Frustrated With Health Care

Make no mistake about it, people are looking for you on the internet.  They may have heard about you from a friend, from the Yellow Pages or from your sign, but they often times want to know more about you.  Even if you have an office web site, which is great, but people know that this is basically just self promotion. What they really want to do it find you on Google.  And, they want to find you high up on the ladder.  So . . . , have you tried to Google your name or your practice with yourtown?  What did you come up with?  Are you on the first page? At or near the top?  To get there you need valuable content about you on the internet.  Here are the 5 strategies.  The specifics for each will be illustrated in seperate posts.

1. Press Release:  A Press Release is an announcement about a specific event that happened or that is about to happen.  Did you open a new office, get a new associate, get a new piece of equipment, change your hours, change one of your office policies, or have a baby.  Any of these are worthy of submitting a Press Release.

2. Articles:  An article is basically your opinion on a specific topic.  We are all experts in something and an article is your way to tell the world about your expertise.  It could be something about your profession or your hobby.  It could be about anything you feel strongly about or you have knowledge about.  If you think you are a great joke teller you could write about that; if you are a member of a service organization you can write an article about that.  Articles are posted on line at an article posting website.

3.  Start your own blog:  Just like an article, your blog should be content rich and not just a sales pitch.  With a blog you need to have a domain name and a blogging interface.  You should also post to your blog at least once or twice a week.  If this is of interest to you start thinking about a domain name.  A good place to start is your name, like JohnSmith.com.  However, if your name is fairly common you might need to be creative.  When we specifically discuss blogs I will offer some suggestions.

4. Video:  Videos are another great way to get your name to the top of the search engines.  This strategy does take a little more time and effort, but it is getting to be a favorite of mine.  If it interests you start kicking around YouTube to get some ideas.

5. Social Networks: This is just another way to get your name out there. However,you probably will not want to open too many different accounts; three is typically a good number. For example, LinkIn, FaceBook and Twitter; these are a great start.  For now you may want to go to these site and open an account using your name.  Try different iterations if your first attempts is already taken.  That’s what happened to me when I tried joining as PeterHolst; believe it or not there are a couple of us out there.  So I chose to use PeterAHolst.  You could use DrYourName.  Since you want to “brand” yourself, it will be in your best interest to use your own name.

Next post I will go into Press Releases and Articles.

Peter Holst, D.C.

http://www.whoispeterholst.com

You know, I really don’t like to beat a dead horse, but I do think that something else needs to be said about the direction our “health care” system is going.  I don’t know, maybe it’s because I’m a chiropractor and I am concerned about how chiropractic services are going to fit into the whole health care picture.  Or, maybe it’s because I see health care continuing along the path of an ever increasing dependence on drugs to cure all our woos. 

It would seem that the push now-a-days is for national health care and what they call “preventative care”; you know, early detection through expensive testing procedures and early intervention through expensive drug regiments.  As previously mentioned, this is sick care and it is LESS cost effective.  Where in this plan is true health care?  Where in this plan do you see chiropractic care fitting in?  As many chiropractors will tell you, it does not!

Back in 1998 chiropractors may have won the battle with the AMA to cease and desist their anti-trust practices, but it would seem that the AMA is getting the final word.  Think about it, what three organizations run the health care industry?  I think you might agree that it is the AMA, the pharmaceutical companies and the health insurance industry.  So, let me ask this, do any of these organizations even consider health care from a wellness point of view?  From a chiropractic point of view?  Not on your life!  It is just not in their best interest!

Medical costs continue to sky rocketed and chiropractic services have been prevented from keeping pace.  Why?  Simple, the allowable fees are also set by the health insurance companies and they do not value chiropractic services.  The result is that with higher overall health care costs the health insurance industry has raised their co-pays, obviously to save money by precluding them from having to deal with what they consider to be nuisance claims; aka, chiropractic services.  One obvious solution is for chiropractors to fight for higher fees, but you know that along with that we would also have to compromise by accepting a cap on care.  OK, great you say, we’ll take $75-$100 per visit with a 12 visit cap.  Then we all know that 12 visits isn’t enough so we’ll just convince our patients to continue care at a cash fee that is much less, right?  Depending on your area getting the full fee might be an unrealistic expectation.  Aaahhhhh, but is it legal to charge less than the established fee schedule?  To answer that let’s take a look at our current model of “national health care”, Medicare.

As a chiropractor in the Medicare system we have three codes that are covered; 98940, 98941, 98942; all chiropractic manipulation codes.  These codes are only covered when there is an active treatment plan with an end result in mind; on going preventative, maintenance care is a non-covered service.  All services, covered or not, are supposed to be properly documented and properly billed.  This means that for all care, covered or not, a claim form must be submitted to Medicare; a special modifier is used to tell Medicare when care is active when it is not.  In either case, your patient is supposed to pay their share, which means that for covered services they pay their co-pay and for non-covered services they are supposed to pay the full fee.  Anything less and you run the risk of having to answer questions of the National Government Services.  It would seem to me that these same rules would apply to any new government plan that comes down the pike.

Now the questions one might have is, why do we need to submit a claim to Medicare for non-covered services?  That’s a good question, but I might speculate that it is because “they” want to keep on eye on us to make sure we are not taking advantage of Medicare patients by convincing them that they require more care than they actually “need”.

The questions abound: Who’s rules are we playing by?  Who says that a patient can’t make their own decisions regarding their need for care?  Since care that is not active is considered a non-covered expense, then why are we bound to the established fee schedule?  Whose to say that we couldn’t give it away for free, and if we did would they still be concerned?

It seems that I am not, and chiropractors in general are not the only healthcare provider frustrated with the healthcare system. 

Just the other day I heard on the radio that across the U.S. something like 35% of Medicare patients could not find a General Practitioner who participates in the Medicare system.  While this is a sad commentary, it is just representative of the bureaucratic nightmare that goes along with taking care of Medicare patients.  Across the board providers are pulling out of Medicare, as well as out of other insurance company provider panels simply because the excessive control prevents them from “being a doctor to their patients”.

Unfortunately at least for Medicare patients and for us as providers is that it doesn’t matter if the provider is Participating or Non-Participating, all the same rules apply.  As a Non-Par provider the only advantage is that you do not have to wait for payment; presumably your patient pays at the time of service.  HOWEVER, as long as you are accepting and careing for Medicare patients, even as a non-par provider, you are still bound by a fee schedule, you still have to bill, code, and document your services and level of care accurately and appropriately, AND you still have to be able to provide this documentation to Medicare upon request; the nightmare continues.

To the best of my knowledge, the only way to avoid this nightmare with Medicare patients is to not accept Medicare patients for care.

And actually, the same would hold true with most other patients who have any type of health insurance.  The only difference is that other insurance companies do not have a non-par fee schedule; presumably you can charge whatever your usual and customary would allow.  But again, if your patient has insurance they are going to want to submit a claim for your services.  As such, as the provider you are required to document and code your services accurately and appropriately, and you must make your records available upon request.

The day of the family doctor where a patient comes in, they get a consultation and examination, you jot down a few notes, give your treatment, and the patient pays . . . , those days are long gone thanks to the controlling eyes of the insurance industry.  Justified???

Just another source of frustration as a healthcare provider.