By Dan Osborne & Brad Hayes, D.C. This manual teaches you the real ins and outs of Compliance. Most doctors do not understand the importance of compliance to their practice. Besides conforming to the law, compliance helps you fight inappropriate claims denials, and helps you identify lost income by understanding proper pricing. This comprehensive manual has succeeded in breaking down two complicated issues, the HIPAA compliance issues, and the Federal Privacy issues into a simple, straightforward and easily understood manner so that your office can come into compliance. First, a step-by-step plan for compliance is given that explains exactly why and how to get your office "into" compliance.
Easily filled out forms take you through the task of auditing files, employee background checks, CPT and ICD coding compliance, and all other issues the government expects regarding compliance. A number of practices have faced fee reductions, fraud investigations, and some, fraud prosecutions, because they were not in compliance. These forms can even help you identify how to fight insurance companies and stop them from cutting your claims. If you are "in" compliance, then you should be paid for what you do. The second section takes you completely through all the issues of patient privacy now demanded by the government. All the myths are exploded and the real issues you must deal with are completely explained. Do you have to shut your computer down if there is patient sensitive information and you are not working on it? Do you have to lock up your files? Can you use birthday announcements and send thank you letters to patients for referring patients? Can you have referral boards in the waiting room? Can you still use sign in sheets? Can you call a patient and leave a message on an answering device? Can you treat in an open area, or must everything be behind closed doors. All of these questions and more will be revealed.
This manual helps to simply implement an action plan that will make your office fully compliant and protected from lawsuits and government hassle. This manual is a must for any office that deals with patients in this day and age. What you will learn! *The procedures that can land you in jail!! *The 7 factors investigators look for when evaluating your records *The specific risk areas you must stay away from to avoid health care fraud investigations *How to appoint a compliance officer *All the simple forms to keep you in compliance *If you suspect that you are under the scrutiny of an investigation...the one thing you must do to protect yourself from leading investigators to your prosecution. *How to report errors *How to enforce disciplinary standards In short, how to be sure you're safe from investigative scrutiny. Also, the complete form library for all identified compliance issues on diskette so that you can customize them for your office.
Evidenced Based Treatment for Common Conditions Seen by Chiropractors
By Hugh Gemmell, D.C. Ed D. and Brad M. Hayes, D.C. How to diagnose, plan tratment, and effectively treat the 25 most common conditions based on actual claims data submitted to third party payers. This manual will show you exactly what should be identified in the history. Read and yellow flags to watch for. Differential diagnoses. How to prove your treatment. What to watch out for and exactly how to treat the condition based on the scientific evidence. Included will be the abstracts of scientific articles that support the treatment and the outcomes you may have. Each condition has the IDC diagnosis code, how the patient will describe the condition, exactly what other conditions you must consider, the best methods of treatment, along with average treatment times found based on actula claims data. Evidenced based treatment guidelines with the best CPT codes will be given. Each condition illustrated in full color. There has never been a a manual lke this written from a chiropractic perspective. This information can be chared with patients, medical doctors, insurance companies, employers and others to help support what you do.
By Brad M. Hayes, D.C. Updated yearly, this manual provides you with a complete understanding of documentation for the D.C. Topics covered include: What an auditor for a health plan looks for in your records; The 6 things you never, never, never, do with your records; What records must include to be properly documentaed; What questions to ask in a history, etc.; The red flags for disease or neurological damage that you must follow up on; The 4 things that justify your re-examination; How to write a report that gets you pain; And, much, much, more!