Peer Review Essentials with Dr. Mario Fucinari | 6 CEs for Peer Reviewers & General Education

Per KBCE statutes - Peer Reviewers are required to obtain 6 hours in-person in the state of Kentucky prior to their renewal. 

This course has been approved for BOTH Peer Reviewers and General Education.

Registration is now CLOSED!!

Walk in registrations are still be allowed on-site, however please arrive early to process registration. You will need to register ON-SITE! 

Title: Peer Review Essentials
Instructor: Dr. Mario Fucinari

Time: 9am EST - 4pm EST

Ethical and effective peer review requires a clear understanding of coverage standards of Medicare and other private payers and how to bill for those services. Peer Review Consultants and practicing Chiropractors must stay up to date with the documentation, billing, and coding changes. Significant changes, including the 2023 evaluation and management guidelines, HEDIS^® measures, ICD-10, and CPT changes will impact the chiropractic office.  Learn how to provide evidence-based and ethical clinical opinions regarding the medical necessity of chiropractic treatment.  Sponsored by NCMIC. Attendees may use this class toward the NCMIC 5% discount for policyholders.

Biography:

Dr. Mario Fucinari is a Palmer Davenport graduate.  He is uniquely qualified as a seasoned practitioner in practice for over 35 years, a nationally recognized speaker, author, and instructor.  Dr. Mario has decades of experience in compliance, coding, and documentation.  He holds certifications in compliance, sports injuries, whiplash injuries, and rehabilitation.  Dr. Fucinari is a member of the Carrier Advisory Committee for Medicare, a Certified Professional Compliance Officer (CPCO), a Certified Physician Practice Manager (CPPM), and a Certified Insurance Consultant (CIC).  

Learning Objectives:

• To understand the key government regulations and industry trends
• To understand legal ramifications in the peer review

• To be able to define “Medical Necessity in various carriers
• Properly identify Elements of the 2023 E/M Guidelines in the Chiropractic practice
• Learn documentation guidelines and requirements
• Identify legal aspects of proper documentation and the Standard of Care
• Gain the ability to scrub a claim form
• Learn documentation requirements for therapeutic modalities and procedures
• To gain an improved understanding of case management

Hour 1

· Ethics and Peer Review

· The Standard of Care

· Legal Requirements in Chiropractic Documentation

• Fraud, Abuse, Cloning, and Carry-Over

Hour 2

• Documentation Requirements for HIPAA
• Informed Consent Guidelines

· Financial Policies and the Anti-Kickback Statute

• The Initial Encounter Report

Hour 3

• The Personal Injury Case Documentation
• Worker’s Compensation Documentation

· Updated 2023  Evaluation and Management Guidelines

· Determining the Appropriate Level of the E/M

Hour 4

• The Importance of the Outcome Assessment Tests
• Treatment Goals and Objectives
• Supporting Medical Necessity
• The Role of Radiology and HEDIS^® Guidelines
• Review of Case Files for the Initial Report

Hour 5

• ICD-10 Coding Guidelines
• SOAP Notes and the Progression of Care
• Medicare P.A.R.T. Assessment of the Subluxation
• The Assessment and Medical Necessity

• The Re-Evaluation
• Correct Utilization of Modifiers

Hour 6

• Documentation of Therapeutic Procedures
• Signature Requirements
• Scrubbing the Claim Form
• Review of Case Examples
• Writing the Peer Review Report

This course has been approved for credit from the KBCE for up to 6 CEs for general education | Approval #: KBCE863

This course has been approved for credit from the KBCE for up to 6 CEs for Peer Reviewers | Approval #: KBCE864

Time includes breaks