Chiropractic Compliance Articles and Resources
Because compliance covers so many areas of a healthcare provider practice, a more thorough explanation is found in Chapter 3-Compliance in the ChiroCode DeskBook. Generally, healthcare providers need to understand:
For additional information visit ChiroCode.com. Since 1993 Chiropractors have depended on ChiroCode as a reliable source of information for the Chiropractic community. Because of the dependability and education ChiroCode has earned much renown. View current and recent webinars, order the ChiroCode DeskBook, (comprehensive go-to chiropractic reimbursement manual) and much more.
Select the title to see a summary and a link to the full article.
October 7th, 2020
Stay out of Trouble — Understand the Qualified Medicare Beneficiary (QMB) Program
Published October 7th, 2020|
To assist low-income Medicare beneficiaries, CMS created the Qualified Medicare Beneficiary (QMB) program; a Medicaid benefit which pays for Medicare deductibles, coinsurance, or copays for any Medicare-covered items and services for Medicare Part A, Part B, and Medicare Advantage (Part C). Providers/suppliers are prohibited from billing premiums and cost sharing to Medicare beneficiaries who are enrolled in QMB.
March 25th, 2020
COVID-19: Cybercrime, Telehealth, and Coding
Published March 25th, 2020|
Your inbox is probably like mine with all sorts of announcements about COVID-19. Here are just a few reminders of things we felt should be passed along. We have heard of several cases of cybercrime related to this outbreak. For example, there was a coronavirus map which loads malware onto your ...
August 9th, 2019
The OIG Work Plan: What Is It and Why Should I Care?
Published August 9th, 2019 - Last Review/Update August 14th, 2019|
The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ...
July 8th, 2019
Q/A: Can I Put the DC’s NPI in Item Number 24J for Massage Services?
Published July 8th, 2019|
Question: Are there scenarios in which it is acceptable to put the DC's NPI in box 24j for massage services? Answer: While the answer to this is yes, it is essential to understand that there are very limited scenarios. In most cases, Item Number 24J is only for the NPI of the individual ...
July 1st, 2019
Rules for Rendering Unproven, Investigational or Experimental Procedures
Published July 1st, 2019|
If you haven’t reviewed your state guidelines or taken a recent look at third-party payer policies on unproven, investigational or experimental procedures, now is the perfect time to make sure you’re up to speed with this important information. Most providers are surprised to see commonly used devices or techniques listed ...
June 25th, 2019
Q/A: Can I Refuse to File a Patient's Medical Insurance for an Auto Accident?
Published June 25th, 2019|
Question: Can a Chiropractor refuse to file a patients Medical Insurance for an Auto Accident? Answer: There isn't a simple answer to this question. It depends on who is responsible and state laws. Who is responsible (the auto insurance or the medical insurance) can depend on state requirements as well as who is ...
April 29th, 2019
Q/A: I’m Being Audited? Is There a Documentation Template I can use?
Published April 29th, 2019|
Question: Our Medicare contractor is auditing claims with 98942. Do you have any suggestions for a template for documentation to warrant the use of 98942? Answer: When you submit a claim with code 98942 you are stating that you have determined that it was medically necessary to adjust all 5 of ...
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November 6th, 2018
Medicare continues to increase their efforts to review doctors and recover “overpayments”. This increases the likelihood that your notes will be reviewed and that you will be required to pay money back to Medicare. In this webinar Dr. Short will show you: Why you should appeal every adverse decision. How to appeal adverse decisions. What information you need in your documentation for an effective appeal. How to structure your appeals to be most effective.
August 14th, 2018
How to Create a Medicare Compliance Plan
In this webinar, Dr. Marty Kotlar (certified coding and compliance expert) will discuss how to create an OIG/Medicare compliance plan. He will explain how to create policies, how to perform a "self-test" on your SOAP notes, search the Medicare exclusions list, Stark, anti-kickback and how to handle compliance concerns.
August 7th, 2018
Medicare reviews claims for a variety of reasons. Some are routine and are not a problem for the doctor or the practice. Some are investigatory in nature and indicate a serious potential threat for both the doctor and the practice. Dr. Ron Short will go over the types of reviews and which are routine and which should cause you to lose sleep. In this webinar you will learn: -What routine reviews are and why they are conducted -What reviews are a potential risk -What triggers reviews -When to get help and what kind of help to get
June 12th, 2018
Healthcare Compliance- Fraud/Waste/Abuse…Avoiding the Pitfalls
Presented by Howard Levinson, DC June 12, 2018 Tuesday @ 10:15 AM PT, 11:15 AM MT, 12:15 PM CT, 1:15 PM ET Dr. Levinson will discuss what constitutes healthcare fraud, waste and abuse and some of the strategies the insurance industry uses to identify outlier providers. Examples of healthcare providers who ...
May 29th, 2018
The Most Expensive Documentation Mistakes Chiropractors Make
Notes need to give payers the information they need in order to adjudicate your claims. Do your notes include what they need to see? Can you standardize and simplify your note taking process to decrease your administrative burden? In this webinar, Dr. Gwilliam, Certified Coder, Certified Professional Medical Auditor, and Clinical Director for PayDC Chiropractic EHR Software, will show you how to make it easy. He will review examples and boost your confidence that you are doing things correctly.
June 29th, 2017
How to Convert Your Medicare Patients to Cash to Avoid the Penalties of MACRA
The #1 concern reported by CMS about chiropractors is that, as a profession, we do a poor job of understanding maintenance care. Of course, that is THEIR definition of maintenance care. When you better understand the rules of medical necessity in Medicare, you begin to see what they are talking about. The truth is that there is a “gray” area between the distinct “white” of active treatment and the “black” of maintenance treatment, and that gray area is confusing when defining “covered” vs. “not covered” chiropractic care in Medicare. Join us to find out the following critical information in time for the MACRA Section 514 implementation January 1, 2017: Find out exactly what Medicare deems as maintenance care and how to recognize it with our patients Learn what your options are for treating your Medicare patient’s maintenance care for cash Hear scripting that is vital to your patient understanding what’s going on with their coverage, or lack thereof Properly document the difference between active and maintenance care Better manage those little incidents that come up for chronic, Medicare patients
Detailed Information on the New Safety Data Sheets (SDS)Disposal of Protected Health InformationHIPAA: Health Insurance Portability and Accountability Act by AMAMedicare Recovery Audit by HHS Office of the Inspector GeneralOfficial HIPAA Guidelines for Media SanitationOIG Compliance Program for Individual and Small Group Physician Practices - Federal RegisterOSHA Small Business Resources - includes trainingOSHA's Computer Workstations eToolTemporary Worker Injury and Illness Recordkeeping Requirements by OSHAUnited States Department of Labor; Occupational Safety and Health Administration
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August 25th, 2020
Do You Have All the Right Dental Resources Needed to Succeed in Dental Medical Billing and Coding?
Discussion with LaMont Leavitt (CEO of innoviHealth) and Christine Taxin (Adjunct professor at New York University, President of Dental Medical Billing, and Links2Success). Some of the resources and tools they discuss will help you with your dental coding/billing and education.
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