Hello and welcome to another episode of the Provider's Report. This one is a little spicy. I wanna talk about a true practice. You start your week on a Monday, you get not so great news, whether it's in relation to your practice directly or maybe a patient or an employee, and it just kind of sets a damper on the week. This just happened to me, and I wanna talk to you guys about how I chose in this moment. To respond and I will be honest and transparent in the sense and remind you guys and myself that I think I chose to respond this way differently now than the old me, especially the old slash new business owner. And here's why. I now have a team. My team is typically anywhere between five to seven individuals. It's not just me anymore. So how I choose to respond to practice blows. Really matters like a lot. and I think that's really one of my favorite areas where I feel like I have achieved growth as an entrepreneur and as a business owner. Is because I know that now the decisions that I make and the actions that I take not only affect me and my family, but also affect employees and sometimes their families. So here's what happened. Let's just dive right into the story. So a lot of my listeners know I'm a chiropractor by trade. My office is a, about a 99% insurance based practice. and we work with specifically musculoskeletal conditions of course. And, because we are so insurance heavy, we are of course bound by contracts. we have to follow certain parameters per insurance company, and we're very used to, the ins and outs of the coding system, billing and how all of that works. So because of this, we have to stay up to date with, Anything that changes by the insurance companies. And we did not receive any notice whatsoever about a big, big change coming to the world of chiropractic and rehabilitation slash physical therapy. Now, fast forward a couple months, I knew that this thing called the MPPR rule, which is about multiple procedure codes and pt, I knew that this was coming because I own a billing company. But I did not realize it was also going to affect chiropractors, and in hindsight, I probably should have, but I knew that this was going to affect my colleagues in the physical therapy community. but nowhere was this being talked about in the world of chiropractic. So this was probably like January, February, and PTs have been fighting it hard. Basically what's happening is if you bill more than one code in a given session. What Blue Cross is doing now is similar to what Medicare already does for physical therapy. You get reimbursed the full amount for that first code, but each subsequent code is getting reimbursed at a lesser rate. So now they're deciding to do this for Blue Cross, which is the number one payer in my state and probably in most states. so this is big. And so initially when it happened, I only found out because I just happened to be going through, some numbers and eras for a client. And that's when I realized, oh my goodness, things are coming back differently. What does this mean? Thankfully, I knew what it was because of my PT community, but in that moment. I'm not gonna lie, I did set into a little bit of a panic because when you look at the numbers, this was a 23% reduction for certain procedures and services that my practice delivers to patients. So immediately when this happened, I'm like, what are we gonna do? And the biggest thing that it's affecting is insurance massage, which there are only a couple companies left that even cover insurance, massage. But in my practice, this is a really important service. We have a provider on my team who does it, and he is lights out, like incredible. He does a sports medical massage with a trigger point emphasis and he's just such a valuable asset. So when this happened, I mean as a business owner, everything was going through my head. What does this mean? Not only for collections, but for my patients? What does this mean for the regulars that have been seeing this provider for 5, 6, 7 years? What does it mean for my employee? I need to find a solution. Do I drop insurance, massage altogether? And then of course, you know, thinking the worst case scenario, do I have to let my massage therapist go? I mean, my brain was going to all of these different avenues right away. So once I realized my brain was starting to get negative, I kind of sat down and I was like, okay, this is a gut punch moment, but I need to make a decision here. Do I choose to wallow? Do I choose to not respond and just complain I immediately got to researching numbers and coding and what's allowed, what isn't allowed. Looked into the legislation of the state of Michigan where I practice to come up with what my options were. Step number two, I reached out to two very amazing colleagues that I know that I can trust people who are going to. Give me great advice, but also let me know when I'm heading in a wrong direction or possibly making a mistake. You know, some of those trusted colleagues that are also friends, but people who aren't afraid to hurt your feelings. So in that moment, I just knew I had to gather whatever I could next. The third step that I had to do was prepare to let patients and staff know so immediately with the help of chat GBT, because if you listen to my podcast, you know that I'm definitely using AI to help me, especially when I need to save time. immediately drafted up a text and email message that could go out to my patients, just explaining some basic information until we have more details, we drafted up. I went through like stats and projections, plugged that all in there. Looked at my own records. So for example, I wanted to know, okay, in quarter four, our busiest month, what did I do last year? That way if this is going to be a 23% drop in collections, which at the time it looked like I wanted to prepare for quarter four this year. So I ran numbers from last year compared to this year. Threw all the stats and projections into monday.com, which I use for a lot of it, but then also threw it into chat GPT for some further analysis, and that's what really helped steer my direction for what our solution was going to be. And then lastly, I looked at it from a timeline perspective. When did I want to have an answer? When did I want to have a final SOP? For my team, I knew that I was gonna have to come up with a solution, which, by the way, we're doing the same thing that a lot of physical therapy offices are doing. We cross-referenced a bunch of coding options and pick the right ones that fit the parameters and procedures that we're already doing in our office. When do I wanna test these codes? And then how am I going to make a decision when I get that response back? So typically trying something new in the world of billing, you'll generally find out within a week or so, maybe 10 days max. So I set up a timeline first week, second week, third week of what I was looking for. Questions that I had, my current estimates at the time, put that together. Let my team know, Hey, just a heads up, all of you, including my massage therapist. I let them all know like, Hey, this is what's going on. No need to panic right now. We're going to come up with with a solution. However, it's gonna take some time. please plan for about two to four weeks of uncertainty. Here's what we know now. Here are my current questions. I'll update you as soon as I can. And I gave them individual scripts that they could use if patients specifically asked them about this particular procedure or code or any changes that would come back on EOBs. I wanted my team to feel. Prepared and not feel like this was a burden to them. In reality, if it's gonna be a burden to anyone, it has to be me as the business owner. So those are the steps of action that I took. We use monday.com for anything project and task related, any kind of communication. I'm very anti email, which should probably be another episode because email is kind of. Quite literally the worst thing ever, and I think it bogs down productivity and just confuses people. So I threw it all in our communication strategy in Monday, and once I had that written down, when I tell you that the mental change and all of my frustration, my stress, I mean, we're talking high levels of stress that day because mind you, all of this input I gathered on a Saturday. So in my mind I'm like, oh my goodness, I have to have everything prepared by Monday. What am I gonna do? Places are closed on the weekend. So Saturday, Sunday, Monday, I was in high levels of stress. Monday morning I was able to contact a lot of the contacts that I needed. And by about, I don't know, two o'clock on that Monday, just getting it all written down and creating a plan immediately calmed down my stress levels. And what could I have done? I could have just panicked. I've spoken to, quite a few offices now about what's going on with this whole billing and coding issue.'cause people are up in arms about it and the vast majority of practices don't even have a solution. They're just kind of waiting. and that's, I think. A very normal response to think, woe is me. What is the solution? I have no idea. I'm just going to wait for somebody to tell it to me. and I think I wanted to be the go-getter and because I knew colleagues in the physical therapy world that had already gone through this and had already, found solutions, I knew that that was the next move. so I'm very grateful. It was obviously stressful for a few days, but it's just a great reminder for us that. we have to get this work done in order to establish transparency and a sense of competency with not only our patient base, but also our team. And that's what this really allowed me to do, instead of just not solving it and then letting them have discrepancies with billing for months. And that's what I think happens in a lot of practices, which is not okay. So what I want this experience to serve as an awesome example for you guys. Obviously this is one example of many, you know, if you're a business owner or a practice owner or both. These things happen all the time, right? Not every day is sunshine and rainbows. We are putting out fires, you know, once a month, once a quarter, something goes wrong that we have to fix. So I encourage you to think when something goes wrong. What are your first three steps that you do? Who's a good point of contact for you? Do you have a colleague? Healthcare or in your specific specialty that is a go-to resource for you? I know I do. His name's Dr. Blake Upton, and man, he's a wealth of knowledge, but more importantly, he's been doing this about twice as long as I have. He's been in Michigan way longer than I have, and not only is he a great friend, but he's somebody that I can reach out to and somebody I know that's gonna be honest with me and also help me whenever I need it. I encourage you to find that person for you. I have those people who are not even healthcare providers who just know so much about certain things, whether it's legal information, tax information. Who is your network? Do you have a friend or a family member that instantly will calm your energy and your nervous system when you have a really hard day? So. Yes, I'm starting this podcast episode off with a horrible situation that happened with Blue Cross, but I think it's a great opportunity for us to talk about how we resolve conflict, not only with our team, but also just from a professional perspective. Things happen, like things get really messy and I feel like we're literally just constantly dealing with chaos. So who are the people in our lives and what is our three to four step system of how we come back from these things? So I'm curious if you have an awesome three-step system that you guys do, let me know. So, fast forward to now, it's been a couple weeks and so far our, our solution has worked really, really well. We've now been in communication with other practices and all of us are in agreement. There's also some big conversations happening at a higher level with Blue Cross right now. and so I feel really content and secure. I'm so grateful I did all the hard stuff right away and that I'm, you know, not sitting here several weeks later. With so much money loss and so many confused patients in a confused team. We did everything very aggressively. We got everything done right off the bat, and I'm so, so grateful for that. So now when I look at this experience, I'm like, okay, what if that was the nudge I needed to become more solid in some of my procedures? what did I learn from this experience? for me, one of the things initially on that very first day of chaos that I thought about was I've been wanting to raise my rates for this procedure and this service for a long time. We have incredibly low rates for this service, and what if this was the nudge I needed to make the conscious business executive decision to raise those rates. We haven't done it yet, but now we have a strategic plan of when we're going to do that, which is huge. And I think it's really important to note that sometimes pressure creates clarity, and again, chaos is everywhere. As a business owner and as much clarity as we can get, why not hang on to that? Embrace those periods of time where we are going through something and it is creating pressure on a day-to-day basis and focus on what the outcome will be when we get through it. There's always a light at the end of the tunnel if you work hard for that solution. I think shifting your mindset is really important. we can't always choose what happens to us. We can always choose how we react to it, and in this moment, we chose to take this experience and move things in a better direction, and ultimately it should help our practice instead of harming it. So if you're listening to this and maybe there's an uncomfortable decision that you know you need to make as a practice owner, whether that be changing a software that you use for your practice, firing somebody or adding a new service, or removing just something that's a little bit more uncomfortable and a harder decision to make. Maybe this is your sign. Maybe you have just this weight on your shoulders right now until you make that decision and go through that awkward step Take this as your sign to run with it. Let it bring you some peace and clarity. I know how much better I feel now compared to a couple weeks ago, and let me tell you, it is worth it. So I hope this episode was helpful. If you've gone through anything like this and have some great strategies on how to mitigate some of these challenging times, I would love to hear about it. Shoot me a DM on Instagram at the providers report, or send me an email at rebecca dot Deo, d o@spinecarepartners.com. Thanks guys. See you next time.