Maximizing Reimbursements Through Unbiased Spinal Imaging: A Guide for Healthcare Providers

Introduction

The Relationship Between Injury Documentation and Reimbursement

Your reimbursement is directly tied to the severity of the injuries you’re treating. For instance, if a patient comes in with a minor injury—say, a small scratch on their arm—treatment will be minimal, and so will your reimbursement. Without a documented injury that requires extended treatment, you can’t justify providing long-term care.

Similarly, when it comes to spinal injuries, your reimbursement is linked to how thoroughly and accurately you document the extent of the damage. Excessive motion tests allow you to properly assess the injury, and ideally, these tests should be conducted by an independent, unbiased party like Spinal Kinetics to ensure accuracy and credibility.

Common Pitfalls: Under-Documentation and Reimbursement Issues

Many providers encounter issues with insurance companies when it comes to reimbursement, with claims of overtreatment or excessive billing. However, in most cases, it’s not over-treatment that’s the problem—it’s under-documentation. When you don’t thoroughly document the injury, you leave yourself open to disputes over the legitimacy of the treatment provided.

Spinal injuries typically involve three main types of damage: fractures, disc herniations, and excessive motion causing spinal instability. Without proper imaging to show the extent of these injuries, you can’t accurately assess the patient’s condition. A fracture is typically visible through traditional imaging, while a disc herniation is usually detected on an MRI. However, damage to spinal support ligaments—which can be just as significant—can only be identified through specialized radiographs and excessive motion testing.

The Importance of Imaging in Spinal Injury Cases

Proper imaging is crucial for accurate diagnosis and treatment of spinal injuries. For example, if a patient has a cranial cervical junction ligament injury, it can mimic the symptoms of a mild traumatic brain injury. Without the right imaging, it’s difficult to connect these symptoms to the injury, which could result in improper treatment and, ultimately, lower reimbursement.

Unfortunately, many doctors are discouraged from ordering necessary imaging, often by attorneys or insurance adjusters focused on minimizing costs. However, when you skip essential imaging tests, you also fail to document the injury fully. This can result in denied claims or reduced reimbursements down the line. Proper documentation through imaging not only protects your patients but also protects your practice financially.

Elevating Your Practice with Spinal Kinetics

At Spinal Kinetics, we help providers improve their documentation and, by extension, their reimbursement. Our excessive motion testing elevates the level of injury assessment, providing clear, objective data that insurance companies can’t easily dispute.

Providers who understand the importance of accurate injury documentation face fewer issues in the personal injury market when it comes to reimbursement. If you don’t fully understand the procedures or why you’re performing them, you’re likely to encounter reimbursement problems. Unfortunately, many providers are taught to minimize their spinal injury workups due to concerns over policy limits or reduced payouts from insurance. This approach is short-sighted and ultimately reduces your ability to get paid for the care you provide.
                               
Consider this: if your practice generates $10 million annually in injury-related services but you’re taking a 60% reduction in reimbursements, you’re only collecting $4 million. By improving your injury workups and reducing your reimbursement reductions—say, to 50%—you would add an additional $1 million to your collections. Further reductions could add even more. This demonstrates how improving documentation on the front end leads to better financial outcomes on the back end.  Even more important than the money, is that the better the patient full injuries are understood and properly treated, the better physical recovery results they will have, reducing their future risk or long term chronic pain and disability that are so prevalent with this type of injury.

The key to higher reimbursement is in demonstrating how severely damaged the patient is. Under-documenting the injury minimizes your role and your profession’s value. By utilizing Spinal Kinetics, you’ll elevate the accuracy of your assessments, which in turn elevates your standing in the market and improves your financial outcomes.

Standardizing Spinal Injury Workups

At Spinal Kinetics, our mission is to standardize spinal injury workups across the healthcare industry. By doing so, we aim to reduce the chronicity rates of spinal injuries, allowing treatment innovators to provide more effective care. Understanding the interrelationship between fractures, excessive motion, and disc herniations is key to improving both patient outcomes and reimbursement.

For example, if a patient has a disc herniation but no excessive motion testing to assess ligament damage, the injury may be dismissed as a pre-existing condition. You must be able to demonstrate how these different injuries interrelate to get proper reimbursement for your care.

Conclusion: Elevate Your Practice with Better Imaging

Spinal Kinetics helps you elevate your practice by improving injury documentation through better imaging. When you document spinal injuries thoroughly and accurately, you protect your practice from denials and reimbursement reductions. If you don’t already have an account with Spinal Kinetics, I highly recommend setting one up. We offer training, resources, and support to ensure you’re getting the most out of your imaging and improving your practice’s financial health.

If you’re interested in learning more about how we can assist you, reach out to us today. Together, we can help you document spinal injuries more effectively, leading to better reimbursements and better outcomes for your patients.