May 2015

May 2015

How do you and your office team handle records requests? If you’re playing ostrich and hoping that if you ignore them they will somehow go away, you’re living on borrowed time.

If this is, or has been your pattern, first: breathe. You may not be doing anything wrong. Many such requests coming from a CERT (Comprehensive Error Rate Testing) contractor, from an A/B MAC (Medicare Administrative Contractor), an RAC (Recovery Audit Contractor), or the OIG (Office of the Inspector General) are generated randomly.

Regardless of whether the records requests you receive are random or targeted, just about the worst thing you can do is not respond. In fact, non-response is the biggest reason for claims denials. Not only does this cost you money, it also makes you and the chiropractic profession look bad. Chiropractors already have a reputation for not following the rules. Adding fuel to the flame by balking isn’t doing you or anyone else a favor.

When you don’t supply the requested documentation the assumption is usually that it’s because you don’t have any! Not only does this often guarantee denial of the claim, it also draws attention to you, which could lead to financial penalties, additional medical review, or even, eventually, an audit.