Services

Vetting

In today’s world it is paramount that you work with/ hire the right people. Vetting is mandatory for your practice. The best practice is to conduct monthly OIG checks. This process takes just a few minutes.

OIG’s LEIE provides information to the health care industry, patients and the public regarding individuals and entities currently excluded from participation in Medicare, Medicaid and all other Federal health care programs. Individuals and entities who have been reinstated are removed from the LEIE.Oct 7, 2022

What happens if a workforce member is notified, they are on an exclusion list?

Those that are excluded can receive no payment from Federal health care programs for any items or services they furnish, order, or prescribe. This includes those that provide health benefits funded directly or indirectly by the United States (other than the Federal Employees Health Benefits Plan).

Exclusions Program – Office of Inspector General – HHS.gov

Credentialing Insurance

We all know that insurance is a game. Most people want to use their insurance to help pay for their care. Whether you participate or not is up to you. Processing and completing paperwork required for health care providers to be in network with insurance companies can be quite daunting. We will discuss your options in taking insurance and brief you on the particularities of each for you to make the most informed decision for your clinic.

This is a process and can take some time. Insurance companies move at their own pace so making sure you allow plenty of time from start to finish. Most insurance companies WILL NOT allow you to see the patient and hold the billing. They set the effective date.

Billing

Billing can be overwhelming with submissions, follow-up’s, appeals, and applying payments. C3-Plus has many options when it comes to billing. Our mission is to inspire and not scare your team. We teach from Medicare standards. Many insurance companies follow Medicare guidelines which are the standard in health care. By understanding these rules and regulations we believe helps you make more money compliantly. It also gives your team a solid foundation to build on and resources to pull from.

Coding

Coding improperly is one of the most common mistakes in a clinic and can really come back to bite you in an audit. C3+ will show you the exact description for codes and be sure you can implement them properly in treatment plans. Do not turn to colleges for advice and do not listen to a product’s manufacturer on what codes to billing for a service.

Protocol Development

From hiring to training, front office to back office, day-to-day tasks; and to the extreme events seen in our clinics, having protocols in place and practicing them will empower your clinic to conquer your goals. C3+ knows each clinic is unique and will develop protocols for a streamline, autonomous office side-by-side with you.

Compliance Manual

Compliance can sometimes be complicated with all the intrici parts that must be included. HIPAA is only one part of the process. You must have a written compliance plan with all the policies and procedures that you use to operate your business. This is a work in progress and will change depending on the needs. Your billing department will be updated and work monthly while other aspects of your office might not need updating but once a year. Part of the policy is that you will have a compliance officer or committee depending on the size of your organization. The committee or individual would report to the doctor monthly or more often if needed.

HIPAA rules and regulations change and need to be updated often. When thinking about HIPAA we often forget to follow the rules when it comes to marketing. In a world where social media drives impressions we must make sure that the engagement on social media is withing the rules. Obtaining reviews and recommendations using social media does not mean that the reviews or recommendations on one side can be used across all sites without permission. A patient should always control the recommendation or reviews and if these are shared across multiple platforms without the patient’s permission due to settings that implemented can possible be a violation. Having a compliance officer or committee who can help with these decisions can safe your company from violations.

The affordable healthcare act implemented a policy as part of the act that you must vet everyone you do business with against the OIG exclusion list. This list is very easy to access and use. You must check everyone at a minimum quarterly and safe the results. If you are found in violation this could be 10’s of thousands of dollars.

C3-Plus offers a very comprehensive compliance plan that includes HIPAA, OIG checks and monitoring policies and procedures. We will train your team for HIPAA and implement your compliance plan. We can also be your compliance officer if needed or train your team.

Our compliance program can be ongoing or a onetime fee.

Our compliance plans include the following:

1. Proper use of ABN
2. Assignment of Benefits
3. Auto Cases how to properly get paid.
4. Business Associate agreements and Confidentiality agreements
5. CA Training
6. Clinical Policies
7. Hiring policies
8. Coding and billing policies
9. DME how to properly bill it and get paid.
10. Documentation Medicare standards
11. Incident 2 bill/ Locum Tenens work
12. Informed consent
13. Insurance policies
14. Malpractice
15. Medicare
16. Non-Covered Services
17. Active/Passive Rehab Therapies
18. Radiology/cold laser
19. Cash Services

The compliance manuals are customized to your office depending on your practice type.

Documentation

If it wasn’t written, it didn’t happen. Documentation determines your safety, patient safety, how you get paid, and how an office communicates patient care. But how are you to write everything in a hard day’s work while working? C3+ will show you the letter of the law, listen to your clinic’s intentions, and help you develop fast and easy note taking to suffice all your documenting needs.

Simulated Audits

We aim to uncover compliance violations as would be found in a full or partial clinic audit, show you our resources information of the violation, and help you fix the problem. This includes sample file audits, clinic inspection, HIPAA and OSHA standards, compliance manual coverage, clinic protocol integrity, and so much more.

Staff Training

We offer in house and web-based trainings. These trainings are designed around your office needs and are customized to meet your goals.

Trainings include but not limited to:

1. HIPAA for your team yearly
2. Compliance plans and training and implementation
3. Insurance billing in house
4. Office Procedures
   • Front desk/CA Training
     1. Phone procedures.
     2. Recalls and activations.
   • Back office
     1. Proper note taking for CA’s.
     2. Rules of 8’s for therapy
   • Doctors for services offered.
     1. Diagnosis
     2. Proper documentation based on Medicare guidelines.
     3. Proper use of modifiers
     4. Proper use of equipment
     5. CASH vs Insurance for services offered.
   • Proper marketing while staying HIPAA compliant.
   • Patient procedures
   • Staff management
   • New staff orientation and training
   • Stats and how to use them to increase your profits.
   • Office manager training
   • Billing and who can bill what.
5. What you need to know about malpractice
   • What is covered under your malpractice?
   • What certifications do you have and are they covered?
   • Who in your offices holds a licensed and do they need malpractice.
   • Locum Tenens coverage and malpractice
   • Do the additional providers in your office need to have an additional insured rider on their policies.

The programs that C3-Plus offers are robust in content and based on the strictest standards in the industry (Medicare). We take our companies reputations and our client’s satisfaction to the upmost importance. We respect the time of the doctors and will work and monitor the staff for efficiency and compliance.

Practice Management

We are not a management company. We are a group of Medical Compliance Specialists who will listen to your goals and develop tools to help you achieve them. Our company’s goal is to allow you to focus on your patients, increase your profits, and streamline practice needs while giving you peace-of-mind it’s being done compliantly. You run a business, it does not run you.

CE’S

Webinars and live seminars including Chiropractic mandatory board hours and Medicare documentation. Have fun getting the most up-to-date compliance information with the lovely Dr. Amy Wood. Sign up for our Newsletter to receive alerts for future dates and guest speaker information.

HIPAA Training

It is your responsibility to train your staff yearly. Rest assured C3+ thoroughly teaches the latest information in our HIPAA staff training sessions. Not only will we take something off your to do list but strengthen your staff’s ability to protect your clinic and your patients’ information.

In house

We understand that sometimes it is better to keep your billing in house. In this case we can train your team and help them the compliant applications of payment, appeals, follow-ups and more. Our in-depth training is 3 1-2 hour zoom or in person training session with notes provided for reference. We also follow up with your billing team each month for questions and guidance.

Outsourcing Insurance Billing

Depending on your state and the rules we offer very competitive billing options for your clinic. Some states require 3rd party bills to get paid with a flat fee and not a %. Our billing services are defined below:

The pricing for the options above is based on your clinic’s needs. If a % is allowed the range is usually 7-9%.

Billing of claims and posting of payments will be done at a minimum of 1 time a week for our smaller clinics and as much as daily if desired. We can remote into your system and work remotely. We work with service-based software in addition to cloud-based software. We can work around schedules so not to disrupt your practice hours if needed as well.

All billing services above will include:

1. Sending and applying claims
2. Following up on secondaries
3. Appeals and claims management.
4. And much more ….

Our goal for your office is compliant billing and collections. We will provide your clinic with updates on denied claims and claim fix information. We will work with your staff to fix the denied claims and make sure that future claims are correct.

For those clients that use a serve based EHR we use the following remote login programs:
Team viewer
Goto MY PC

If you already have a subscription, you can use that for no additional charge. If you need to use ours there will be a 1-time yearly fee added to your first bill.

For those clinics that want statements sent postage fees will be added to each month.

Add on:

Add on’s are services that can be added on for an additional fee to the basic option.