OIG and Chiropractors: The methodology of finding fraud
For the third part of this series, Patient Options breaks down the OIG report detailing the red flags the OIG used to detect fraud.. This article will list the areas of concern that they found tended to be fraudulent. METHODOLOGY This study is national in scope and is based primarily on paid Medicare claims for…
OIG and Chiropractic: The Background
Patient Options is bringing you the background of why chiropractors are on the Office of the Inspector Generals hit list for areas of fraud in government spending. In this multi-part series we summarize the report that came out in 2015 that guides their fraud investigation. In this post we bring you the background and basis…
OIG and Chiropractors: The Introduction
Practitioners are on the radar. At patient options we try to go above and beyond serving you with the latest and newest information when it comes to being able to give legal compliant discounts and avoiding fraud. We are introducing our new blog series that deals with the office of the inspector general and chiropractors specifically.…
The Current Patient Lending Landscape
As health insurance premiums rise and coverage decreases physicians everywhere must find ways to provide healthcare in a manner that is accessible. The self-pay model has risen in popularity because of this. That is a good thing. But just because it is good does not mean that there are no negative repercussions. According to Forbes,…
Keep Audits from Sinking Your Practice
Medical audits can be daunting for healthcare providers due to various reasons. The fear or apprehension associated with audits is valid. We all have heard horror stories of doctors losing their clinic and livelihood to an audit. An entire career or life’s work thrown to the wolves, gone before you even have time to process…
Cash-Based Physical Therapy: Trends to Consider
The concept of cash-based healthcare is growing. Health insurance coverage continues to diminish. The demand for self-pay services is more prevalent than ever. With change arises new challenges healthcare providers must address and overcome. Physical therapists are no exception. In some ways PTs have are the hardest. The advent of prior-authorizations on physical therapy cpt…
Medical Doctors and the Growing Trend of Cash-Based Practice Models
Medical doctors are transitioning to a cash-based or direct primary care (DPC) model. In a traditional healthcare model, doctors bill insurance companies for their services. This can be a complex and time-consuming process. In contrast, a cash-based model involves patients paying directly for medical services, often through a subscription or fee-for-service arrangement. There is a…
Dual-Fee Schedules: Common Violations
Dual fee schedule violations may occur when healthcare providers engage in unethical or illegal practices related to their billing and fee-setting processes. These violations can involve charging different fees for the same services based on the patient’s payment method (insurance vs. self-pay), which can lead to discriminatory practices or fraud. It’s essential for healthcare providers…
Chiropractors: What Your Patient’s Need to Know about Medicare Part C Plans
Medicare Part C, also known as Medicare Advantage, is a type of health insurance plan offered by private companies approved by Medicare. These plans provide an alternative way to receive Medicare benefits, combining coverage for hospital (Part A) and medical (Part B) services, and often include additional benefits not covered by Original Medicare, such as…
Chiropractors, Dual-Fee Schedules, and the Future of Direct Pay Healthcare
Chiropractors play a crucial role in maintaining the health and well-being of their patients, but like all healthcare professionals, they must navigate a complex landscape of regulations and compliance requirements. One area of concern for chiropractors is the use of dual-fee schedules, which can lead to compliance issues. Dual-fee schedules are pricing structures that involve…
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