It seems like auditors are sitting on the edge of their seats, waiting to find a mistake on a patient’s chart and go after a doctor’s practice. Chiropractors have been fighting to keep auditors away so as to not have to deal with audits and possibly a great loss of revenues.
Red flags are what catch an auditors eyes and billing services can help Chiropractors reduce their audit risk. To an auditor, big red flags usually have to do with SOAP notes. If these notes are not properly documented then auditors will contact a practice and investigate. SOAP notes play a big role in letting auditors know if a Chiropractor is or isn’t keeping up with their patient’s history and correctly using documentation. Post-payment audits can come from a number of things including a change in rates, repetition of actual procedures performed by a Chiropractor on a patient, an increase in payment for work and can even come from geographical issues. Red flags from auditors can go undetected by a Chiropractor who has a practice to run.
The last thing a busy doctor needs is the worry that an auditor might be trying to audit them. By using a billing service, Chiropractors keep on top of their work. Billing services will help Chiropractors monitor red flags as they could potentially happen, keeping Chiropractors on track. . They can help to reduce the risk of auditors accusing Chiropractors of fraud. Billing services have software that allows Chiropractors to safely run a practice.
Billing services provide software that can keep SOAP notes and keep red flags under control by electronically recording important information about patients. This way, there are no messy charts or missing files and auditors will see that the Chiropractor has been keeping their practice running smoothly and their patients happy. Billing services consider audits the most dangerous thing that a Chiropractor can fall victim to and therefore work hard to help protect these doctors from them.
Audits are scary, but they are avoidable. There are a number of red flags that can call attention to a Chiropractor’s practice and every precaution should be taken against them. Billing services can help Chiropractors breathe a little easier by helping to decrease their chances of ever getting audited and by decreasing the chances of losing an audit by giving them the tools to properly document the necessity for care at the same time warning the doctor when they are raising audit red flags.
Gina Bortolussi is a graduate of Manhattan College and has her B.A. in Communications. She is currently focusing on research of modern Internet-based chiropractic office management solutions, such as Billing Precision http://www.billingprecision.com
Billing Precision is an all-in-one Internet-based system that includes accountable and transparent billing service, state-of-art touch-screen SOAP notes, advanced patient scheduling, and real-time monitoring for compliance and audit exposure.
Neck Pain, Upper Back Pain And Shoulder Pain – A Chiropractors Perspective
As a practicing chiropractor, I see a large number of patients with neck pain or upper back pain that begins to affect one or both shoulders. Frequently, the opposite occurs as well where a shoulder injury aggravates the neck. The biomechanics of the shoulder joint and the joints of the neck and upper back are dependant on each other for proper function.
Many conditions of the neck and upper back affect the shoulder and visa versa. There is a good reason as to why this happens and I will use this article to explain it.
There is that old statement regarding the human body that goes something like “everything is connected”, of course in this instance we are talking about anatomy – specifically a kinematic chain.
In a kinematic chain, the function / health of adjacent joints are dependant on each other. A simple example of a breakdown among joints in a kinematic chain and the resulting consequences would be as follows; a person sprains their ankle, limps on that ankle for several days and then develops knee pain secondary to the limp caused by the injured ankle. If the limping or gait impairment continues for any period of time, the irritation can involve the hip and eventually the low back. The ankle, knee, hip, sacroiliac joints and the joints of low back all form a kinematic chain.
In a similar yet more complicated kinematic chain, the vertebra of the cervical and thoracic spine are intertwined with the shoulder joints. The shoulder is made up of a series joints that allows for a tremendous amount of movement in a number of planes.
Compared to the knee, for example, that only allows for about 120 degrees of flexion and very little rotation and translation, the shoulder is incredibly mobile. While, like the shoulder joint has ligaments and a joint capsule that tie the humorous to the scapula and the clavicle, the primary source of stability of the shoulder joint is the muscles, many of which attach into the cervical and thoracic vertebra.
Regarding the spine – in particular the cervical and thoracic spine – the joints found in the spinal column have considerably less motion than do most other joints in the body. That being said, the cervical spine dis
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plays the greatest amount of motion found in the spine while the thoracic spine is the most limited in its flexibility. The fact that many of the big muscles of the neck and upper back insert onto the scapula and the clavicle links these two joint complexes together.
In many cases, shoulder pain or dysfunction can result in spasms of the larger muscles that act to stabilize the shoulder – most of these muscles originate from the vertebra of the neck and upper back. The stress of this spasm can cause pain or dysfunction in the neck and upper back. Because of the shared muscles between the neck, upper back and shoulder girdle, the exact opposite scenario can occur with a primary spinal problem causing muscle spasms that have a negative effect on the shoulder.
Both the shoulder and the neck joints display complex, compound movements. Adjacent joint complexes like these that share major muscle groups make for an increased likelihood of pain / dysfunction affecting more than one group of joints.
In my practice, the two most common activities that I see that lead to pain / dysfunction of the neck, upper back and shoulder are computer work and single sided sports injuries like pitching, bowling, golf, etc. When confronted with neck pain and shoulder pain, I advise my patients to apply ice packs to the affected area in 20 minute sessions at least twice daily and limit the offending activity for two or three days. If the joint is not dramatically better with this at home management, get in to see a chiropractor. Chiropractors are specialists in joint biomechanics and can help you make a complete recovery from many cases of neck pain and shoulder injuries.
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Dr. Steve Jones is a licensed Chiropractor in San Diego. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice. He is certified as a Specialist in Health Ergonomics. In addition to his work as a chiropractor, Dr. Jones also invented and patented the Ergo Nav – a chair mounted mouse platform that is considered the most versatile mousing surface available. www.JonesPainRelief.com, www.ErgoNav.com
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