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Naturopathic Doctor

Documentation 199
Documentation and Risk Management - From Medical Necessity to Clinical Appropriateness


Hour One: Documentation and Compliance Overview, Rules and Regulations

  • Recognize and avoid or correct behavior that is contrary to the rule of “no opt-out for chiropractors”
  • Apply compliance rules set forth by governmental agencies that apply to providers of service to Federally insured patients
  • Demonstrate day-to-day application of guidance on Federal Program and state requirements for coding, billing, and finances
  • Differentiate between active and maintenance care, according to the official Medicare definitions and other third-party guidelines
  • Interpret the four types of risk the Office of Inspector General (HHS) expects providers to focus on with Policy and Procedure, per the OIG Guidance for Small Practices
  • Recognize the limitations of experimental, investigational, and unproven technologies

 Hour Two: Documentation of Initial Visits-New Patients, New Episodes, and New Conditions

  • Identify and apply concepts that differentiate types of initial visits, from new patients to updated episodes
  • Produce documentation of initial visits that comply with board requirements for chiropractors
  • Summarize documentation requirements as they apply to the new initial Evaluation and Management guidelines set forth January 1, 2021
  • Establish medical necessity for your care and know with surety that initial visit documentation is complete
  • Rank complicating factors and contraindications according to priority and include with initial assessment
  • Populate a required treatment plan for care, whether for short- or longer-term care

 Hour Three: Documentation and Case Management for Routine Visits, Preventive Maintenance, and Wellness Care

  • Differentiate between requirements for medically necessary services vs. maintenance which is self-pay
  • Apply primary subluxation vs secondary compensation logic to mitigate risk for the full-spine adjustment
  • Reproduce the key elements of routine chiropractic visits in documentation as set forth by third-party, State and Federal guidelines
  • Interpret functional data to determine stages and levels of care
  • Demonstrate the ability to implement therapeutic withdrawal and to document its results
  • Recognize maximum therapeutic benefit (MTB) and properly document discharge from active treatment

 Hour Four: The Risks Associated Billing and Financial Compliance Regulations

  • Give examples of billing and financial compliance that cross the line of False Claims Act and Anti-Kickback Statute violations
  • Apply billing and financial compliance regulations to the day-to-day operations of the practice, including payment and prepayment plans
  • Execute random auditing of charges and collections to meet OIG compliance guidelines
  • Recognize and apply the rules of offering financial hardship discounts
  • Produce advertising that falls within the guidelines of board and federal rules

Kathy Mills Chang, MCS-P, CCPC

AudioVisual Course

$80.00 USD

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