In past articles, I have addressed the various options available to chiropractors who seek to add neuromuscular diagnostic testing to the services they deliver in their practices. The diagnostic procedures that I am referring to are Nerve Conduction Velocities (NCV). Somatosensory Evoked Potentials (SSEP). Dermatomal Evoked Potentials (DEP). and Spinal Ultrasound. In this article. I will discuss the extremely serious issue that faces chiropractors today, and that is the legal compliance issues dealing with neuromuscular diagnostic testing. "Everyone else is doing it, so it must be legal." The rationale of, "everyone else is doing it. so it must be legal" is the furthest thing from the truth when discussing on-site neuromuscular diagnostic testing. You may have dealt with a diagnostics company in the past and not thought twice about the legal issues involved with on-site testing, because you assumed that what you were being told must be legal. You may have questioned the diagnostics company about the legality of their service and. most likely, a quick-talking representative tried to convince you that what they are doing is perfectly legal. The representative may have even produced an opinion letter from an attorney to confirm that what they are doing is legal. Unfortunately, these legal opinion letters have often been found to be very misleading and inaccurate. For the most part, these letters are not drafted by true healthcare attorneys. They arc often created by an attorney who is operating well outside of his or her area of expertise. The only attorney that has the qualifications to draft such an opinion letter is a "Certified Healthcare Attorney'", nothing less. You might have selected a diagnostics company after receiving one of the many faxed advertisements from chiropractors representing a diagnostics company, enticing you with the possibility of generating thousands of dollars per patient for performing diagnostic tests. It can be challenging enough for chiropractors to receive the respect that they deserve, but now you have members of your own profession sacrificing the reputation of chiropractic for the almighty dollar—shame on them and anyone like them for selling out your profession. Chiropractors have enough outside obstacles facing them, and they certainly don't need fellow chiropractors creating more for them. Unfortunately, many diagnostic companies focus solely on how much revenue they can generate. What they should be thinking about is you. the chiropractor—your clinic, your patients, and the sanctity of your pro- fession. You deserve better! On-site neuromuscular diagnostic testing is an important tool tor chiropractors, and I believe that you should utilize every tool that is available to be the best doctor you can be and to best serve the needs of your patients. How. then, are you to know what is really in your best interest, as far as on-site diagnostic testing is concerned? Research is important when choosing a quality diagnostics company for your practice. There are several compliance '"red flags" that you should be aware of when interviewing potential diagnostics companies. First of all. the company you select should demonstrate the highest standards in their policies and procedures. The diagnostic technicians and interpreting physicians should be board certified and professional, and the testing equipment used must be state-of-the-art. If the company will not provide you with the credentials of their professional staff, the first red flag should be raised. The next red flag to consider involves the lease agreement provided by the diagnostics company. If the company uses a lease that requires you to pay for equipment and technicians per hour, per patient, per day, or per nerve, you should be very leery of that company. This type of lease agreement does not qualify as a true lease, due to the fact that your monthly lease payments are an inconsistent amount based upon your patient volume. This is a problem. As an example, consider another lease you may have entered into, if you leased your x-ray equipment. Does the leasing company charge you a greater amount in the months in which you perform a greater number of x-rays? Of course not. When entering into a lease agreement, you must be sure that the payments are the same each month, regardless of number of patients tested in the specified time frame of the agreement. You should, also, never be forced to provide a certain number of patients or tests before the company will come to your office. Another red flag to be aware of is a high fee schedule. Keep in mind, that the primary reason for performing Continued Page 42 ...from Pat>i' 25 these tests is because they are a valuable diagnostic tool to assist you with providing your patients with the best possible healthcare. The purpose of diagnostic testing is run to inflate the claims submitted to insurance companies. If a diagnostics company is elusive when asked what they bill for their component of the tests, it is a sign for you to distance yourself from thai company. You can be sure that they are billing ridiculously high fees to the insurance companies. This will have a negative impact on you and your practice. Not only from the insurance companies, but from your patients as well, because they will be furious after receiving these high fees on their Explanation of Benefits. Guess who will receive the brunt of their fury? You. the chiropractor, will, because you ordered the tests performed by the diagnostics company. When selecting a diagnostics company, it is most important lo choose a company that cares about you. your patients, and your reputation. Take the time to review the red Hags we have discussed. Diagnostics companies don't lose patients who are unhappy with high fees or poor service, you do. Diagnostic companies don'l lose their chiropractic license lor illegal leases. you do. Your destiny should be in your hands: don't place it in theirs. Neuromuscular diagnostic testing plays an important role in the modern chiropractic practice. These tests serve as a vital tool that you can employ to determine more effective treatment programs, provide objective documentation, and to assist you in making better diagnoses. Once you decide that you should be performing on-site neuromuscular diagnostic test- ing. you should take the time to choose the right diagnostics company to assist you. If you wish to contact me tor more information. I would he happy to discuss any of the legal issues surrounding diagnostic testing. If you need assistance with cither choosing the proper company to work with, or evaluating a company that you are current-Is working with, please don't hesitate to call or email me. Glenn A. Becker is the Presisdent and CEO of Advanced Diagnostics Group, Inc., a leading provider of neu-roskeletal diagnostic and healthcare sen'ices to the chiropractic profession. For literature or more information about diagnostic testing, contact Advanced Diagnostics Group. Inc.. at (800) 848-8910 or email: [email protected]. Website www.adv-diag.com. °