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Dynamic Chiropractic – March 11, 2008, Vol. 26, Issue 06

The DOT Third-Party Administrator

The DCís Ally

By Clinton M. Smith, DC

So, you've decided to begin performing Department of Transportation (DOT) testing in your office?

Wise move. Since this testing is mandated for nearly 10 million drivers in the United States, why shouldn't you have a piece of the action? If you perform DOT physicals, mandatory drug collections and mandatory breath-alcohol testing, what you need is an ally.

You need someone at "arms' length" distance to help you get that testable work force in your office. Not only will you enhance your practice by performing DOT work, but you also will see people who may never have come to your office. They will see you are a quality physician with a nice, comfortable office and great staff. You'll be surprised at how many DOT testing clients who traverse through your office will become patients with minimal marketing pressure.

But how do you get DOT clients in the first place? Do you have to manage those pesky randoms for alcohol and drugs? Who keeps track of when a physical is due? The answer is a certified DOT third-party administrator (TPA). A TPA helps with two major services. The first is managing the drug and alcohol program for the company. The company simply transfers the names and IDs of its testable workforce to the TPA. The TPA administrator then adds those workers into randomization software. Every quarter, the DC collector and the enrolled company get a copy of the random pulls from the TPA. Those workers then come into the DC's office where the collection is performed. The TPA handles all billings and makes sure the doctor's office has all the necessary supplies and mailing packets for transfer to the labs. The doctor does not even pay for shipping of the specimens! The TPA pays the doctor, pays the lab and takes a management fee, usually around $5 per test.

The second major service the TPA provides is as the liaison between the doctor and a company in their area that collects specimens. The DC simply calls the TPA and provides the name and number of the designated employer representative of the company. This is the person employed by the company (usually not the owner) who is in charge of a company's testable work force for DOT compliance. The TPA then sets up the company and begins funneling collections to the DC.

A few DCs have asked me why they should not be a certified TPA instead of using another established company. I usually respond with "Do you feel comfortable enough in this business to withstand a DOT audit?" That usually gets the point across. I am not saying that you cannot be a TPA or should not start a TPA service, but you need to understand the system and have 5-6 years of experience before venturing on your own.

I mentioned audits. When a company you are collecting for is audited, the onus typically falls on the TPA to provide all the documentation to the DOT auditor. The only time I have ever seen a chiropractic office get involved in a DOT audit is when they are making a large number of collection errors. Rarely, they will be excluded from performing DOT work.

If you are trained in DOT work and are doing collections now, get a good TPA to assist you. There is no direct cost and nothing is ever out of your pocket. Plus, you have the security of knowing you are covered by an entity that knows DOT work inside and out. If not, I recommend you get trained in DOT physical exams, urine drug collections and breath-alcohol testing. Training in physicals will soon be mandatory, so get going now and get comfortable doing them. Drug and alcohol testing require training certification; find a reliable TPA to assist you. The cost of starting this service in your office is very reasonable, and business will grow year after year naturally.

Dr. Clinton Smith, a 1988 graduate of National College of Chiropractic, is a practicing chiropractic physician in the Metro East area of St. Louis. He was one of the initial members of the Working Integrated Product Team of the NRCME program in Washington, D.C., and has been performing DOT examinations, drug collections and breath alcohol testing for 15 years. Contact Dr. Smith with questions or comments at .

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