Documentation 199

Course overview

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.