Medicare Compliance

Ted Arkfeld, DC, MS, CPC

Getting denied payment on services is the last thing you need. Why do you think this keeps happening? Proper coding and documentation under specific standards is what Medicare is looking for… and if you do that, then you are half way there. Yes, that’s good but it’s only half way…

The second question to ask yourself is this – do you have the clinical findings to support medical necessity?

No matter how well you document care, if your findings don’t support medical necessity, then you won’t get paid either. Will your documentation support the care you are providing? Are the mechanism of injury and the clinical findings based on your examination sufficient?

Purchase this Course


Upon completion of this course, participants are expected to be able to:

1. To understand why we continue to have the highest error rate among Part B providers, and how and why we must change.

2. Understand how to launch a clinical documentation improvement program for attendee’s offices

3. Learn how and when to apply biomechanical injury models to patients presenting with both acute and chronic injuries.

4. Gain knowledge on how to document an appropriate and measurable treatment plan and then administer an ABN for main

This special series on Medicare consists of the following modules:

“Why We Must Change”
Chiropractors have the highest error rate among Medicare Part B providers. For this reason, we continue to come under closer scrutiny from post-payment and probe audits. Worse yet, is the fact we continue to make the Office of the Inspector General’s Work Plan every year. This is not a list we want the chiropractic profession to be on each year. We must change, and it must begin with each individual office receiving education and training on proper billing, coding, and documentation requirements of Medicare Part B carriers.

“Clinical Documentation Improvement Program”
This session covers in depth the initial visit must haves, along with daily note requirements as directed in the CMS Manual for Chiropractic. After reviewing this webinar, doctors of chiropractic are encouraged to launch their own Clinical Documentation Improvement Program, so we may lower our error rates, and get off the OIG yearly work plan.

“Mechanism of Trauma”
This session provides a brief overview on how to determine injury causation, and the various loads necessary to produce pain. Documenting the mechanism of trauma is initial visit must have per CMS documentation requirement.

“Care Plans & ABN”
Care Plans and Advance Beneficiary Notices continue to be often misunderstood and not correctly administered in offices nationwide. This session we go step by step on what constitutes a compliant care plan and when to administer an ABN for wellness patients.

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