Newsletter

Medicare Fee Cut One Year Extension
Plus (RAD) "Requests for Additional Documentation Missing Percentages"

Updated: December 20, 2010
Dear Doctors and Staff,

As the window of opportunity to become a Non-participating provider closes, we do have news that Congress passed regulation delaying the severe Medicare fee cuts until the end of December 2011. The Sustainable Growth Rate (SGR) was introduced 10 years ago when the problem first began. Flaws in the SGR formula became noticeable which did not reflect changes to the actual costs for caring for Medicare patients.

So, the Fee Schedule listed by your Medicare carrier that was sent on the Medicare DVD's you received does NOT reflect this action by Congress. You must wait until January to review your Medicare Carrier Website to update your new fees for 2011.

President Obama urged Congress to change the underlying problem with the formula. He is quite aware the problem has been confronted with only temporary fixes and stop-gap measures. He asked for a permanent solution that doctors and seniors can depend upon.

NOTE: January 1st, 2011, as a participating provider, you may continue billing Medicare at your normal fees.

Non-participating providers can not bill Medicare above the limiting fees set by the Medicare carrier. That means a non-participating provider should NOT bill Medicare after January 2011 until the NEW fees are posted by your Medicare carrier.

RED FLAG RULES - Congress passed the "Red Flag" Program Clarification Act of 2010 which exempts physicians from the requirements established by the "Fair and Accurate Credit Transactions Act of 2003." This bill is currently awaiting President Obama's signature.

IMPORTANT........
Since our fees will not be cut by 25% and may increase due to other circumstances, we must remember Medicare audits are increasing at an alarming rate! The Medicare carrier can go back three (3) years on a preliminary audit and further if the preliminary audit is successful.
Can you survive this audit?

The following are percentages of Chiropractic requests for additional documentation (missing information from Chiropractors):
Treatment Notes/Plan missing.....70%
Office/Progress Notes missing.....14%
Medical (Chiropractic) Necessity missing.....70%
History of Onset or Present Illness.....14%?
Chief Complaint missing.....4%
Symptoms missing.....4%
Documentation indicating patient-----for-----6-12 mo. .....58%
Legibility.....32%
Of all the percentages of Chiropractic errors, "Documenting" the necessity of Chiropractic care is the highest at 70%.

Documentation in Medicare is NOT S.O.A.P. Notes! Please consider giving us a call and/or purchasing our Chiropractic Medicare DVD that covers everything in Chiropractic Medicare including the correct way to "document" the Chiropractic necessity of care by Federal Standards.
BOTTOM LINE: If you wish to learn how to do Chiropractic Medicare correctly, including "documenting" by federal standards, please consider ordering our Chiropractic Medicare DVD and booklet. It explains piece by piece every important step in doing and billing Chiropractic Medicare so there are no limits for the chiropractic adjustment. If you are audited you will have done Medicare correctly and win your audit. You and your staff will be very happy you have this important and mandatory information. I promise it will make a difference in your understanding of Medicare and how you bill Medicare.
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Keep in mind, Medicare is the only insurance type program that if done incorrectly is fraud, a felony, a fine and/or jail.

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I promise you will be more than satisfied that you made the right decision to purchase this information or attend our presentation. Please give me a call if you have questions. 1-618-395-3162

Best regards,
Dr. Gary R. Street


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