Academy of Chiropractic

MD Referral Program

Program Infrastructure – Novice

William J Owens Jr DC DAAMLP CPC

“If you do NOT have a plan, you are part of someone else’s” – Terrance McKenna

Managing Referrals and Infrastructure

When the program starts ramping up for you, two things are going to start to happen.  The first is you are going to start seeing more patients and the second is you are going to realize that you need to document and report to someone other than the insurance carrier.  This is the biggest hurdle to practice and too often the reason that practices hit a certain point and stop.  There are many reasons to build a proper infrastructure, but by far the two most important are ensuring that you are safely and accurately caring for your patients and that you continue to meet important documentation standards.  Let’s look at each of these separately and examine them a bit further.

Deliver Proper Care:

Let’s start out properly and state, “This is about QUALITY time with patients, not how much time you are in the room.” This is irrespective of your technique and has more to do with focus and your office flow.  A busy office will have patients with MRIs of multiple levels to review, pain management or surgical referrals to maintain and coordinate, work and school disability paperwork and records requests.  I am not telling you anything that you are not already experiencing, but the point is that these items are real and important to patient care.  Quite frankly, this can be done with LESS WORK THAN MOST OFFICES PUT INTO IT.   In the end what does that mean?  It means a smooth flow to your office that continues to grow and make you more money.  With that being said, if your infrastructure starts crumbling, patient care will suffer and you will open yourself up to risk and decreased patient flow. 

This is no different than a busy restaurant, one that when you first began to frequent was the best; great service, fantastic food.  You weren’t rushed, but you weren’t ignored either.  What happened when everyone and their brother found out about it?  It got busy!  The owners either developed the infrastructure or they didn’t…You get my point.  Your office is no different.  There is no reason why a patient should be waiting for extended periods of time and there is certainly no reason why you can’t see double your patient load, complete all you documentation properly and have a weekend with your family! 

Infrastructure is everything and it does not need to cost you money.  You do not need fancy computers or hundreds of dollars worth of paper and toner each week.  It is about staying organized and working in the moment.  Everything gets done as you are moving through the day.  The more referrals that come in, the less time you will have to “go back” and complete things.  Part of the end of the day routine is making sure everything is complete.  ESPECIALLY NEW PATIENT EVALS AND NOTES! This is easy to fix, but takes a willingness to learn.

Proper reporting:

New Patient Examination and Re-Evaluation

Daily SOAP/Progress Note – Single sheet

Imaging Referral – Must correlate with ICD-9 codes and physical examination findings

Specialist Referral – Surgical, electrodiagnostic testing, neurological or pain management

Infrastructure issues are everyone’s hurdle, but they are unique to who we are and how we run our offices.  If you are experiencing problems, call me and we can discuss how to streamline your office without upsetting the apple cart or causing your staff to run in the other direction. 

To continue to build a referral base with the medical community, this is critical!  If you are just starting out, this is a PERFECT time to address this issue.

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