Chiropractic Billing and Patient Relationship Management

Return patients generate approximately 80 percent of clinic's revenue. Patient Relationship Management (PRM, also known as CRM, for Customer Relationship Management outside of healthcare) can enhance financial performance of the clinic by helping retain current and attract new patients. Effective PRM uses integrated data using patient travel card (SOAP notes), frequency recommendations (care plan), and billing (charges, payments, and balance).

PRM is a data-driven and patient-focused methodology to strategic practice building and effective patient relationship development. PRM helps identifying new service needs and then designing care programs and office and billing processes to meet the needs.

PRM also helps providing timely, patient centered, and efficient care, emphasizing preventive instead of reactive care. A basic PRM system captures patient information during entire period of the care plan in terms of functional health improvement, care plan implementation, and billing.

Patient Relationship Management Principle

PRM includes a travel card (TC), treatment frequency measures, and billing balance. PRM system tracks changes in the travel card, in Frequency Recommendation summary, and in billing balance, and generates reports to alert office management about lists of patients reaching important thresholds. The office manager or the doctor can review such reports and respond according to practice development strategy, using call centers, Internet, direct mail, or personal conversations during office visits.

Electronic Travel Card

An electronic equivalent of a paper travel card (Electronic Travel Card, or ETC) contains complete information about patient's health and care history. It is similar to electronic medical record and subject to same HIPAA compliance regulations. ETC includes:

• Numbers and dates of visits
• SOAP notes for each visit
• ICD-9 and CPT codes
• Care frequency recommendation summary
• X-rays and posture images

Frequency Recommendation

Frequency recommendation summary presents an interpretation of patient's compliance with doctor's recommendation in concise form and allows specification of PRM thresholds. Specifically, it has four parts:

• Weekly treatment frequency recommendation, typically a single digit between 1 and 3
• The number if weeks when the patient complied with the recommendation
• The total number of weeks for a given recommendation
• Care plan start date
• Number of missed appointments along with documented reasons for missing an appointment

For instance, a frequency recommendation summary [3X: 3/13] means that treatment is recommended three times per week for thirteen weeks, and the patient complied three weeks out of thirteen.

A treatment plan then is a list of such frequency recommendation summaries, for instance, [3X: 3/13], [2X: 15/15], [1X: 4/12].

In summary, Patient Relationship Management (PRM) can become a major differentiating factor in building successful and competitive chiropractic clinics. It requires integrated systems combining data about patient's health, care plans, and billing.