Hour 1

• Utilize a more comprehensive knowledge in a clinical consultation setting with a Chiropractic prenatal patient.
• Integrate a deeper understanding of the contextual nature of Chiropractic Patients attitudes toward prenatal and postnatal status
• Describe the key environmental factors that impact outcomes for pregnant Chiropractic patients.

Hour 2

• Identify three elements of the birth protocols that consider for the treatment of postnatal Chiropractic patients.
• Provide patients Chiropractic input on prenatal and postnatal biomechanical and other considerations to optimize treatment experience.

Hour 3

• Review various aspects of pregancy to consider with Pregnancy Chiropractic Patients
• Analyze different scenarios that may affect Pregnant Chiropractic patients
• Communicate the current evidence comparing safety and efficacy.

• Compare the associations of chiropractic care and stroke with primary care physician (PCP) care and stroke in the Medicare population
• Quantify risk of stroke after chiropractic spinal manipulation, as compared to evaluation by a primary care physician, for Medicare beneficiaries aged 66 to 99 years with neck pain
• Determine the hemodynamics in the Circle of Willis with Internal Carotid Artery Stenosis under cervical rotatory manipulation: a finite element analysis
• Review compensation claims for chiropractic in Denmark and Norway 2004-2012
• Examine the risk of traumatic injury associated with chiropractic SMT in the Medicare population 

Educational Objectives: for Documentation portion:

Hours 1 and 2

• Recognize the key components regarding good documentation and record keeping
• Identify the legal requirements of informed consent and the key elements of the informed consent process
• Discuss why doctors are held to higher standards
• Describe the 21 NCQA guidelines for record keeping
• Document progress notes (SOAP) to meet insurance guidelines and medical necessity
• Apply the PARTS system and its transformation utilizing a new method AIR S & M
• Utilize CMT coding appropriately
• Utilize E/M (Evaluation/Management) coding appropriately to meet insurance guidelines and medical necessity
• Identify the 3 categories and 2 subcategories of E/M codes
• Identify the 4 levels of E/M services for new and established patients
• Recognize the importance of a medically appropriate history and physical exam
• Identify the 2 key elements used to determine the level of E/M service
• Select the appropriate level of E/M services utilizing 4 simple steps

Educational Objectives: for Ethics

Hour 3

• Identify challenging/inappropriate patient requests and behaviors encountered by chiropractors.
• Explain prevention strategies, office procedures and effective responses to inappropriate patient activity.
• Describe safety concerns associated with a patient's inappropriate acts and communications, as well as ethical principles related thereto.
• Illustrate legal and ethical issues arising where the doctor/patient relationship is terminated due to inappropriate patient behavior.
• Analyze how aberrant patient behavior presents risks to staff, the treating doctor, and to fellow patients, and how proper documentation is important in such instances.

Educational Objectives: for Risk Management

Hour 4

• Comprehend the association between the doctor-patient relationship and the charge of patient abandonment.
• Evaluate the role voluntariness plays in the establishment of the doctor-patient relationship, in informed consent, and in abandonment as associated with the inappropriate termination of the professional relationship.
• Contrast and compare "ostensible agency" with "voluntary association" for purposes of assessing potential patient malpractice liability.
• Comprehend the requirement for the continued administration of healthcare for purposes of determining possible patient abandonment issues.
• Carry out proper documentation as demonstrates non-existence of abandonment.
• Effect policies that systematize screening of non-compliant patients and execute relevant medical record documentation to ensure no patient is legally "abandoned."
• Discuss prepaid treatment programs

• Identify key players in rules and regulations
• Map the process from Initiative, Proposed Rule to Final Rule
• Learn to track Protected Health Information (PHI) in the practice
• Recognize the components of a compliant Risk Analysis
• Demonstrate the proactive steps to building a compliant culture in the practice

• Identify which supplements are commonly used in exercise and sport
• Ascertain the rationale of using specific individual sport supplements
• Differentiate between fact and fiction of the supplement in relation to sport and exercise
• Determine the practical use in sport for individual supplements
• Determine the benefits of individual ergogenic supplements
• Examine the risks associated with individual supplements
• Investigate the value of specific supplements via studies
• Define contraindications and interactions with the supplement
• Recommend the correct dose of the supplement for sport and exercise

• Explain the origin of the vagus nerve, its anatomy, and its critical role in regulating bodily functions, including its connection to the sympathetic and parasympathetic nervous systems.
• Describe common causes of headaches and explore how the vagus nerve contributes to the pathophysiology of headache conditions.
• Discuss the science behind vagus nerve stimulation, its impact on neurological pathways, and its therapeutic benefits for treating headaches, epilepsy, treatment-resistant depression, reduced anxiety, and improved mood.
• Assess the efficacy and limitations of vagus nerve stimulation as a non-invasive treatment for headache reduction, referencing current research and clinical findings.
• Review the range of vagus nerve stimulation devices, from surgically implanted medical devices to over-the-counter options, and discuss their appropriate uses and considerations.

Hour 1

• Utilize improved patient communication skills with Medicare Patients 
• Apply appropriate risk management procedures to enhance patient communication
• Identify the four elements of legal malpractice and recognize the key components to avoid a malpractice action  
• Utilize key components of good documentation and record keeping
• Integrate the legal requirements of informed consent in your informed consent process 

Hour 2

• Summarize why doctors are held to higher standards
• Discuss the Do’s and Don’ts of record keeping
• Use the 21 NCQA guidelines for appropriate medical record keeping and integrate the 3 key components of Evidence Based Practice (EBP)

Hour 3

• Assess Medicare’s mandatory Electronic Health Records (EHR) requirement        
• Discuss key items related to the Office of Inspector General (OIG) reports regarding Medicare and chiropractic services
• Summarize Executive Order issued by the White House titled reducing improper payments and eliminating waste in the Federal Programs

Hour 4

• Determine what triggers an audit and key items to consider if audited
• Utilize a step by step approach to meet all Federal Medicare Documentation guidelines 
• Summarize Medicare’s guidelines for necessity of chiropractic care and its covered services
• Prepare treatment plans per Medicare’s regulation requirements
• Recognize Medicare’s policy requirements pertaining to x-ray/diagnostic reimbursement
• Determine if ordering vs. referred services meet Medicare’s policy when performed by a chiropractic physician

• Identify missing components before they become critical issues for your practice
• Determine the basic requirements of documentation for all payer classes
• Learn to identify payer requirements as part of your documentation standards
• Understand the key documentation components that boards, auditors and reviewers expect

• Determine the epidemiology of low back pain in children and adolescents
• Assess the risk factors associated with back pain in school children
• Outline the effect of an intervention to improve sitting habits in schoolchildren
• Assess the effects of reading a book or using a computer on neck and upper back muscle activity in children
• Review the diagnostic criteria of tension-type headaches in children

• Assess various treatment modalities
• Implement treatment protocols as found in the latest research
• Progress patients to incorporate wellness into their lifestyle
• Perform postural evaluations and discuss clinical significance to the patient
• Appropriately factor radiographic findings into diagnosis and clinical decision making of the geriatric patient
• Examine physical findings and set specific and measurable patient treatment goals

• Review the risk factors and mechanisms of heart disease.
• Identify the parts of a proper diet to prevent heart disease.
• Evaluate various supplements that are beneficial in prevention and treatment of heart disease.

• Identify plain film features of abdominal pathology that may present in the Chiropractic office, with an emphasis on calcifications
• Differentiate cystic from solid mass lesions
• Classify vascular calcifications
• Recognize when calcifications need immediate medical referral

Educational Objectives: for Documentation portion:

Hour 1 and 2

Educational Objectives:  Documentation

• Discuss key items related to the OIG reports regarding chiropractic services
• Discuss Executive Order issued by the White House titled reducing improper payments and eliminating waste in Federal Programs
• Discuss what triggers an audit and key items to consider if audited
• Discuss Medicare’s guidelines for necessity of chiropractic care as it relates to covered services, x-ray/diagnostic reimbursements, Quality Payment Program (QPP), diagnosis coding requirements and Medicare’s appeals process  
• Discuss appropriate use of modifiers
• Discuss Medicare’s documentation requirements when utilizing Medicare’s ABN (Advanced Beneficiary Notification) form
• Recognize the key components regarding good documentation and record keeping
• Identify the legal requirements of informed consent and the key elements of the informed consent process
• Discuss why doctors are held to higher standards
• Describe the 21 NCQA guidelines for record keeping
• Document progress notes (SOAP) to meet insurance guidelines and medical necessity
• Apply the PARTS system and its transformation utilizing a new method AIR S & M
• Utilize CMT coding appropriately

Educational Objectives: for Ethics

Hour 3

• Perform communication with patients and the public at large such that it informs, instructs and doesn't mislead.
• Discuss the parallels between accurate communication and ethical conduct.
• Administer healthcare practice compliant with HIPAA, state confidentiality statutes, and relevant rules, regulations and state court cases applicable to patient confidentiality.
• Comprehend the commercial, regulatory, social and familial interests seeking to obtain and/or are served by the release of patient information.
• Develop effective office systems and policies for securing and documenting patients’ informed consent
• Appropriately disclose charges

Educational Objectives: for Risk Management

Hour 4

• Assess court and Office of Inspector General rulings relating to anti-kickback restrictions.
• Demonstrate how anti-kickback and Stark legislation is both viewed and enforced by relevant professional boards and state and federal enforcement agencies to avoid fraud
• Explain how to avoid misleading claims
• Identify specific conduct and activities within the practice of healthcare that violate a host of regulatory and statutory proscriptions relating to patient referral arrangements.
• Properly Delegate authority in your office
• Identify parallels between Stark self-referral laws and anti-kickback restrictions.

• Determine the effect of chiropractic on movement time
• Assess the effects of spinal manipulation and ultrasound on chronic low back pain
• Describe heart rate variability as a measurement tool
• Assess the effects of chiropractic on heart rate variability

• Summarize the bowel protective mechanisms and their role in health and disease
• Outline a treatment strategy for imbalanced gut flora/leaky gut
• Identify common food allergies and determine appropriate nutritional therapy
• Examine the role of fiber in gastrointestinal health
• Create a treatment plan for common GI complaints of constipation and diarrhea
• Determine appropriate nutritional treatments for ulcers
• Theorize how diet can affect Inflammatory bowel disease
• Understand how to successfully use nutrition to treat a variety of gastrointestinal disorders
• Comprehend a rationale treatment protocol for Irritable bowel syndrome
• Determine correct doses of supplements used for various gastrointestinal disorders
• Ascertain the safety and risks associated with commonly prescribed gastrointestinal supplements

• Determine appropriate exercise recommendations
• Design a proper fitness program for patients
• Identify proper exercises for the osteoporotic patient
• Review exercise guidelines with patients and encourage compliance

Hour 1

• Identify the societal cost of migraine in the US
• Describe the global burden of disease studies related to migraine
• Summarize the genetic components of migraine to help understand the various phenotypes
• Define migraine based on the ICHD-3 criteria
• Outline the 4 main phases of migraine

Hour 2

• Summarize the impact of brainstem nuclei in migraine
• Identify how autonomic dysfunction impacts migraine and vice versa
• Explain how autonomic changes leads to blood flow abnormalities in the facial blood flow of migraine patients
• Distinguish the 3 main theories of migraine from the new ‘brain-state’ theory of migraine

Hour 3

• Be able to identify common dietary stressors for migraine and how to eliminate them
• Discuss vitamin, herbal, and other supplemental remedies for migraine
• Explain how an increased allostatic load increase the probability of migraine
• Identify migraine patients that would benefit from hormonal testing

Hour 4

• Discover how to tailor neuromodulation techniques to each migraine patient
• Identify current literature evaluating the benefits of low level laser
• Discuss probable mechanisms of action for low level laser
• Summarize migraine pathophysiology and explain a comprehensive approach to reducing and eliminating migraine days

• Evaluate the necessary elements to properly document established patient re-evaluations of all types
• Deliver appropriate evaluation and management services to justify continued care, assess progress, and discharge from this active care when the time is right
• Report the necessary components of documenting the transitional diagnosis and treatment plan after a periodic re-evaluation
• Complete the fundamentals of documenting the assessment of change since the last evaluation as it applies to federal regulations in Medicare

Hour 1

• Demonstrate the key elements pertaining to Medicare’s documentation requirements for initial and subsequent patient encounters  
• Describe the three categories of chiropractic care covered through Medicare and the one category exempt from Medicare coverage
• Apply Medicare’s x-ray requirements for documenting a subluxation
• Utilize Medicare Advance Beneficiary Notification (ABN) form and its guidelines 
• Use Medicare’s PARTS system to document a subluxation
• Summarize the transformation of Medicare’s PARTS system utilizing the AIR S & M method               
• Include proper Medicare documentation for daily progress notes (SOAP), in order to meet insurance guidelines and meet medical necessity 

Hour 2

• Integrate a 4 step approach to meet E/M (Evaluation/Management) coding requirements to meet Medicare’s guidelines

Hour 3

• Review Medicare Access and CHIP Reauthorization Act of 2015 (MARCA) aka Medicare Quality Payment Program (QPP) and the Merit Based Incentive Payment Program (MIPS)                                                                    

Hour 4

• Apply the critical components of Chiropractic Manipulative Treatment (CMT) coding and Medicare’s requirements for documentation
• Use diagnostic codes ICD-10 (primary subluxation M-codes biomechanical lesions and secondary medical codes) to meet Medicare’s diagnosis requirements
• Recognize Current Procedure Terminology (CPT) codes and how it relates to the Medicare system
• Utilize Medicare modifiers   
• Identify some of the key items with regards to completing the Center for Medicare and Medicaid Services (CMS) 1500 claim form   
• Summarize Medicare’s mandatory claims submission policy                                   
• Explain the five levels of Medicare appeals process
• Distinguish between Medicare participating vs. non-participating provider requirements

• Discuss the pertinent anatomy of the fore, mid and rear foot
• Differentially diagnose disorders of the fore, mid and rear foot pain
• Assess examples of representative imaging cases
• Quantify and assess different imaging modalities and gauge their use in evaluating foot pain

Educational Objectives: for Documentation

Hour 1 and 2

• Identify the correct amount of time a chiropractic record must be maintained with specific differences for that of an individual under the age of 18 as well as records related to a civil, criminal or administrative proceeding
• Keep appropriate records and maintain required information and provide requests for information and records from licensee’s.
• Describe various types of patient encounters and levels of documentation, and determine how to properly document each encounter.
• List the various governing bodies and organizations which may impose requirements on your record keeping of the patient’s health chart.
• Identify key components of the office entry forms and relate the importance of follow up and systems review.
• Compare and contrast various outcome assessment instruments, describe the importance of these tools and properly use and score various outcome assessment instruments.
• Recite tests traditionally thought of as objective and tests traditionally thought of as subjective in the context of reliability and validity.
• Define the characteristics of a good outcome assessment tool, and be able to properly implement it in clinical practice.
• Compare and contrast the various types of electronic health records available.
• Itemize the requirements of a “paperless” office.

Educational Objectives: for Ethics

Hour 3

• Identify legal prohibitions against promising healthcare cures, guaranteeing treatment results, and deceptive patient communication.
• Distinguish between appropriate and inappropriate communication relating to patients' healthcare prognoses and progress.
• Explain scientific literature linking patients' mental states with healthcare outcomes.
• Demonstrate alignment between compliance with states' current patient communication restrictions and instances of patient encouragement that foster mental states favorable to desired healthcare outcomes.
• Explain office procedures and staff training which are likely to ensure ongoing ethical patient communication and the documentation thereof.

Educational Objectives: for Risk Management

Hour 4

• Appropriately disclose charges to patients
• Identify potential problems associated with sharing fees with non-healthcare professionals.
• Demonstrate anti-trust issues associated with setting professional fees
• Explain connections between co-pay waivers and violations of the False Claims Act
• Describe the appropriate delegation of authority in a Chiropractic office to avoid licensure complaints
• Assess parallels between fee-splits and principles of ostensible agency that can lead to malpractice liability.
• Compare and contrast fee-splitting and the corporate practice of medicine.
• Legally provide Prepaid Treatment Plans

• Identify imaging modalities used for head and neck imaging
• List imaging modalities available for neuro imaging
• Contrast and compare CT and MRI in brain imaging
• Indicate conditions suitable for advanced imaging
• Use advanced imaging to justify treatment and referral

Hour 1 - PI Case Management Part 1

• Identify and avoid common PI history mistakes and liabilities
• Recognize many keys to a quality initial PI patient history
• Develop an awareness for the materials and tools necessary for a PI history
• Create a plan and protocol to improve the quality and thoroughness of the PI history

Hour 2 - PI Case Management Part 2

• Recognize common PI history red flags and contraindications 
• Identify symptoms and clinical history for two common PI traumatic injuries 
• Create a plan to identify and eliminate common patient errors pertaining to the PI history
• Develop an awareness for potential med-legal issues that can arise from a PI history

Hour 3 - How to Humanize Your PI Cases

• Create a protocol to consistently implement outcome assessments into PI cases 
• Recognize other options and opportunities available to humanize PI cases   
• Identify common outcome assessments utilized in PI cases
• Improve awareness of clinical decisions that can be made from humanizing cases

• Review the pertinent anatomy of the achilles tendon and adjacent structures
• Discuss watershed zones of microvascualrity and how they can be compromised 
• Discuss the mechanisms of how many achilles tendinopathies and pathologies occur
• Present some methods of treatment and remediation for achilles tendinopathies

Educational Objectives: for Documentation portion:

Hours 1 and 2

• Recognize the key components regarding good documentation and record keeping
• Identify the legal requirements of informed consent and the key elements of the informed consent process
• Discuss why doctors are held to higher standards
• Describe the 21 NCQA guidelines for record keeping
• Document progress notes (SOAP) to meet insurance guidelines and medical necessity
• Apply the PARTS system and its transformation utilizing a new method AIR S & M
• Utilize CMT coding appropriately
• Utilize E/M (Evaluation/Management) coding appropriately to meet insurance guidelines and medical necessity
• Identify the 3 categories and 2 subcategories of E/M codes
• Identify the 4 levels of E/M services for new and established patients
• Recognize the importance of a medically appropriate history and physical exam
• Identify the 2 key elements used to determine the level of E/M service
• Select the appropriate level of E/M services utilizing 4 simple steps

Educational Objectives: for Ethics

Hour 3

• Identify challenging/inappropriate patient requests and behaviors encountered by chiropractors.
• Explain prevention strategies, office procedures and effective responses to inappropriate patient activity.
• Describe safety concerns associated with a patient's inappropriate acts and communications, as well as ethical principles related thereto.
• Illustrate legal and ethical issues arising where the doctor/patient relationship is terminated due to inappropriate patient behavior.
• Analyze how aberrant patient behavior presents risks to staff, the treating doctor, and to fellow patients, and how proper documentation is important in such instances.

Educational Objectives: for Risk Management

Hour 4

• Comprehend the association between the doctor-patient relationship and the charge of patient abandonment.
• Evaluate the role voluntariness plays in the establishment of the doctor-patient relationship, in informed consent, and in abandonment as associated with the inappropriate termination of the professional relationship.
• Contrast and compare "ostensible agency" with "voluntary association" for purposes of assessing potential patient malpractice liability.
• Comprehend the requirement for the continued administration of healthcare for purposes of determining possible patient abandonment issues.
• Carry out proper documentation as demonstrates non-existence of abandonment.
• Effect policies that systematize screening of non-compliant patients and execute relevant medical record documentation to ensure no patient is legally "abandoned."
• Discuss prepaid treatment programs

• Explain the biomechanics of the lumbopelvic spine
• Describe the examination of the lumbopelvic spine
• Explain the mechanism of scoliosis
• Describe the pathological conditions of the lumbopelvic spine
• Demonstrate soft tissue treatments for pathological conditions of the lumbopelvic spine  

Hour 1

• Describe four purposes for performing orthopedic tests
• Describe three approaches to performing orthopedic tests
• Discuss the clinical importance of pertinent negative findings when performing orthopedic tests
• Discuss the concept of “Evidence Based Medicine”
• Define “Orthopedic Test Item Cluster”
• Describe several metrics used in the validation of orthopedic tests for inclusion in orthopedic test item clusters

 Hour 2

• Describe three Orthopedic Test Item Clusters (OSTs) relevant to the evaluation of the sacroiliac region
• Describe the five procedures included in the Laslett Cluster #2 for the assessment of sacroiliac pain
• Describe the two primary types of Thoracic Outlet Syndrome
• Discuss the clinical utility of the Bakody Test and the Reverse Bakody Test

 Hour 3

• Describe four testing procedures included in Wainner’s Cluster for the assessment of cervical radiculopathy
• Describe Cook’s Cervical Myelopathy Cluster
• Discuss potential problems that may arise in the application of OST clusters
• Discuss ways to minimize inappropriate application of OST clusters

• Outline the anatomy of cervical spine proprioception
• Review clinical studies investigating cervical spine proprioception
• Assess existing literature on the reliability of cervical spine joint position sense
• Assess the effect of spinal adjustments/manipulation on cervical spine proprioception

• Systematically identify features of degenerative conditions of the spine.
• Identify and correlate x-ray findings with gross anatomy
• Distinguish types of degenerative changes of the spine
• Review gross anatomy of the spine

Educational Objectives: for Documentation

Hour 1 and 2

• Identify the correct amount of time a chiropractic record must be maintained with specific differences for that of an individual under the age of 18 as well as records related to a civil, criminal or administrative proceeding
• Keep appropriate records and maintain required information and provide requests for information and records from licensee’s.
• Describe various types of patient encounters and levels of documentation, and determine how to properly document each encounter.
• List the various governing bodies and organizations which may impose requirements on your record keeping of the patient’s health chart.
• Identify key components of the office entry forms and relate the importance of follow up and systems review.
• Compare and contrast various outcome assessment instruments, describe the importance of these tools and properly use and score various outcome assessment instruments.
• Recite tests traditionally thought of as objective and tests traditionally thought of as subjective in the context of reliability and validity.
• Define the characteristics of a good outcome assessment tool, and be able to properly implement it in clinical practice.
• Compare and contrast the various types of electronic health records available.
• Itemize the requirements of a “paperless” office.

Educational Objectives: for Ethics

Hour 3

• Identify legal prohibitions against promising healthcare cures, guaranteeing treatment results, and deceptive patient communication.
• Distinguish between appropriate and inappropriate communication relating to patients' healthcare prognoses and progress.
• Explain scientific literature linking patients' mental states with healthcare outcomes.
• Demonstrate alignment between compliance with states' current patient communication restrictions and instances of patient encouragement that foster mental states favorable to desired healthcare outcomes.
• Explain office procedures and staff training which are likely to ensure ongoing ethical patient communication and the documentation thereof.

Educational Objectives: for Risk Management

Hour 4

• Appropriately disclose charges to patients
• Identify potential problems associated with sharing fees with non-healthcare professionals.
• Demonstrate anti-trust issues associated with setting professional fees
• Explain connections between co-pay waivers and violations of the False Claims Act
• Describe the appropriate delegation of authority in a Chiropractic office to avoid licensure complaints
• Assess parallels between fee-splits and principles of ostensible agency that can lead to malpractice liability.
• Compare and contrast fee-splitting and the corporate practice of medicine.
• Legally provide Prepaid Treatment Plans

• Discuss actual cases of problems remediated by orthotic therapy
• Discuss the pathomechanics of the problem and kinetics/ kinematics of the remediation
• Show orthotic modifications for specific issues
• Demonstrate additional therapies/exercises/modalities that assist in specific problem management

• Breakdown the biomechanical processes of spinal degeneration
• Explain the biochemical processes that occur in the geriatric population
• Differentiate between various diagnosis of structural and chemical conditions seen in geriatric patients
• Analyze the radiological findings and how they influence clinical decisions
• Explain Syndrome X and how it affects physiology
• Differentiate trauma and its late effects on the body

• Determine the epidemiology, etiology and background on obesity
• Assess the theories of obesity development and pathophysiology
• Outline the risks and morbidities related to obesity

• Recall various foods with high amounts of Flavonoids and briefly relate their impact health
• Indicate the basic chemical structural similarities and differences of Flavonoids
• Relate potential benefits of combining Flavonoids, and ways of improving their bioavailability and efficacy
• Explain why some Flavonoids may be effective according to their chemical structure, specifically in a study for neuroprotection
• Discuss Flavonoid use and neuromuscular treatment considerations
• Integrate knowledge of Flavonoids and biochemical pathways to prescribe individualized nutrition treatments to your patients and appreciate the potential for overprescribing too many competing herbs
• Examine and demonstrate how and why Green Tea extract may play an inclusive role in health

• Identify neurological, arterial and venous causes of Thoracic Outlet Syndrome and associated disorders.
• Assess between Thoracic Outlet Syndrome, Hyperabduction Syndrome and Costoclavicular Syndrome (as associated disorders) and their symptoms.
• Diagnose the neurological, muscular and bony structures associated with the cause of Thoracic Outlet Syndrome and associated disorders.
• Apply manual methods to the soft tissue structures in the treatment of Thoracic Outlet Syndrome and associated disorders.
• Apply the use of modalities to the soft tissue structures in the treatment of Thoracic Outlet Syndrome and associated disorders.

Educational Objectives: for Documentation portion:

Hour 1 and 2

Educational Objectives:  Documentation

• Discuss key items related to the OIG reports regarding chiropractic services
• Discuss Executive Order issued by the White House titled reducing improper payments and eliminating waste in Federal Programs
• Discuss what triggers an audit and key items to consider if audited
• Discuss Medicare’s guidelines for necessity of chiropractic care as it relates to covered services, x-ray/diagnostic reimbursements, Quality Payment Program (QPP), diagnosis coding requirements and Medicare’s appeals process  
• Discuss appropriate use of modifiers
• Discuss Medicare’s documentation requirements when utilizing Medicare’s ABN (Advanced Beneficiary Notification) form
• Recognize the key components regarding good documentation and record keeping
• Identify the legal requirements of informed consent and the key elements of the informed consent process
• Discuss why doctors are held to higher standards
• Describe the 21 NCQA guidelines for record keeping
• Document progress notes (SOAP) to meet insurance guidelines and medical necessity
• Apply the PARTS system and its transformation utilizing a new method AIR S & M
• Utilize CMT coding appropriately

Educational Objectives: for Ethics

Hour 3

• Perform communication with patients and the public at large such that it informs, instructs and doesn't mislead.
• Discuss the parallels between accurate communication and ethical conduct.
• Administer healthcare practice compliant with HIPAA, state confidentiality statutes, and relevant rules, regulations and state court cases applicable to patient confidentiality.
• Comprehend the commercial, regulatory, social and familial interests seeking to obtain and/or are served by the release of patient information.
• Develop effective office systems and policies for securing and documenting patients’ informed consent
• Appropriately disclose charges

Educational Objectives: for Risk Management

Hour 4

• Assess court and Office of Inspector General rulings relating to anti-kickback restrictions.
• Demonstrate how anti-kickback and Stark legislation is both viewed and enforced by relevant professional boards and state and federal enforcement agencies to avoid fraud
• Explain how to avoid misleading claims
• Identify specific conduct and activities within the practice of healthcare that violate a host of regulatory and statutory proscriptions relating to patient referral arrangements.
• Properly Delegate authority in your office
• Identify parallels between Stark self-referral laws and anti-kickback restrictions.

• Present the 5 basic foot types
• Discuss the biomechanics of each foot type
• Show and explain pedograph prints of each foot type
• Contrast and compare traditional vs a novel method of foot type determination
• Talk about common orthotic prescriptions for specific foot types

Hour 1

• Review basic concepts of exercise physiology
• Understand the fitness training model
• Identify various communication strategies
• Determine appropriate behavior change techniques

Hour 2

• Identify the components of the client investigation stage
• Review the various tests to determine functional ability of a client
• Discuss the tests necessary to determine a clients physiological sport abilities
• Analyze proper movement patterns through testing

Hour 3

• Design an appropriate resistance exercise program
• Understand the components of an appropriate cardiovascular program
• Determine various ways to progress in training
• Review basic concepts of sport nutrition

• Summarize the central role of muscle protein in whole-body metabolism and muscle mass
• Outline the role of skeletal muscle metabolism in health and disease (such as diabetes, obesity, osteoporosis)
• Describe the role of hormones for influencing muscle metabolism and health
• Identify the catabolic and anabolic mediators of muscle metabolism
• Specify ways to maximize muscle mass and metabolism to promote wellness

• Apply thorough passive and active examination methods to soft tissue structures of the cervical spine, TMJ, thoracic spine and rib cage, lumbopelvic spine, and upper and lower extremities.
• Discern between scleratomal pain, dermatome pain and myofascial pain to assist in examination procedures and treatment outcome.
• Determine necessity for diagnostic imaging of soft tissue structures after acceleration/deceleration impact.
• Explain the best treatment options to your patient after complete examination is combined with their particular accident Movement Dynamics and forces upon the patient’s body at impact.
• Utilize examination findings in combination with Factor Analysis and complicating factors to best determine treatment plan and prognosis.

• Identify the risk factors associated with osteoporosis
• Outline a beneficial diet for osteoporosis
• Determine an appropriate supplement protocol
• Examine the role of exercise in the treatment of osteoporosis

Hour 1

• Determine appropriate protocols for patient progress.
• Discuss tools to reduce vertigo symptoms.
• Incorporate nutritional support for better brain function.
• Utilize brain therapy programs to improve cognition.
• Apply traction therapy to reduce intrathecal pressure.

 Hour 2

• Evaluate balance and stability with a variety of tools.
• Demonstrate mobility exercises to improve musculoskeletal function.
• Discuss cardio exercise to stimulate blood flow to the brain.
• Apply exercise therapy to stimulate neogenesis.
• Devise strength protocols using graduated isometrics.

Hour 3

• Discuss the benefits of flexibility training.
• Define contra-indications for flexibility training.
• Interpret evaluation tools to discover zones of tension.
• Measure pain, agility and crepitus with outcome-based tools.
• Integrate PreActive StretchingSM protocols to improve agility.