Hour 1

• Describe pathophysiology as it relates to concussions. 
• Discuss the diagnosis and prognosis of concussions.
• Review concussion red flags and dangers of manipulation.
• Understand the health concerns of pediatric athletes.
• Explore diagnostic tests to evaluate concussion status.

Hour 2

• Demonstrate non-thrust treatment techniques.
• Introduce the half-somersault maneuver for vertigo relief.
• Address cranial nerve lesions with manipulation techniques.
• Explore sleep strategies for concussed patients.
• Incorporate nutritional support for better brain function.
• Discuss cardio exercise to stimulate blood flow to the brain.

Hour 3

• Apply mobility exercises to improve musculoskeletal function.
• Integrate PreActive StretchingSM protocols to improve agility.
• Explain return to lifestyle guidelines.
• Understand modifying factors for RTP.
• Compare professional Position Papers.
• Discuss the role of Chiropractors and concussions.

• Demonstrate understanding of the key elements of revised E/M services
• Determine the elements that count as Time-Activities and how to calculate appropriately
• Establish protocol to determine Medical Decision Making element of E/M encounter
• Apply the new algorithm to appropriately code for E/M services under the 2021 model
• Discover how to still demonstrate Medical Necessity with the revised E/M codes
• Determine why history and examination are still needed

Educational Objectives: for Documentation portion:

Hours 1 and 2

• Recognize the key components regarding good documentation and record keeping
• Identify the legal requirements of informed consent and the key elements of the informed consent process
• Discuss why doctors are held to higher standards
• Describe the 21 NCQA guidelines for record keeping
• Document progress notes (SOAP) to meet insurance guidelines and medical necessity
• Apply the PARTS system and its transformation utilizing a new method AIR S & M
• Utilize CMT coding appropriately
• Utilize E/M (Evaluation/Management) coding appropriately to meet insurance guidelines and medical necessity
• Identify the 3 categories and 2 subcategories of E/M codes
• Identify the 4 levels of E/M services for new and established patients
• Recognize the importance of a medically appropriate history and physical exam
• Identify the 2 key elements used to determine the level of E/M service
• Select the appropriate level of E/M services utilizing 4 simple steps

Educational Objectives: for Ethics

Hour 3

• Identify challenging/inappropriate patient requests and behaviors encountered by chiropractors.
• Explain prevention strategies, office procedures and effective responses to inappropriate patient activity.
• Describe safety concerns associated with a patient's inappropriate acts and communications, as well as ethical principles related thereto.
• Illustrate legal and ethical issues arising where the doctor/patient relationship is terminated due to inappropriate patient behavior.
• Analyze how aberrant patient behavior presents risks to staff, the treating doctor, and to fellow patients, and how proper documentation is important in such instances.

Educational Objectives: for Risk Management

Hour 4

• Comprehend the association between the doctor-patient relationship and the charge of patient abandonment.
• Evaluate the role voluntariness plays in the establishment of the doctor-patient relationship, in informed consent, and in abandonment as associated with the inappropriate termination of the professional relationship.
• Contrast and compare "ostensible agency" with "voluntary association" for purposes of assessing potential patient malpractice liability.
• Comprehend the requirement for the continued administration of healthcare for purposes of determining possible patient abandonment issues.
• Carry out proper documentation as demonstrates non-existence of abandonment.
• Effect policies that systematize screening of non-compliant patients and execute relevant medical record documentation to ensure no patient is legally "abandoned."
• Discuss prepaid treatment programs

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.
• Understand 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 crosses 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.

Educational Objectives: for Documentation

Hour 1 and 2

• Identify the correct amount of time a chiropractic record must be maintained with specific differences for that of an individual under the age of 18 as well as records related to a civil, criminal or administrative proceeding
• Keep appropriate records and maintain required information and provide requests for information and records from licensee’s.
• Describe various types of patient encounters and levels of documentation, and determine how to properly document each encounter.
• List the various governing bodies and organizations which may impose requirements on your record keeping of the patient’s health chart.
• Identify key components of the office entry forms and relate the importance of follow up and systems review.
• Compare and contrast various outcome assessment instruments, describe the importance of these tools and properly use and score various outcome assessment instruments.
• Recite tests traditionally thought of as objective and tests traditionally thought of as subjective in the context of reliability and validity.
• Define the characteristics of a good outcome assessment tool, and be able to properly implement it in clinical practice.
• Compare and contrast the various types of electronic health records available.
• Itemize the requirements of a “paperless” office.

Educational Objectives: for Ethics

Hour 3

• Identify legal prohibitions against promising healthcare cures, guaranteeing treatment results, and deceptive patient communication.
• Distinguish between appropriate and inappropriate communication relating to patients' healthcare prognoses and progress.
• Explain scientific literature linking patients' mental states with healthcare outcomes.
• Demonstrate alignment between compliance with states' current patient communication restrictions and instances of patient encouragement that foster mental states favorable to desired healthcare outcomes.
• Explain office procedures and staff training which are likely to ensure ongoing ethical patient communication and the documentation thereof.

Educational Objectives: for Risk Management

Hour 4

• Appropriately disclose charges to patients
• Identify potential problems associated with sharing fees with non-healthcare professionals.
• Demonstrate anti-trust issues associated with setting professional fees
• Explain connections between co-pay waivers and violations of the False Claims Act
• Describe the appropriate delegation of authority in a Chiropractic office to avoid licensure complaints
• Assess parallels between fee-splits and principles of ostensible agency that can lead to malpractice liability.
• Compare and contrast fee-splitting and the corporate practice of medicine.
• Legally provide Prepaid Treatment Plans