
Compliance Officer
Acton Chiropractic

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The whole borrowing from the insurance company hasn't really worked for me so far!!  LOL  Still waiting to hear back from Aetna on the audit.  I feel really good since working with you guys.  Tina is continuously tweaking things in the office. 
I told her she has complete authority to implement anything you guys tell her to. 
I enjoy sleeping better at night since we have become much more compliant.
Sincerely,
Dr. Jeff Roistacher


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The “rules” have never been more confusing. Dr. John Davila has become the expert in our current system which favors insurance companies and leaves chiropractic providers
facing huge penalties.
Full-time staff members at CSSI alert providers when rules change, provide documented evidence in the form of a compliance manual, and continued patience
after the same question has been asked for the fourth time. 
They take pride in their own ethical business practices by eliminating doubletalk on the sales side and never-ending automated systems after purchase.
Dr. Lisa Prusinski
 


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Dr. Davila,
As you know you have lectured on E/M coding, documentation, recordkeeping and compliance issues many times for Palmer Florida Clinics as well as our Homecoming events.
I have personally attended many of these lectures. Not only do I feel you are qualified to teach this material but you have been the most qualified and popular speaker
we have had on these topics.
Sincerely,
Albert J. Luce, D.C.
Director of Clinics


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Hello,
I attended a seminar in St. Peters, MO on 10/25/08 and was wondering about getting the notes for that.  I really want to make sure that I get them because it was one of the most informative seminars that I have been to in a long time.  It's not often that you get something that satisfies your required hours and is interesting at the same time. 
Thank you for that.
Chad May, DC


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