b'agreement with the provider. A very few providers have5been able to negotiate some rate between what the plan is supposed to pay and what was originally paid with a reduction. The vast majority, however, attempted to negotiate or appealed, but the reimbursements were not changed. The ANJC sent cease and desist letters to CIGNA and Data iSight, filed a complaint with and met with DOBI on this matter. As the majority of the claims affected are self-funded and outside the jurisdiction of NJ DOBI, the ANJC Board has approved an action in federal court against DataBy Don RasmusseniSight, and others on this issue. The paperwork has beenQuartermaster Tax Management Servicesdrafted and our attorney is waiting on documents from named plaintiffs to formally file the suit. We anticipate thisAfter reviewing hundreds of chiropractors tax returns to be done very soon.this year, I have identified the following top five causes of Aetna-DOBI response: In June of this year, the ANJCunnecessary tax losses.filed a complaint with DOBI against Aetna for a number1.Incorrect Entity: Not knowing whether a Schedule C-Sole of processing issues. ANJC Leadership met with DOBIProprietor, Partnership, Sub S-Corporation, or C-Corporation Commissioner Marlene Caride and her team, followingis the best primary entity to have for their chiropractic up to our complaint in July. The complaint was comprisedpractice. The wrong choice can cost a chiropractor as much of three main issues; Triad being sent claims erroneously which delayed payment, various pre-authorization errors,as $5,000-$10,000 in unnecessary annual taxes.and the inappropriate denial. 2. QBI: Not understanding how the NEW Qualified Business Triad HealthcareProcessing Errors Income deduction can save chiropractors as much as 20% off Aetna has acknowledged that the transition from Triad totheir tax liability.NIA resulted in claims processing errors and delays. On3. RC: Not knowing what the IRS considers Reasonable July 5th, Aetna implemented a new system, and claimsCompensation. This was a crucial component to overpaying are no longer being mis-routed. All impacted claimsunnecessary taxes in 2018 and/or increasing the risk of a should have been reprocessed by the end of August;red flag for IRS audit. It is important to know the IRS and claims payments will include late claim interest whereDepartment of Labor guidelines and identify exactly how applicable. much a New Jersey chiropractor, in his or her respective Pre-Authorization Processing Errors county, should claim as W-2 wages.Aetna acknowledged several system errors between them4.Cost Segregation: 80% of New Jersey Chiropractors who and their pre-certification vendor NIA. These includedhave owned their buildings for 20 years or less, are losing authorizations granted by NIA not being received bytens of thousands of dollars in hidden deductions by not Aetna, Aetnas system not properly recognizing codeshaving a certified engineers cost segregation review.covered under NIA Utilization Review Matrix (the parent5. No Written Tax Plan: Sir Winston Churchill stated, He code denials), Aetnas system not accurately counting the number of visits paid versus visits allowed.who fails to plan is planning to fail! Since most CPAs and The authorization and matrix issues have reportedlyaccountants are very busy with compliance tasks such as tax been resolved and erroneously denied claims will bepreparation, bookkeeping and payroll for various businesses, reprocessed automatically and with interest whenthey are often prevented from providing their clients with a appropriate. The counting of visits issue is scheduledpersonalized tax reduction strategy.to be resolved in November. In the meantime, Aetna isBottom line. many chiropractors are overpaying on their reviewing claims manually on a monthly basis to catchtaxes by the THOUSANDS. The good news is that knowl-any of these errors and reprocess them, with interest ifedge can turn this around. There are experienced, ethical applicable.companies out there that can help them repair the leaks. Denials of CPT Codes with -25 and -59 Modifiers Conduct your due diligence and find a tax savings consultant In November 2018, Aetna implemented a new claim- who has demonstrated success and fits your needs. editing software to verify billing of -25 and -59 modifiers. The software considered patient claim history andDon Rasmussen is a Certified Tax Strategist and a managing diagnosis codes; in some cases, a clinical nurse coderpartner of Quartermaster Tax Management Services, a tax reviewed the information to determine if the modifierplanning firm that specializes in chiropractic tax reduction should be allowed. Aetna has stopped using the claimplanning. Quartermaster is a proud ANJC sponsor and is editing software to review these modifiers effectivededicated to helping DCs around the state to increase their August 1, 2019. Claims will be reprocessed, if needed. tax savings. For a personalized Chiropractic Tax X-Ray, QM Please note that Aetna has indicated to DOBI thatReasonable Compensation Report or Cost Segregation Analysis; providers do not need to submit anything for claims to beor to schedule a complimentary tax reduction discovery call, visit reprocessed. www.chirotaxpro.com or call 704-490-4111.www.njchiropractors.com I 13'