Billing & Coding Resolutions for the New Year With Kathy (KMC) Weidner

Hello everyone, welcome to another episode of Catch Up with ChiroTouch. I'm your host, Dr. Brian Blask, and my guest today is Kathy Weidner of KMC University. Most doctors in the profession know her as Kathy Mills-Chang.

Kathy is one of the chiropractic profession's leading billing, coding and compliance experts. She's dedicated her career to making sure chiropractic is central in the healthcare arena, with its doctors earning the respect and financial rewards that are deserved. This dedication is no more apparent than in KMC University for what she is the founder and CEO.

Happy New Year, Kathy. Thank you so much for joining me today.

Oh, it's my pleasure. Thank you so much for inviting me.

It's been a long time since we've gotten you on and had a nice casual conversation like this. Thanks for joining us. Before we get into the meat of the topic today and your expertise, can you just give our audience a brief one-minute synopsis of who you are, what you do, just in case there are a few docs listening that don't know anything about you?

Sure. Given, I guess, this coming February, I will be celebrating my 38th year in chiropractic. This is my, my entree was as a chiropractic assistant and I served in that capacity for many years until I moved to New York with my family at that time.

And I was the practice administrator for a large collection of pretty much the largest chiropractic group practice in that state. And then another government move, moved us to Washington, DC, where I became assistant director for insurance for the ACA. After that and then moved to Denver, which is the area where I live now, I worked with Breakthrough Coaching, which is an overarching practice management firm.

And in 2008, I kind of decided that I loved the reimbursement and compliance aspects of things and decided to launch KMC University. I do live in Highlands Ranch, Colorado, with my husband Michael, and we have a couple of basset hounds that we like a lot. And we are a team of 22 people around the country with a large online university of training and resources and things of that nature in the areas that we focus in.

Yeah, that's amazing. It's quite the career already. Thank you.

Thanks for doing that for our profession, because anyone that goes to conferences, I'm sure has seen you speak and you're so knowledgeable. That's why ChiroTouch partners with you is because we like to partner with the best. And you are definitely the best when it comes to billing, coding and compliance.

So thank you for all your work.

My pleasure. We could also just put Geyser under my. Eventually, you earn Geyser status after a long time.

So the main thing that we want to discuss today are really just billing and coding. It's your wheelhouse, billing, coding, compliance. So resolutions for the new year.

Can you give our audience a few helpful hints regarding any changes that are taking place here in 2021?

Yeah, there's some big ones actually that are probably already on most people's radar, but we're having the first change in evaluation and management codes since 1997 that are in effective January 1st of 2021. It's been something that's been in the works for a long time and just has never gotten across the line. But in the way that the codes are calculated, so there's a series of machinations and algorithms based on bullet points and all these sorts of things that determine the level of code that was actually provided.

It's why coders are hired in the medical profession to read the documentation and make them into a code. And so they've simplified this down to where we no longer calculate history and examination, but rather all the coding will be based on either time or pure medical decision making. So, it's a lot more involved than I can talk about here, but it's a big change.

We've certainly done some public training. We have that training available on our site. We've certainly done that for your ChiroTouch users on some of our monthly webinars along the way to get everybody prepared.

But it doesn't excuse the provider from still doing a medically necessary history and examination, but we no longer will use the components of that to create our code. So that's a big, big, big, big change. I love when we did our training, I created 12 kind of case examples, six for medical decision making and six for time, to help doctors figure out when it's appropriate to use time and when it's appropriate to use the MDM.

The good news is doctors can use either one. I could use one on a new patient at nine in the morning, and it may make more sense to use time for calculation on the new patient at 11 in the morning. We really hope that doctors and team members will learn this.

I feel like it's a do-over because so many doctors never learned the true details of E&M coding and how to get to a code. We sort of guessed, if you will. I love the idea that we have the opportunity to really learn this and do it right.

The second thing I would say really goes along with the new Medicare Advanced Beneficiary Notice that expired in March of this year was kind of pushed down the road because of COVID and the things that were going on. They were going to make it effective August 24th, but instead they have pushed it out to January 1st. There is a new ABN form that must be used effective January 1st and a new set of rules that come along with what's called a qualified Medicare beneficiary.

That's the beneficiary that's getting some additional assistance, perhaps Medicaid that could be duly insured. But there are very particular rules that have been in place around these patients. One of those things, for example, is that the doctor cannot charge co-insurance or deductibles or things like that.

What's interesting is even if Medicaid in your state does not include chiropractic, if they're a qualified Medicare beneficiary QMB, you still cannot collect even for maintenance care. So it's a very precarious rule. We've been training our clients on this for probably the better part of six months because it's going to be a big deal.

And honestly, other than just the day-to-day stuff, those are the three big things that we're really focusing on as we come into the new year.

But there's actionable points there that chiropractors need to be able to take away from exactly what you just said. So, there's things they have to do, right? You have to go get that new ABN form.

Exactly.

Right? You have to upload that. If you're using the CT forms app in ChiroTouch and you need to change that form or you are just using a paper form for whatever reason, you need to have that form.

Well, the great news is that we worked with you all and your team at ChiroTouch to get that new form in over the summer when it came out. And the templates have been updated for your users for quite some time because that's one of the advantages of being a ChiroTouch user. We keep you on the cutting edge.

That's exactly it. So you want to make sure that you are staying up to your compliance measures and thinking about, okay, as a ChiroTouch user or even as a chiropractor in general, that they're following the information that you're putting out there because you do stay in the forefront of it to make sure that you're compliant. We keep saying it all the time, but we kind of get in is as humans, we get into our patterns, right?

And so you want to make sure that, oh, something new is coming out. I probably should update how I do things in the office. So if you're not a ChiroTouch user, get that form.

It's free. You just go download it. You can Google it.

Well, what's interesting is we recently did a survey. We have such a large following base and such, gathering it all these years. And one of the things we're so incredibly proud of is that, of all the words that people think of when they think of KMC University, and I'm so honored that this was, I mean like 98% overwhelming, is accuracy.

So they know that people will run around from free webinar to free webinar and try to manage their risk and manage their reimbursement. And that's frankly, it's not a great idea because you don't know who you're getting that from. And so we really have made it our purpose and it's one of our core values to serve the profession in that way.

And I'm so honored that it is literally our pledge. We insist on accuracy for your protection. And so you know you're going to get the right answer.

And so I'm honored that the profession does see us in that light.

Well, your company does. I mean, your company comes in and they do audits, right? You do consulting work for chiropractors.

Like you look at their practice and see kind of where they're deficient. So that's your business.

Yes.

That being said, what would you say? This is something I always think about when I think about you. I always wonder this.

What would you say are the biggest mistakes you see doctors making?

I don't know that I can say one thing, but I think that we consistently state these three things. So we are absolutely documentation experts. That is part of the reason why we assist with updating those macros and helping with some of the pieces to make them as easy to use as we can with the ChiroTouch software.

But doctors, assuming that you don't have to include personal information or that the macro or the computer can do all of your documentation for you. So not enough patient specific personalized information added to the note on a daily visit is absolutely one of those things. I think the second thing that I could just do a broad brush stroke on is that, and maybe it comes from my history, but that doctors need to value their chiropractic assistance and they need to invest in their learning.

We have some that call us for help and we say, we've got this great module you can do on this. Well, my doctor doesn't want to pay for that. I think about the doctors that invested in me when I was a young CA, and would I be where I am today if they didn't?

Because I learned so much from the training that I was given. We're going to be launching some CA certifications in 2021. We're excited about that so that the CA can really take on more for the doctor and be more of an assistant to the doctor.

Probably the last thing I would say we see are mystery and burstment opportunities. So short-cutting, not understanding enough about the coding or the service that you're providing. And there are things that you could and should be doing that maybe you don't know until someone does that practice performance profile like we do.

And says, well, wait a minute, we like to see 10% of this in a practice that's doing that. And you're at 1%. Is there a reason for that?

So those are probably the three things that stand out in my mind.

Can, that being said, on the reimbursement side, can ChiroTouch help with that? Can our software help you get reimbursed?

I think it can, because, you know, from a reimbursement perspective, if, well, and I'll put my tongue in my cheek and say this, one of the other challenges along with training, for properly training a CA to do the job that's necessary to run the business for the doctor, think about how we see people who maybe never did their ChiroTouch training properly, or they shortcut it, or they rushed it. And so they don't even know all the features that it has, or all the ways to use it. So for me, I will ask, particularly a ChiroTouch user, to pull a report on X, Y, and Z so that I can analyze something, and they act as though they've never heard that before when I know it's been done in training.

So I think it's important, the data that ChiroTouch gathers for you, and the way that it's been created, data is invaluable. And I love the types of reports when we're working one on one with a client in kind of a hands-on environment. We know what reports to pull, and those that have been, took their training seriously, I would say.

And I know that it's a drink of water from a fire hydrant, but it is honestly so valuable to know all of the components that you have in front of you.

That's a great point. I do these demos every single day for the past six years. So people don't use the reports enough, I feel, just like you do, you get about 85 of those reports in ChiroTouch.

Go in and start filtering, creating your favorites. I mean, doing it on a monthly, doing it on a weekly basis, it's a great tip.

One of the best things you can do is a coding report, and we call it a coding audit. It is one of the components of mandatory compliance anyway that doctors should be doing. But I would start with looking at your chiropractic manipulative treatment codes, the three codes, and pull a report, monthly or annual or trailing 12 months, and see how many of each you did and look at those ratios.

If you find your 98941s are over about 60 percent, then the question comes, will your documentation match that? Because if we know that from looking at your software, guess who else knows that? The payer knows that you are branded, Dr. Brian, as somebody who uses the crap out of a 98941, and they could go well.

We know the odds say that you're not going to have the right documentation, and so let us audit you. It's better he who has the most information wins, and ChiroTouch really makes it easy for doctors to know that and self-audit.

Yeah, that's wonderful wisdom that people need to understand and utilize in the practice. That being said, let's touch on a few things before we wrap up here that you mentioned. We run a monthly billing and coding webinar series with you, part of ChiroTouch.

You can go to chirotouch.com/resources and get all this information. Thank you for doing that because you are helping the profession, you're helping our client base. Also, where can they go on your website?

Is it just kmcuniversity.com to get more help? Can you lead our-

Sure. Well, if you're users, we created that webinar series a while back. It's called Billing and Coding, but we do cover just about any question.

The idea behind that really was that somebody could come once a month, save up their questions, that they would love to ask support or love to ask me, and come and ask any question. For a long time, Lawrence and Marty and I would have to dig questions out of people. We've got them primed now, they know what to do.

Plus, we start with a topic. We call it a pump primer, so to speak. That's where I've talked about these new E&M codes and different things to give some valuable information but also to get juices flowing on different questions.

So go to that. That is a wonderful thing and if the time doesn't work, go back and listen to it inside the ChiroTouch website. For us, ChiroTouch users get special pricing on our discovery consultations.

Not unlike a chiropractic visit, somebody could just come in our office and lay down on a table and get adjusted. They could do that, but that's not going to get them what they really need. So we do something called a discovery consultation.

kmcuniversity.com is absolutely the way to reach us. There's no doubt about that or to call our toll-free number which is on our website. But we really love the opportunity to start with a discovery consultation, kind of filling out some questions and needs analysis.

It's very inexpensive for ChiroTouch users, only $49. Should there be something that you need, we always apply that $49 toward it. So it's very easy to work with us.

But first and foremost, get on that webinar once a month.

Yeah, we really, honestly, our whole goal is to help doctors. We want to protect you. We want to help you get reimbursed more.

We're giving you all these resources to do it. It's just on you to now take that action.

You bet.

Any final thoughts, parting words of wisdom for the audience before we rock and roll?

Well, I will tell you that I've seen it all. I've been around a long time. I've seen the good, the bad, and the ugly, and I know that this too shall pass.

That is absolutely something that we've seen. But, you know, we are at an unprecedented time in our profession with the opioid crisis and an opportunity for patients to be able to get in and see doctors of chiropractic in this fashion. And I can tell you that positioning your business to be prepared for that has never been more important.

And I hope that you'll let people like ChiroTouch and KMC University help you do it.

That's amazing. It really is. Thank you again for everything.

Thanks for coming on, sharing your perspective on this topic with us.

My pleasure. Thank you so much for inviting me, Dr. Brian.

And thank you to our listeners for tuning in to Catch Up with ChiroTouch. You can always find more episodes of Catch Up with ChiroTouch on Spotify, on iTunes, and you can go to chirotouch.com/podcast. I'm your host, Dr. Brian Blask, and I wish everyone listening a healthy and prosperous 2021.

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