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.