Record-Keeping Know-How

Record keeping is an integral part of professional practice and is a tool to support the care process. Failure to record information accurately in health records can have serious consequences for patients and their relatives. These failures may result in reduced quality of care and litigation. The Record Keeping Know-How Course is a four-hour overview designed to help the chiropractor and staff improve record keeping behavior and documentation in the medical and office records.

Dr. Fucinari is a Certified Insurance Consultant and a Certified Medical Compliance Specialist (MCS-P). His class will give you up-to-date information to aid in identification of possible deficiencies in your office.

Topics include:

  • The Law and the Medical Record
  • Avoidance of Deficiencies in the Medical Record that Lead to
  • Malpractice Suits or Disciplinary Action
  • Guidelines of Coding and Documentation of Services
  • Medicare Guidelines
  • Record Retention
  • Informed Consent
  • Non-Pregnancy Verification
  • Treatment of a Minor
  • OSHA
  • Stark I and II Laws
  • False Claims Act
  • OIG Compliance Guidelines

Any five-digit numeric Physicians’ Current Procedural Terminology, 2006 Edition (CPT) codes, service descriptions, instructions and/or guidelines are Copyright 2006 American Medical Association (or such dates of publication of CPT as defined in the federal copyright laws.) All rights reserved. The training sessions include only CPT codes and descriptions selected by Mario Fucinari DC for inclusion in the workshop.