Oregon Chiropractic Assistant Education and Continuing Education

• Define abuse and neglect
• Differentiate the various forms of abuse
• Recognize who are mandatory reporters of abuse
• Identify the reporting requirements for mandatory reporters
• Cite resources for obtaining specific state laws and statutes pertaining to child abuse and neglect
• List signs of abuse and neglect
• Explain the appropriate history and examination components in cases of suspected abuse and neglect
• Cite resources for patient education
• Define Mandatory Reporter and Permissive Reporter
• Explain the term perpetrator as it pertains to child abuse
• Explain the reporting requirements of mandatory reporters
• Differentiate Child Protective Services from General Protective Services
• List the penalties for failure to report suspected child abuse by mandatory reporters

• Summarize the types of interviews: Forensic, Diagnostic, Therapeutic
• Describe who is involved in the interview process
• Explain the importance of the medical history
• Identify reasons for non-disclosure of information by the victim
• Recognize how family dynamics effect disclosure
• Indicate how the age and developmental status of the child affects the interview process
• Describe the proper use of open and closed ended questions
• List components of the medical history
• Summarize the responsibilities for disclosure of information
• Identify safety issues related to the disclosure of confidential information

• Define abuse and neglect
• Differentiate the various forms of abuse and neglect
• Identify the reporting requirements for mandatory reporters
• Cite resources for obtaining specific state laws and statutes pertaining to elder abuse and neglect
• Describe the concept of immunity and confidentiality as it relates to elder abuse and neglect
• List signs of abuse and neglect
• Explain the appropriate history and examination components in cases of suspected elder abuse and neglect
• Cite resources for physician, caregiver and patient education

• Discuss the history and philosophy of acupuncture
• Identify and differentiate the three founders of Chinese Medicine
• Differentiate the three pillars (three central influences of Chinese thought)
• Identify the first material used to make acupuncture needles
• Identify acupunctures struggle to survive and become recognized and accepted
• Recognize the most influential scripts and texts used in early acupuncture history
• Discuss the most significant events in acupuncture history from the early 20th century to the present time
• Discuss acupuncture theory (Yin/Yang, Qi and Five Elements)
• Differentiate Yin/Zang organs and Yang/Fu organs
• Differentiate the different types of Qi
• Identify the Five Elements/Phases
• Differentiate the four interactions of the Five Elements/Phases
• Identify the Five Shu (Transporting) Points

• Define HIV
• Outline HIV epidemiology and symptoms
• Discuss the effects of HIV on health and wellness
• Review current facts about the HIV and AIDS epidemic both in the U.S. and worldwide

• Define HIV
• Outline HIV epidemiology and symptoms
• Discuss the effects of HIV on health and wellness
• Review current facts about the HIV and AIDS epidemic both in the U.S. and worldwide
• Discuss strategies for preventing HIV in the health care workplace
• Outline universal precautions and additional precautions to prevent transmission of HIV by blood
• Apply what to do when there has been a possible exposure to HIV infection
• Define and discuss confidentiality laws covering the medical records of HIV/AIDS patients
• Define and discuss behavioral interventions for HIV/AIDS patients
• Outline the screening of HIV-infected persons for HIV transmission risk

• Discuss strategies for preventing HIV in the health care workplace
• Outline universal precautions and additional precautions to prevent transmission of HIV by blood
• Apply what to do when there has been a possible exposure to HIV infection

• Define and discuss confidentiality laws covering the medical records of HIV/AIDS patients
• Define and discuss behavioral interventions for HIV/AIDS patients
• Outline the screening of HIV-infected persons for HIV transmission risk

• Dissect and identify musculature of the anterior cervical spine.
• Identify and learn the origin and insertion of specific musculature of the anterior cervical spine.
• Describe the innervation of specific anterior cervical musculature.
• Learn the anatomic relationship of anterior cervical spine musculature to other structures.

• This contains all courses with the educational objectives listed from Anatomy 101 through 112

• To dissect and identify musculature of the shoulder
• Identify and learn the origin and insertion of specific musculature of the shoulder
• Construct a list of differential diagnoses for Clinical Shoulder Pathologies
• Learn the anatomic relationship of shoulder to other structures and correlate them to an MRI

• Locate and identify the various bones that make up the hand
• Identify bony landmarks and the parts of the bones that make up the hand
• Identify various joint structures within the hand
• View the anatomic relationship of the bones of the hand to other bony and soft tissue structures

• Dissect and identify musculature, nerve and vascular aspects of the hip
• Identify and learn the origin and insertion of specific musculature of the hip
• Describe the innervation of specific hip musculature.
• Learn the anatomic relationship of hip musculature to other structures and their relationships on the MRI

• Locate skeletal structures and landmarks of the elbow joint.
• Identify ligamentous and neurovascular anatomy of the elbow complex.
• Name the origin, insertion and innervation of musculature around the elbow.
• Assess the relationship of bony and soft tissue structures around the elbow.

• Identify anatomical landmarks pertaining to osteology of the humerus
• Locate attachments of prime movers of the shoulder joint
• Identify ligaments of the shoulder joint
• Identify bursae of the shoulder joint
• Recognize pathologies associated with shoulder joint anatomy

• Locate and identify major nerve structures of the shoulder area
• Locate and identify arteries of the shoulder area
• Locate and identify veins of the shoulder area
• Locate and identify lymphatics of the shoulder area

• Identify anatomical landmarks pertaining to osteology of the tibia
• Identify anatomical landmarks pertaining to osteology of the patella
• Identify anatomical landmarks pertaining to osteology of the fibula
• Correlate bony landmarks of the knee with clinical conditions that affect them

• Identify attachment sites of muscles around the knee joint
• Identify attachment sites of ligaments of the knee joint
• Identify attachment sites of cartilage of the knee joint
• Correlate the clinical aspects of the structures identified in this course

• Identify the ligaments that support the knee joint
• Identify the cartilaginous structures of the knee
• Correlate clinical conditions of identified knee structures with the anatomy studied
• Compare and contrast MRI images with the dissection images of the knee

• Locate and identify arteries which supply the area around the knee
• Locate and identify nerves which supply the area around the knee
• Locate and identify veins which drain the area around the knee
• Outline the anatomical course followed by the neurovascular structures as they pass through the area of the knee

• Locate and identify the muscles act on the knee joint
• Identify origins and insertions of muscles that act on the knee joint
• Recognize the peripheral nerves which supply the muscles that act on the knee joint
• Correlate clinical conditions of the muscles that act on the knee joint with their anatomy

• Identify anatomical landmarks pertaining to osteology of the tibia
• Identify anatomical landmarks pertaining to osteology of the fibula
• Identify anatomical landmarks pertaining to osteology of the tarsals
• Identify anatomical landmarks pertaining to osteology of the metatarsals and phalanges

• This contains all courses with the educational objectives listed from Anatomy 113 to Anatomy 124 

• Identify the ligaments of the ankle and foot
• Identify the attachment sites of the ligaments of the ankle and foot
• Describe the structures supported by the ligaments of the ankle and foot
• Correlate the anatomy with clinical conditions of the ligaments of the ankle and foot

• Identify muscles of the foot and ankle
• Locate origin and insertions of the muscles of the foot and ankle
• Identify the nerve supply of the muscles of the foot and ankle
• Correlate clinical conditions with the anatomy of the muscles of the foot and ankle

• Locate and identify arteries which supply the ankle and foot
• Locate and identify nerves which supply the ankle and foot
• Locate and identify veins which drain the ankle and foot
• Outline the anatomical course followed by the neurovascular structures as they pass through the area of the ankle and foot
• Correlate clinical conditions of neurovascular structures of the ankle and foot with the anatomy

• Identify anatomical landmarks pertaining to osteology of the sacrum and coccyx
• Identify anatomical landmarks pertaining to osteology of the ischium
• Identify anatomical landmarks pertaining to osteology of the ilium
• Identify anatomical landmarks pertaining to osteology of the pubis
• Correlate bony landmarks of the pelvis with clinical conditions that affect them

• Identify ligaments of the pelvis
• Correlate anatomical relationships of the ligaments of the pelvis
• Identify deep muscles of the pelvis
• Locate origin and insertions of the deep muscles of the pelvis
• Identify the nerve supply and actions of the deep muscles of the pelvis

• Identify nerve structures of the pelvis
• Locate the anatomical course of the nerves of the pelvis
• Identify structures supplied by nerves of the pelvis
• Identify nerve root levels that supply the peripheral nerves of the pelvis

• Identify the arteries and veins of the pelvis
• Locate the anatomical course of arteries and veins of the pelvis
• Describe the anatomical areas supplied by the arteries of the pelvis
• Describe the anatomical areas drained by the veins of the pelvis

• Identify anatomical landmarks pertaining to osteology of a typical lumbar vertebra
• Identify anatomical landmarks pertaining to osteology of an atypical lumbar vertebra
• Identify anatomical landmarks pertaining to osteology of the sacrum
• Identify bony attachment sites of selected muscles and ligaments of the lumbar spine

• Identify ligaments of the lumbar spine
• Correlate anatomical relationships of the ligaments of the lumbar spine
• Identify deep muscles of the lumbar spine
• Locate origin and insertions of the deep muscles of the lumbar spine
• Identify the nerve supply and actions of the deep muscles of the lumbar spine

• Identify the muscles of the posterior vertebral column
• Locate the attachments of the muscles of the posterior vertebral column
• Describe the actions of the muscles of the posterior vertebral column
• Identify the nerve supply of the muscles of the posterior vertebral column.

• Identify neural structures of the brain stem and spinal cord
• Identify structures of the meninges
• Describe the function of the structures of the brain stem and spinal cord
• Describe anatomical relationships between structures of the brain stem, spinal cord and meninges

• Locate and identify anatomical structures of the spinal cord
• Locate and identify the columns and tracts of the spinal cord
• Describe the functions of the columns and tracts of the spinal cord
• Locate and identify the vascular structures that supply the spinal cord

• This contains all courses with the educational objectives listed from Anatomy 125 to Anatomy 136 

• Locate and identify the rami, anterior and posterior divisions of the lumbar plexus
• Locate and identify the peripheral nerves that arise from the lumbar plexus
• Recognize anatomical landmarks that surround the lumbar plexus
• Identify the structures supplied by the nerves of the lumbar plexus

• Locate and identify the bones of the cranium
• Identify anatomical landmarks on the bones of the cranium
• Identify the sutures of the cranium
• Describe the structures passing through the foramina of the cranium

• Locate and identify the extraoccular muscles
• Locate and identify deep muscles of the face and pharynx
• Describe nerve the supply of muscles identified
• Describe the actions of the muscles identified

• Locate and identify intermediate muscles of the face and pharynx
• Describe nerve the supply of muscles identified
• Describe the actions of the muscles identified
• Locate origins and insertions of the muscles identified

• Locate and identify superficial muscles of the face and pharynx
• Describe nerve the supply of muscles identified
• Describe the actions of the muscles identified
• Locate origins and insertions of the muscles identified

• Identify the arteries that supply the face and head
• Identify the nerves that supply the face and head
• Describe the structures innervated by the nerves of face and head
• Identify the veins that drain the face and head

• Locate identify muscles of the eye and orbit
• Locate and identify blood vessels of the eye and orbit
• Locate and identify connective tissue structures of the orbit
• Describe location and innervation of the lacrimal glands

• Locate the major anatomical landmarks of the orbit
• Describe anatomical relationships between structures of the orbit
• Correlate functions of the structures of the orbit with the anatomy
• Identify the nerves, muscles and blood vessels of the orbit

• Identify the structures of the interior structures of the eyeball
• Explain the function of the interior structures of the eyeball
• Correlate anatomical relationships between interior structures of the eyeball
• Explain the actions of the extraoccular muscles

• Identify anatomical landmarks of the ossicles of the ear
• Locate and identify the organs of hearing in the ear
• Explain the transmission of sound in the ear
• Locate and identify the organs of balance in the ear

• Identify anatomical landmarks pertaining to osteology of the temporomandibular joints
• Locate and identify the soft tissue structures of the temporomandibular joint
• Correlate specific muscles with the possible movements of the temporomandibular joint
• Locate attachment sites of the structures of the temporomandibular joint

• Identify anatomical landmarks pertaining to surface anatomy of the wrist and forearm
• Locate the surface landmarks of prime movers of the wrist
• Identify locations where major structures of the wrist may be palpated of the wrist
• Identify when and where deep structures may be visible at the surface of the wrist and forearm

• This contains all courses with the educational objectives listed from Anatomy 225 through Anatomy 230

• Identify the trigger points for selected muscles in the gluteal region and the anterior and lateral compartment of the hip and thigh
• Label the primary and secondary referral patterns for the identified trigger points
• Summarize the differential diagnoses associated with each trigger point in the hip and thigh
• Indicate the proximal and distal attachments of the selected muscles in the gluteal region and the anterior and lateral compartment of the hip and thigh
• Describe the action of the selected muscles in the gluteal region and the anterior and lateral compartment of the hip and thigh
• Recognize when muscles are acting agonistically and antagonistically

• Identify the trigger points for the selected muscles of the foot
• Label the primary and secondary referral patterns for the identified trigger points
• Summarize the differential diagnoses associated with each trigger point in the foot
• Indicate the proximal and distal attachments of the selected muscles of the foot
• Describe the action of the selected muscles of the foot
• Recognize when muscles are acting agonistically and antagonistically

• Define common terminology used in the Chiropractic office
• Identify terminology associated with specific conditions and their treatment
• Describe locations on the body using appropriate anatomical terminology
• Describe the four procedures that constitute vital signs
• Identify normal values for pulse, blood pressure, temperature and respiratory rate in the adult

• Explain the phases of human walking gait
• Discuss the biomechanical events associated with stance phase of gait
• Discuss the biomechanical events associated with swing phase of gait
• Explain biomechanically what is happening during each phase of gait in the foot, ankle, knee and hip
• Discuss the 3 rockers of the foot and how they apply to the gait cycle
• Understand the calcaneocuboid locking mechanism and defend it's importance in the stance phase of gait
• Summarize the ranges of motion of the foot, ankle, knee and hip and their importance in normal gait
• Explain how stance phase abnormalities would impact the gait cycle
• Demonstrate competency in obtaining a reproducible Pedograph print
• Interpret rearfoot, midfoot and forefoot mechanics as seen on a pedograph print
• Identify and interpret problem areas in a pedograph print
• Identify stance phase abnormalities on a Pedograph print
• Extrapolate pathomechanics which would occur rostrally in the kinetic chain during pathomechanics occurring in the gait cycle
• Evaluate the impact of gait abnormalities on human locomotion

• This contains all courses with the educational objectives listed from Biomechanics 201 through Biomechanics 216

• Describe how the motor and sensory homunculus relate to the foot and are integral to training and rehabilitation
• Discuss the 3 rockers of the foot
• Give examples of problems that result from a loss of the 3 rockers of the foot
• Explain the concept of pelvis neutrality and its effect on training
• Describe and examine the tripod of the foot
• Breakdown most movement into 2 basic rules or tenets
• Give examples of the problems which can arise if the 2 basic rules or tenets of movement are not followed
• Discuss the clinical consequences of loss of the medial and lateral tripods of the foot

• Discuss the normal walking gait cycle
• Apply the biomechanics of the pelvis and lower kinetic chain during walking to clinical practice
• Predict and discuss problems and clinical strategies that can arise from altered lower extremity biomechanics
• Apply visual analysis skills
• Evaluate case studies in gait analysis
• Clinically apply solutions for gait abnormalities

• Describe and identify how the parts of a running shoe affect running biomechanics
• Compare and contrast different shoe constructions to the biomechanical needs of an individual
• Determine the appropriate last shape for different foot types
• Discuss the biomechanical consequences of improper vs. proper selection of last types
• Predict which features in a shoe are necessary to correct faulty gait patterns

• Explore barefoot running from a position of biomechanical efficiency
• Contrast the differences in shod vs unshod running
• Predict problems that can arise from shod and barefoot running
• Apply visual analysis skills to barefoot running technique
• Describe how to introduce barefoot running to your patient population

• Review the pertinent anatomy of the foot
• Review the kinematics and kinetics of foot function during the gait cycle
• View and discuss case studies involving foot function and common pathomechanics
• Predict pathomechanics that will arise from the gait abnormalities presented
• Propose remedies for the gait abnormalities seen

• Define the crossover gait
• Visually identify the crossover gait
• Explain the biomechanical elements of the crossover gait
• Analyze the cross over gait
• Give examples of the cross over gait
• Integrate your knowledge of the cross over gait to formulate an appropriate treatment plan
• Outline some common exercises for cross over gait remediation

• Examine how arm swing correlates and integrates with the gait cycle
• Visually identify arm swing
• Explain the biomechanical elements of arm swing
• Analyze arm swing
• Give examples of normal and abnormal arm swing
• Integrate your knowledge of arm swing to formulate an appropriate treatment plan

• Define minimal vs. neutral vs. guidance vs. motion control shoes
• Contrast minimal vs. neutral vs. guidance vs. motion control shoes
• Discuss current shoe trends
• Discuss ramp delta and its implications in shoes and shoe fit

• Review the injuries associated with an improperly fitting bike frame and how to properly size a frame to a person
• Discuss how cleat position can lead to biomechanical problems and injuries related to power loss.
• Demonstrate how to properly place cleats on shoes to avoid injury and increase power transfer
• Discuss injuries that stem from inappropriate seat height, saddle for and aft position and handlebar reach and explain how to determine appropriate seat height, fore and aft saddle position and handlebar reach.

• Discuss retraining CNS sensory and motor patterns
• Present several key concepts in visual gait analysis
• Introduce lesser known anatomical points of interest in the sacroiliac joint
• Discuss some rehabilitation strategies for the sacroiliac joint
• Discuss the ideal kinetics and kinematics of the walking gait cycle
• Present the normal lower extremity parameters/ontogeny surrounding the requisites for gait
• Explore the impact of lower extremity torsions on foot progression angle
• Highlight the differences between tibial and femoral leg length discrepancies
• View video examples of different aspects of gait
• Review the mechanics of the bridge exercise
• Discuss the current indexed literature surrounding the bridge exercise
• Describe potential pitfalls in performing and prescribing the bridge exercise
• Point out the differences of maintaining a "neutral spine" versus an increased or decreased lumbar lordosis
• Identify potential ways to correct faulty mechanics and optimize performance of the bridge exercise
• describe a new, novel test to diagnose gluteus medius tears
• explain the various functions of the gluteus maximus and medius
• explore the effects of a resistance band around the knees on the gluteus maximus, quadricep and valgus angles on the knees during a back barbell squat
• contrast gluteus medius resistance and rehabilitation exercises with respect to maximal recruitment
• discuss electromyographic activity in the gluteus medius, gluteus maximus, biceps femoris, vastus lateralis, vastus medialis and rectus femoris during the Monopodal Squat, Forward Lunge and Lateral Step-Up exercises

• Discuss the concept of Gender as it relates to society, language and culture
• Identify Gender roles in Western Society
• Recognize innate gender traits in males and females
• Summarize socially imposed gender traits

• This includes all courses with the educational objectives listed from Boundary Training 101 through Boundary Training 112

• Identify aspects of male and female psychological development
• Relate basic concepts of Gender and Power
• List female and male leadership factors
• Discuss gender and the Doctor/Patient relationship
• Identify the ways which gender affects the Doctor/Patient relationship

• Describe what accounts for the differences, in practice style and patient care, between males and females healthcare providers
• Define differing sexualities in western culture
• Review sexuality as it relates to the Doctor/Patient relationship
• Identify misconceptions in personal definitions of male, female, power and sexuality
• Recognize when Power is misused and becomes a threat

• Define Touch as it relates to perception, gender and culture
• Discuss the giving up of power as it relates to patients and touch
• Recognize the perception, intention, and uses of touch
• Perform an analysis of individual conceptions of gender and sexuality

• Perform an exercise to identify personal concepts of touch
• Create practical applications for healthcare practitioners with regard to gender, touch, and sexuality
• Define sexual misconduct
• Recognize the difference between sexual misconduct and sexual harassment
• Critique different models of misconduct

• Describe how misconduct occurs
• Distinguish between different types of offenders
• Give examples of case studies in sexual misconduct
• Identify common fears and misconceptions of sexual misconduct
• Specify important concepts of treated a patient who has a history of abuse

• Define professional boundaries and relate the issue of consent
• Describe the three types of power, the three patterns of power, and how power is used
• Discuss the differences between adherence vs. compliance and transference vs. countertransference
• Identify anatomical risk levels for touch

• Develop safe touch guidelines
• Create a set of office based interventions and patient based interventions in the development of safe practice strategies
• Define educational interventions for safe practice strategies
• Define the basics of the supervision for a safe practice strategy

• Develop and outline for safe practice analysis
• Perform a risk factor analysis
• Execute a healthcare provider questionnaire
• Create a staff evaluation to implement at the office

• Develop and implement a buddy/supervisor evaluation of the healthcare provider and staff
• Develop and implement a patient evaluation of the healthcare provider and staff
• Create a system of analysis for the buddy/supervisor, healthcare provider, staff and patient evaluations

• Develop a plan for change based on the risk factor analysis (RFA) and practice evaluation questionnaires
• Identify areas of improvement for touch, consent, communication and respect
• Address concerns raised by staff and patients
• Discuss ways to defuse attraction

• Develop guidelines of dealing with a patient who is attracted to you
• Develop guidelines of dealing with feeling an attraction
• Discuss the six factors for a safe practice
• Describe the new partnership between healthcare providers and patients

• Define and discuss professional boundaries
• Define and discuss sexual misconduct
• Sensitize The D.C. To Issues Relating to Sexual Interaction With The Patient
• Discuss the problem of sexual misconduct, either real or perceived
• Define and discuss specific examination procedures
• Provide methods for recording examinations and incidents
• Discuss case of alleged sexual misconduct
• Discuss strategies to avoid misunderstandings that may lead to charges of sexual misconduct

• Identify the purpose of professional boundaries
• Differentiate between boundary violations and boundary crossings
• Identify the various factors related to dual relationships
• Identify issues related to bartering, gifts and boundaries

• Recognize the challenges of social networking and boundaries
• Evaluate issues specific to boundaries
• Clarify guidelines for maintaining professional boundaries
• Reflect on the maintenance of professional boundaries

• This contains all courses with the educational objectives listed from Breathing Essentials 201 through Breathing Essentials 207

• Discuss the place cannabis products have in healthcare.
• Recall the historic relevance cannabidiol (CBD) has in patient care.
• Analyze which manual therapeutic modalities best compliment CBD usage and apply it to their practice.
• Discuss federal and state laws that apply to CBD use within their practice.
• Assess and differentiate between different CBD products to find that best suits their personal/ professional use.

• This contains all courses with the educational objectives listed from Chiropractic and Pregnancy 201 through Chiropractic and Pregnancy 207

• This contains all courses with the educational objectives listed from Chiropractic and Pregnancy 208 through Chiropractic and Pregnancy 212

• Discuss a brief history of Chiropractic
• Describe the basics of Chiropractic Philosophy
• Discuss Chiropractic, Adaptation and Innate Intelligence
• Review how Chiropractic is built upon the basic sciences of anatomy (structure), physiology (function) and the clinical sciences (patient application).
• Understand how Chiropractic affects specific conditions

• Explain the basis of chiropractic, as taught by DD Palmer
• Recite DD Palmer's definition of disease
• Explain the Founder's concept of subluxation
• Using DD's words, justify the statement: Spine straightening is not chiropractic
• Compare and contrast spinal manipulation with chiropractic adjustment
• Define intelligence
• Describe the process of falsification and how it is applied to science
• Explain why intelligence must precede energy/matter
• Explain why the placebo effect cannot exist in a mechanistic world view
• Explain why adaptation is the basis of chiropractic research

• List and describe each Medicare required document, content requirements and timing rules
• Summarize and explain Medicare’s documentation requirements and how to comply with those requirements to improve patient care
• Examine and review how Medicare reviews PT and OT documentation
• Describe how to demonstrate and document medical necessity in order to treat patients and prepare for a potential appeal

• Interpret compliance advice and regulations directly from the Federal Office of Inspector General (OIG)
• Identify and become compliant with other requirements from the state level through third-party payer contractual obligations
• Review existing policy and procedure for compliance, including OIG compliance, HIPAA compliance, and other federal and state programs

• Apply guidelines for accurate coding and compliant billing practices
• Install monitoring to ensure standards are met
• Self-audit for compliance purposes
• Create internal policy and procedure to improve compliance

• Identify risk areas in the claim adjudication process and apply learned knowledge to prevent missteps
• Discuss federal, state, and payer guidelines that govern billing activities
• Avoid behaviors that violate the carrier contract and ensure compliance with regulations
• Evaluate provider contracts and payer policy for complete clarification on claim process

• Utilize self-auditing methods to identify high risk areas of patient finance in the office
• Develop systems for accountability and transparency in patient accounting
• Apply appropriate fee schedule measures to ensure validity in account posting
• Address federal and state guidelines for discounting to ensure compliance

• Apply the process for setting your fees legally and compliantly and according to Federal regulation
• Know the policies of ALL your carriers to be compliant
• Properly administer desired discounts without running afoul of the Federal and State regulations
• Implement legal hardship discounts, if desired, using the Federal guidelines to appropriately verify hardship

• Distinguish between the five most important federal fraud and abuse laws that apply to physicians
• Identify red flags in your practice that increase vulnerability
• Comprehend what has been discovered in previous OIG workplans and how to apply the findings to your practice
• Determine what entities require a formal compliance program for your office
• Develop an action list to start today for implement a Compliance Program for your clinic

• Develop an appreciation of the impact of culture group, minority group and racial group on the health care relationship
• Increase sensitivity, knowledge and skills to promote effective intercultural interactions
• Identify the professional's own cultural identity/judgments /biases and their impact on their behavior and how they are perceived by clients and patients
• Recognize cultural variables that appear in verbal and non-verbal communication
• Examine the influence of culture in our patient population
• Differentiate the provider's culture

• Examine the historical background of the various Latino/Hispanic groups in the U.S.
• Develop the skills needed to care for people from Spanish speaking parts of the world
• Increase our understanding of the cultural traits of Latino/Hispanic groups in the U.S.
• Summarize specific traits of various Latino/Hispanic groups
• Recognize how we can narrow the gap between us

• Develop an appreciation of the impact of culture group, minority group and racial group on the health care relationship.
• Increase sensitivity, knowledge and skills to promote effective intercultural interactions.
• Identify our own provider culture/judgments /biases and their impact.
• Examine characteristics of Asians, Blacks and Middle Easterners.
• Summarize how to care for patients of these three ethnic/racial groups and how to narrow the gap between us
• Develop an understanding/plan of how to reach out to these populations.

• Describe cultural diversity
• Recognize the need for cultural competence in health care
• Explain the concept of health disparity
• Define culture and cultural competence
• Differentiate between the concepts of culture, race, ethnicity, diversity, and minority
• Describe the Cultural Competence Continuum
• Discuss the interdependency between the levels of cultural competence

• Discuss the evolution of multicultural policy
• Describe the phases of multiculturalism
• Discuss three major perspectives on culture and diversity that have influenced healthcare literature and practice
• Identify the common myths and misconceptions associated with culture
• Recognize the paradoxical dilemmas associated with cultural competence

• Identify the need for cultural competence in health care and in medical literature.
• Examine and Research the historical perspectives
• Examine your world view or cultural beliefs about diversity and explain how you can develop an attitude of cultural competence.
• Analyze the five aspects of ethnicity used to describe cultural differences in the health care environment. 

• Review and explain the racial and ethnic disparities in health care.
• Explain the role of health care providers and organizations as mechanisms to reduce racial and ethnic disparities in health care. 
• Explain how language and communication of the health care provider can be a barrier to establishing relationships.
• Identify tools that can foster empathy for differing cultures.

• Explain the need for improving cultural awareness in the workplace to build cultural competency.
• Identify five practices that can be implemented to increase cultural awareness in the workplace.
• List the benefits of building an organization's cultural competence
• Explain how to deliver culturally competent care.

• Demonstrate The ability to communicate clearly and concisely with current and future patients 
• Describe ways to establish and maintain relationships and facilitate constructive interactions with individuals and diverse groups.
• List strategies to align personal and organizational conduct with ethical and professional standards that include a responsibility to the patient and health care community. 
• Demonstrate an understanding of the healthcare system and the environment in which healthcare managers and providers function.

• Develop an appreciation of the impact of culture group, minority group and racial group on the health care relationship
• Increase sensitivity, knowledge and skills to promote effective intercultural interactions
• Identify the professional's own cultural identity/judgments /biases and their impact on their behavior and how they are perceived by clients and patients
• Recognize cultural variables that appear in verbal and non-verbal communication
• Examine the influence of culture in our patient population
• Differentiate the provider's culture

• Examine the historical background of the various Latino/Hispanic groups in the U.S.
• Develop the skills needed to care for people from Spanish speaking parts of the world
• Increase our understanding of the cultural traits of Latino/Hispanic groups in the U.S.
• Summarize specific traits of various Latino/Hispanic groups
• Recognize how we can narrow the gap between us

• Develop the skills for medical documentation record keeping for proper patient care and adherence to insurance protocols
• Summarize informed consent, Mercy guidelines, Medicare guidelines and NCQA guidelines
• Identify common treatment procedures and modalities used in a chiropractic practice And recognize contraindications to them
• designate specific items to consider when interpreting and/or taking plain film X-rays
• Summarize the value of laboratory and diagnostic testing.
• Recognize the importance of patient communication skills in order to assist in the diagnosis and treatment of patients
• Modify procedures and forms to prevent the possibility of a legal malpractice action against the doctor

• Develop the skills for medical documentation record keeping for proper patient care and adherence to insurance protocols
• Summarize informed consent, Evidenced-based care, Medicare guidelines and NCQA guidelines
• Identify common treatment procedures and modalities used in a chiropractic practice And recognize contraindications to them
• designate specific items to consider when interpreting and/or taking plain film X-rays
• Summarize the value of laboratory and diagnostic testing.
• Recognize the importance of patient communication skills in order to assist in the diagnosis and treatment of patients
• Modify procedures and forms to prevent the possibility of a legal malpractice action against the doctor

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

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

Hour 1

• Define standard of care.
• Examine the requirements of Chiropractic documentation.
• Evaluate Chiropractic care and the functional relationship.
• Review state specific examples of documentation requirements.
• Discuss what is mean by episode of care.

 Hour 2

• Establish the baseline of care.
• Identify the inadequacies of intake forms.
• Comply with the requirements of the initial encounter report.
• Review the consultation documentation in various case scenarios.
• Apply appropriate medical decision-making processes and documentation.

 Hour 3

• Examine the Documentation Requirements of a SOAP Note.
• Utilize PART in documentation.
• Utilize outcome assessment tests in documenting medical necessity of care.
• Identify Assessment and its relationship to medical necessity.
• Solidify elements of the treatment plan to support medical necessity.
• Apprise utilization management and review analysis of documentation.

• Demonstrate understanding of the key elements of revised E/M services
• Determine the elements that count as Time-Activities and how to calculate appropriately
• Establish protocol to determine Medical Decision Making element of E/M encounter
• Apply the new algorithm to appropriately code for E/M services under the 2021 model
• Discover how to still demonstrate Medical Necessity with the revised E/M codes
• Determine why history and examination are still needed

• Develop the skills for medical documentation record-keeping for proper patient care and adherence to insurance value based parameters
• Recognize the importance, and benefits of thorough chart documentation from the standpoint of the patient, the provider, the profession and third-party payors
• Show how outcome assessment documentation benefits the patient, the provider, the profession, and third-party payors
• Demonstrate physical examination procedures that are the basis for diagnosis formulation and value based data
• Examine skills necessary to incorporate an outcomes-based, evidenced-influenced approach to patient-centered health care in bodily injuries

• Develop the skills for medical documentation record-keeping for proper patient care
• Recognize the importance and benefits of documentation methodology from the standpoint of risk management
• Identify selected documentation problems and errors
• Summarize recommendations for improving patient care documentation for those Doctors not using an EHR

• Define the Problem Oriented Medical Record (POMR).
• Demonstrate taking a complete patient history.
• Define the Evaluation and Management examination for the musculoskeletal system.
• Define Outcome Assessment.
• Illustrate the P.A.R.T. format of documentation.
• Define proper assessment for SOAP notes.
• Discuss proper documentation of treatment performed on each visit.
• Discuss proper documentation of treatment plans.

• Comprehend the reasons for transitioning from ICD9 to ICD10
• Determine the critical differences with the new ICD10 codes
• Utilize the proper alpha and numeric aspects of commonly used ICD10 codes for  Chiropractic
• Observe the practicality of combining clinical documentation and the proper use of ICD10 codes.

• Discuss the history of ICD-10-CM codes
• Discuss the Official ICD-10-CM Guidelines for Coding and Reporting
• Identify and discuss the tools needed to navigate the ICD-10 codes
• Discuss the General Equivalence Mappings (GEM’s) and their significance and how they relate to ICD-10-CM Tabular List of Diseases and Injuries
• Identify and discuss how to select the appropriate ICD-10 code to its highest specificity
• Examples to be discussed

• 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 5 levels of E/M services for new and established patients
• Identify the 7 components (descriptors) used to determine the level of E/M service
• Select the appropriate level of E/M services utilizing 7 simple steps

• Differentiate between active and maintenance care in clinical documentation
• Execute the use of advance notice in third party patients correctly and accurately
• Identify and implement strategies to clarify the difference between active and maintenance care in documentation
• Recognize and adopt best practices in proper notification about maintenance care vs. active treatment

• Properly document findings and recommendations around muscle therapies
• Master the documentation necessary in daily visits to verify medical necessity
• Identify and implement strategies the most important findings and rationale necessary to add muscle therapies to the treatment plan
• Recognize how to differentiate between various manual therapies to meet the requirements of third-party payers' medical review policy

• Differentiate between supervised modalities, constant attendance modalities, and therapeutic procedures
• Properly document the time and service for any physical medicine modality and procedure
• Clearly define the rationale for these services within the patient's medical record

• Recognize the varying specific requirements for documenting unique adjusting techniques in regards to compliant records and risk management
• Properly document patient encounters for medical necessity
• Discuss the Medical Review Policy insurers use in reviewing medical documentation
• Review case studies and examples to identify documentation errors during self-auditing

• Apply best practices for using abbreviations, addressing legibility, authentication of signatures, and managing the day-to-day flow of your patient records 
• Clearly delineate the beginning and end of episodes of patient care, proper recording of these episodes, and boundary discussions with patients 
• Locate and utilize the definitions of medically necessary care, and apply it as a differentiator from clinically appropriate care
• Assess documentation across the life cycle of the patient’s chart from history to discharge and on through maintenance and wellness care based on live examples demonstrated
• Identify the deficiencies that may be present in your documentation through the eyes of an auditor

• Utilize documentation requirements for the most commonly used CPT codes in the profession
• Apply coding techniques and algorithms to ensure the proper code is selected to meet E/M documentation guidelines
• Recognize the codes that carry the highest degree of risk and confirm that documentation meets the code requirements
• Identify the mandatory elements of medical review policy for selected chiropractic codes

• Compose Complete and Accurate Treatment Plans
• Formulate multiple Standard Treatment Protocols for better compliance and efficiency
• Differentiate patient care plans per Patient condition severity
• Propose recommendations based on exam findings, not third party coverage

• Discuss Medicare’s guidelines for documenting quality measures 
• Discuss Medicare’s Merit-Based Incentive Program (MIPS)
• Identify and determine the eligibility requirements for MIPS
• Identify and discuss the 4 categories under MIPS (Quality, Cost, Promoting Interoperability (PI) and Clinical Practice Improvement Activities (CPIA)
• Recognize how Medicare calculates MIPS to determine payment adjustments

• Know how to document exactly what’s required for initial visit treatment plans including physical medicine procedures
• Apply sample language to include in each daily visit note that will meet documentation guidelines for these modalities and procedures, including properly recording time for timed services
• Command the mechanics of how to authenticate documentation for services provided by auxiliary team members
• Tie the patient’s diagnosis to the treatment plan for tissue-specific, physical medicine solutions
• Tell a complete and coherent account of the patient’s daily visit journey, outlining the crucial language necessary to justify medical necessity for all services rendered

• Recognize and document the difference between active and maintenance care
• Use a decision-making matrix to determine the reportability of active treatment, and to be able to help the patient understand the distinction
• Apply the Medicare standard of recordkeeping to intake requirements to establish a baseline for episodes of care
• Determine whether routine visits qualify as active treatment when presented with new and updated complaints

• Describe the need for prognosis
• Summarize what a prognosis is
• Demonstrate the use of prognostic tools
• Appraise your individual patient’s outlook for recovery.
• Measure the progress
• Make evidence based clinical decisions
• Substantiate your opinion for expert testimony.
• Illustrate the evidence for care.
• Prescribe evidence based care plans.
• Properly document and code complicated cases
• Improve the patient report of findings and discharge procedures

Hour 1 - 5

• Describe the need for prognosis
• Summarize what a prognosis is
• Demonstrate the use of prognostic tools
• Appraise your individual patient’s outlook for recovery.
• Measure the progress
• Make evidence based clinical decisions
• Substantiate your opinion for expert testimony.
• Illustrate the evidence for care.
• Prescribe evidence based care plans.
• Increase your reimbursement for complicated cases.
• Improve the patient report of findings and discharge

Hour 6

• Interpret in documentation, the difference between active, medically necessary care vs. clinically appropriate but possibly maintenance adjustments
• Able to distinguish compensatory vs. primary subluxations and document them properly
• Specify proper documentation techniques as a full spine adjuster
• Demonstrate the ability to classify documentation for each chiropractic technique employed

• Interpret in documentation, the difference between active, medically necessary care vs. clinically appropriate but possibly maintenance adjustments
• Able to distinguish compensatory vs. primary subluxations and document them properly
• Specify proper documentation techniques as a full spine adjuster
• Demonstrate the ability to classify documentation for each chiropractic technique employed

• Perform functional testing to identify patients who will benefit from active care rehab
• Correlate functional testing findings with a protocol-driven care plan customized to the patient’s diagnosis
• Recognize and document preferred outcomes that result from properly executed active care techniques
• Follow clinical algorithms to best understand the beginning, middle and end points of active care rehab
• Properly document the clinical rationale for active care rehab by linking it to the diagnosis and treatment plan of initial visit documentation

• Discover all the elements necessary for appropriate documentation of an episode of care, from the initial visit through the discharge from active treatment
• Have clearer delineation of the beginning and end of episodes of patient care
• Decide when an active episode of care should turn into maintenance care, and document the decision making appropriately
• Identify the required components of documentation as they are outlined in state board documentation requirements, Medicare documentation requirements and other entities’ regulations

• Define and recognize common procedures that may be deemed unproven, investigational or experimental
• Determine how individual state boards and payers view these various treatments
• Recognize guidance or rulings from state boards that dictate the need for informed consent
• Properly document the procedures in the medical record
• Apply correct coding to describe the procedure provided
• Personalize a sample Consent to Treat for the procedure provided

• Awareness of the value of orderly documentation to you and others
• Ability to duplicate key documentation components that auditors and reviewers expect
• Steps necessary to address how poor documentation can turn a simple record review into a full audit
• Ability to identify commonly missed links connecting documentation to treatment

• Differentiate and document for the difference between medical necessity and clinical appropriateness
• Execute a complete and compliant treatment plan that includes all required elements
• Properly record the elements necessary to justify the full-spine adjustment
• Command the mechanics of properly documenting clinical rationale for ordered diagnostics and treatment
• Ensure the inclusion of diagnostic assessment and doctor’s rationale in routine daily visit notes

• 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

• Recognize the mandatory enrollment guidelines for chiropractors and apply the rules to daily practice
• Distinguish between active and maintenance care and employ proper procedure to administrate both types of care
• Complete and document required elements of documentation of active treatment
• Prepare patients to best differentiate care that Medicare considers medically necessary from care that the patient is expected to pay for
• Apply the Medicare standard of financial transactions with patients in order to stay within the Federal collection guidelines

• Discover how proper documentation impacts the revenue cycle and profitability of your office
• Distinguish between Medically Necessary and Clinically Appropriate Care
• Demonstrate how your office compliance program either leaves you vulnerable or reduces your risk
• Develop understanding of compliant fee systems
• Evaluate federal guidelines regarding discounting and/or hardship

• Discern Part B from Part C and know the rules for each
• Discuss mandatory enrollment necessary for Chiropractic specialty
• Master the definition of medical necessity vs. clinical appropriateness and who pays in either case
• Recognize the differences between acute, chronic, and maintenance car
• Locate and understand the Medicare Local Coverage Determination (LCD) for your state including all the rules and guidelines
• Identify CMT coding and how it is differentiated from maintenance in Medicare

• Discern Part B from Part C and know the rules for each
• Discuss mandatory enrollment necessary for Chiropractic specialty
• Master the definition of medical necessity vs. clinical appropriateness and who pays in either case
• Recognize the differences between acute, chronic, and maintenance car
• Locate and understand the Medicare Local Coverage Determination (LCD) for your state including all the rules and guidelines
• Identify CMT coding and how it is differentiated from maintenance in Medicare

• Understand the difference between clinically appropriate and medically necessary care
• Identify the clinical indications of when to initiate therapeutic withdrawal
• Execute the components of a final discharge evaluation with proper documentation and recommendations
• Learn how to transition a client from an active phase of care to maintenance as a part of your treatment plan

• Understand the difference between clinically appropriate and medically necessary care
• Identify the clinical indications of when to initiate therapeutic withdrawal
• Execute the components of a final discharge evaluation with proper documentation and recommendations
• Learn how to transition a client from an active phase of care to maintenance as a part of your treatment plan

• Cite the difference between Therapeutic Exercise and Therapeutic Activities
• Properly document all aspects required when utilizing timed therapy services
• Assimilate payer policy details to ensure proper code utilization
• Discuss common errors when documenting and billing exercise therapy services

• Demonstrate why each and every digit of the DX tells the payer something important Distinguish the nuances of specialized DX coding rules for carriers such as Medicare.
• Discover the importance of DX pointing, and which CPT codes are an absolute MUST to point to DX
• Illustrate how to diagnose with a higher level of specificity and through proper hierarchy Identify the role of the diagnosis in the documentation process'

• Identify the expected standards of a compliant and complete patient record
• Audit documentation to ensure the most important details are present
• Demonstrate how to conduct a complete baseline audit of record documentation

• Demonstrate the components of recognizing Medical Necessary Care vs. Clinically Appropriate
• Identify CMT coding trends and indicators as they relate to medical necessity
• Properly manage treatment effectiveness for exacerbations and reoccurrences
• Determine Proper Diagnosis and Assessment for Federal Patients
• Acknowledge and audit CMT coding ratios to evaluate the potential risk

• Identify Dually Eligible Individuals (QMB) and Understand How Medicare Works with Medicaid
• Ascertain the practice’s obligations for QMB patients, regardless of Medicaid participation or coverage
• Provide accurate and legal advance notice to dually eligible individuals within the new guidelines
• Recognize the differences between acute, chronic, and maintenance care and how that affects billing and charges
• Duplicate Medicare financial rules and collections guidance into a process within the practice

• Apply the changes in the 2022 ICD-10 code set to the clinical diagnosis process
• Compare examination findings, couple with history, to select the most appropriate written diagnosis
• Document within the clinical record your thought process of selecting diagnostic codes
• Classify diagnoses in order of severity and hierarchy to match projected treatment plan

• Properly document “doctor thinking” daily in routine patient visit documentation
• Recognize the role of the PART documentation process in Routine Office Visit notes
• Identify and execute the key components of written assessment in daily documentation
• Recognize aspects of documentation and coding of Route Office Visits (ROV) whether active treatment, preventative maintenance, or wellness care.
• Distinguish the unique components of Subjective, Objective, Assessment and Plan

Hour One: Documentation and Compliance Overview, Rules and Regulations

• Recognize and avoid or correct behavior that is contrary to the rule of “no opt-out for chiropractors”
• Apply compliance rules set forth by governmental agencies that apply to providers of service to Federally insured patients
• Demonstrate day-to-day application of guidance on Federal Program and state requirements for coding, billing, and finances
• Differentiate between active and maintenance care, according to the official Medicare definitions and other third-party guidelines
• Interpret the four types of risk the Office of Inspector General (HHS) expects providers to focus on with Policy and Procedure, per the OIG Guidance for Small Practices
• Recognize the limitations of experimental, investigational, and unproven technologies

 Hour Two: Documentation of Initial Visits-New Patients, New Episodes, and New Conditions

• Identify and apply concepts that differentiate types of initial visits, from new patients to updated episodes
• Produce documentation of initial visits that comply with board requirements for chiropractors
• Summarize documentation requirements as they apply to the new initial Evaluation and Management guidelines set forth January 1, 2021
• Establish medical necessity for your care and know with surety that initial visit documentation is complete
• Rank complicating factors and contraindications according to priority and include with initial assessment
• Populate a required treatment plan for care, whether for short- or longer-term care

 Hour Three: Documentation and Case Management for Routine Visits, Preventive Maintenance, and Wellness Care

• Differentiate between requirements for medically necessary services vs. maintenance which is self-pay
• Apply primary subluxation vs secondary compensation logic to mitigate risk for the full-spine adjustment
• Reproduce the key elements of routine chiropractic visits in documentation as set forth by third-party, State and Federal guidelines
• Interpret functional data to determine stages and levels of care
• Demonstrate the ability to implement therapeutic withdrawal and to document its results
• Recognize maximum therapeutic benefit (MTB) and properly document discharge from active treatment

 Hour Four: The Risks Associated Billing and Financial Compliance Regulations

• Give examples of billing and financial compliance that cross the line of False Claims Act and Anti-Kickback Statute violations
• Apply billing and financial compliance regulations to the day-to-day operations of the practice, including payment and prepayment plans
• Execute random auditing of charges and collections to meet OIG compliance guidelines
• Recognize and apply the rules of offering financial hardship discounts
• Produce advertising that falls within the guidelines of board and federal rules

• Label the main driver is for “Medical Necessity”, how and why you must communicate this to 3^rd party payers
• List the foundation of coding and be able to apply pertinent ICD10 coding guidelines
• Discover how correct coding may dictate our strength to 3^rd parties and have national implications for our profession.
• Discuss critical questions of the benefits and risks of our Chiropractic diagnosis codes in the insurance industry.
• Identify red flags, complicating factors, and have awareness of Risk management when documenting and coding.
• Identify how insurance companies rank the importance of various diagnoses and its effect on claims’ coverage and processing

• Know how to prepare for a medical emergency
• Review four emergency medical conditions: Stroke, Heart Attack, Difficulty Breathing, Diabetic Emergencies
• Recognize the causes, symptoms and signs for these emergencies
• Understand how to provide the appropriate emergency treatments

• Gain the knowledge to develop an Emergency Preparedness Manual for your office
• Define crisis management procedures in advance for fires, child abduction, workplace violence, bomb threats and other situations
• Explain the importance of an emergency continuity plan
• Recognize why CPR was changed and compare the new rules
• Perform more effective CPR even before you refresh your certification

• Recognize Altered Mental Status and apply the appropriate emergency response
• Distinguish types of Burns, their mechanisms of injury and pathophysiology
• Plan for the treatment of burns and the appropriate emergency response
• Apply and use the Rule of Nines
• Recognize Allergic Reactions, discuss their pathophysiology and the proper emergency response

• Identify the most common emergencies that occur on airline flights
• Describe what may be expected of you in caring for a patient at high altitude
• Describe what resources and equipment may be available to you as an in flight medical provider
• Observe important clinical differences seen on examination of patients on airplanes
• Demonstrate to patients skills to prevent medical emergencies during air travel

• Know how to prepare for a medical emergency
• Review four emergency medical conditions: Stroke, Heart Attack, Difficulty Breathing, Diabetic Emergencies
• Recognize the causes, symptoms and signs for these emergencies
• Understand how to provide the appropriate emergency treatments

• Demonstrate the importance of communicating in an ethical manner and what that entails
• Develop an understanding of what 'spin' is, why it is unethical and how to monitor and minimize/stop it
• Evaluate the barriers to effective and ethical communication
• Develop an understanding of exactly what takes place/needs to take place during the provider/client interaction
• Discover what it is that patients want from their visits to a provider
• Appraise how to deal with challenging clients and situations
• Discover how to become a skilled helper by studying the tools of communication
• Apply listening skills to the provider's repertoire
• Demonstrate the importance of the impact of nonverbal communication on the caregiver/client relationship
• Develop, analyze and apply the verbal and nonverbal skills that will help to gather information and support the patient effectively
• Write an Ethical Communication Protocol (EPC) for your practice

• Determine how critical it is for us to take excellent are of ourselves
• Indicate the ways in which we can stay healthy physically, mentally and emotionally
• Examine the impact of stress on providers
• Recognize the issue of burnout
• Demonstrate the fiduciary duty that providers have

• Differentiate between assault and battery
• Outline various kinds of legal problems that may result from sexual impropriety claims
• Identify and describe distinctions between innocent flirtatious behavior and sexual misconduct
• Evaluate possible defenses to sexual misconduct Disciplinary complaints
• Discuss the applicability of the transference phenomenon to Doctors of Chiropractic

• Recognize the legal and ethical implications of billing, collections, fees, bartering, and financial gain
• Navigate the tricky waters of appropriate interaction with vendors/suppliers.
• Understand the fiduciary relationship that governs patient-doctor interactions.
• Grade your role as the chiropractor in all professional inter-relationships, including staff, patients, peers.
• Use self-assessment techniques to stay compliant in all areas of ethics and boundaries.

• 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.

• 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.

Hour 1

• Define Ethics
• Review various ethical issues recently reported on
• Identify ethics as related to the whistleblower
• Discuss Ethical standards specific to laws in various states

Hour 2

• Discuss Ethical standards specific to laws in various states (cont’d)
• Summarize awareness related to anti-discrimination
• Classify various aspects of professional boundaries and sexual misconduct

• Define morality and ethics and distinguish between the two
• Describe three moralities that health professionals must integrate into their own moral life
• Identify some major sources of moral beliefs in Western societies
• Distinguish between an ethical issue and ethical problem
• List three ways that ethics is useful in everyday professional practice
• Describe what material cooperation entails
• Identify some mechanisms available to protect the personal moral convictions of health professionals

• Identify the goal of professional ethics activity.
• Describe the basic idea of a caring response and some ways this response in a professional relationship is distinguished from expressions of care in other types of relationships.
• Identify three component parts of any ethical problem.
• Describe what an agent is and, more importantly, what it is to be a moral agent.
• Name the three prototypical ethical problems.
• Describe the role of emotions in ethical distress.
• Distinguish between two varieties of ethical distress.
• Compare the fundamental difference between ethical distress and an ethical dilemma.
• Define ethical paternalism or parentalism.
• Describe a type of ethical dilemma that challenges a professionals desire (and duty) to treat everyone fairly and equitably.
• Identify the fundamental difference between distress or dilemma problems and locus of authority problems.
• Identify four criteria that will assist you in deciding who should assume authority for a specific ethical decision to achieve a caring response.
• Become familiar with AOTA and APTA Code of Ethics
• Become familiar with the Guide to Professional Conduct for PT
• Indiana PTs - become familiar with the IN PT Rules and Practice Act
• Texas PTs - become familiar with the TX PT Rules and Practice Act
• Utah PTs - become familiar with the UT PT Rules and Practice Act

• Identify six steps in the analysis of ethical problems encountered in everyday professional life and how each plays a part in arriving at a caring response.
• Describe the central role of narrative and virtue theories in gathering relevant information for a caring response.
• List four areas of inquiry that will be useful when gathering relevant information to make sure you have the story straight.
• Describe the role of conduct-related ethical theories and approaches in arriving at a caring response.
• Describe why imagination is an essential aspect of seeking out the practical alternatives in an ethically challenging situation.
• Discuss how courage assists you in a caring response.
• Identify two benefits of taking time to reflect on and evaluate the action afterward.
• Become familiar with AOTA and APTA Code of Ethics
• Become familiar with the Guide to Professional Conduct for PT's

• Define the terms confidential information and confidentiality.
• Identify the relationship of a patient's legal right to privacy with his reasonable expectations regarding confidential information.
• Describe how the telling and keeping of secrets is relevant to understanding the importance of confidentiality.
• Discuss the ethical norms involved in keeping and breaking professional confidences.
• Name five general legal exceptions to the professional standard of practice that confidences should not be broken.
• Consider practical options that a professional can take when faced with the possibility of breaking a confidence.
• Discuss some important aspects of documentation that affect confidentiality.
• Compare ethical issues of confidentiality traditionally conceived with those that have arisen because of computerized medical records and patient care information systems.
• Describe the key ethical strengths and challenges of the recent U.S. federal regulations related to privacy considerations (Health Insurance Portability and Accountability Act of 1996).
• Become familiar with AOTA and APTA Code of Ethics
• Review and become familiar with the TX PT Rules
• Read case scenarios illustrating ethical decision making

• Describe three basic legal concepts that led to the doctrine of informed consent.
• Describe three approaches to determining the disclosure standard for judging that a patient or client has been informed.
• Discuss three major aspects of the process of obtaining informed consent.
• Distinguish "general consent" from "special consent" documents.
• Differentiate between the never-competent and once-competent patient or client and the challenges posed by each in regard to informed consent.
• Compare informed consent as it is used in health care practice and in human studies research.
• Describe some considerations one must always take into account to be sure one is being culturally competent and honoring cultural difference when informed consent is the standard.

• Explore contemporary healthcare issues from the perspective of Robert Lustig, MA and John Abramson, MD.
• Integrate the relevance of these issues to the chiropractic profession.
• Evaluate at the concept of evidence-based “medicine,” especially the “randomized controlled trial,” and describe how it applies to the chiropractic profession.
• Discriminate recent examples of “randomized controlled trials,” especially as related to pain syndromes and opioid drugs.Discusss the importance of the 2021 Nobel Prize for the chiropractic profession and mechanical-based care.
• Detail the physiology of the Piezo1 mechanical receptor.
• Introduce the concepts of mechanical function and mechanical neurology.
• Integrate the importance of the cerebellum to mechanical integrity and mechanical based care.
• Explain a randomized clinical trial that supports mechanical-based chiropractic care for visceral physiology.
• Distinguish the basic physiology of the neurotransmitter norepinephrine.
• State the basic physiology of the neurotransmitter dopamine.
• Outline the basic physiology of the neurotransmitter serotonin.
• Integrate the balance of the neurotransmitters dopamine and serotonin.
• Recite the relationship between the neurotransmitters dopamine, epinephrine and norepinephrine.
• Explore the concept of Heart Rate Variability (HRV).
• Integrate upper cervical chiropractic care, spinal chiropractic care, and HRV.

• Examine the impact of sexual boundaries on the health care relationship
• Recognize the most common misconceptions about sexual boundaries
• Distinguish between sexual misconduct and sexual harassment
• Demonstrate the need for providing safety for patients
• Identify the inherent dangers of being in a power position

• Define sex abuse
• Identify the characteristics of an abused individual
• Appraise the effects of abuse on the health care relationship
• Create an individualized Patient Protection Protocol
• Develop office procedures and policies that will create a safe and comfortable environment for all patients