Newsletter

Chiropractic Medicare PROTECT YOURSELF!
Please share this info with other D.C.'s

Updated: September 27, 2010
Dear Doctors and Staff,
A very high percent of Chiropractors will have a C.E.R.T. Audit usually on one patient, two or three visits. Even though the audit will ask for S.O.A.P. notes primarily and/or any other information in relation to those dates of care, consider also sending the following information:
1. Code 99203 (most commonly used E/M code in Chiropractic) requires social history, family history and past health history. Be certain your new patients Initial Visit Report form includes this information. Be sure this Initial Visit Report is sent with CERT review.
2. Box #14 should indicate date of current and not over two (2) months old. Documentation each event that changes date in box 14 and should be sent with CERT review.
NOTE: Evaluation on Management (E/M) code level should be appropriate for the condition. (E/M 99205 is rarely used in a Chiropractic Office.)
3. Re-Evaluation of the patient under active care every 10-12 visits or 30 days. Update treatment goals, frequency and plan. The patient must show progress.
4. S.O.A.P. notes should tell the story of "what is going on with both your patient and your care." How the patient is improving. Why they need care. All in S.O.A.P. note format. (This is NOT the key "documentation" in Medicare.)
5. You must have proven a subluxation with either an x-ray (less than one year old) or P.A.R.T. form for each and every visit.
6. Diagnosis determines the adjustments necessary. Cervicalgia (neck pain), Lumbago (low back pain) are a short term diagnosis.
7. Documentation: This document (NOT the S.O.A.P. Notes) must be sent on ALL CERT reviews to make the claim payable.
8. COMPLIANCE PLAN AND AUDIT: The Patient Protection and Affordable Care Act, signed into law March 23, 2010, has now mandated a compliance plan. The OIG stated that a Compliance Plan will be used as "a mitigating factor" against fines and jail time.
BOTTOM LINE: If you wish to learn how to do Chiropractic Medicare correctly, including "documenting" by federal standards, please consider ordering our Chiropractic Medicare DVD and booklet. It explains piece by piece every important step in doing and billing Chiropractic Medicare so there are no limits for the chiropractic adjustment. If you are audited you will have done Medicare correctly and win your audit. You and your staff will be very happy you have this important and mandatory information. I promise it will make a difference in your understanding of Medicare and how you bill Medicare.
2010 Seminar Schedule
The next seminar is scheduled for Thursday, November 18, (8:30 am to 12:30 pm) at the Courtyard Hotel, W. Palm Beach, FL.
Keep in mind, Medicare is the only insurance type program that if done incorrectly is fraud, a felony, a fine and/or jail.

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I promise you will be more than satisfied that you made the right decision to purchase this information or attend our presentation. Please give me a call if you have questions. 1-618-395-3162

Best regards,
Dr. Gary R. Street


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