Chapter One - The Most Powerful Tool in the Fight Against Fraud
- Common Fraud Methods
- When a Medical Audit be Considered
- Reviewing the Demand Package
- Indicators of Fraud
- Before You Begin
Chapter Two - The Clinic Investigation
- The Purpose of the Clinic Investigation
- Establishing Clinic Ownership
- Licensure Verification
- On-Site Clinic Inspection
- Copying the Medical File
- Radiograpic Films
- Completing the Clinic Inspection
- Interviewing Clinic Personnel
Chapter Three - Who May Provide Physical Therapy and Who May Not
- Medical Doctors
- Physical Therapists
- Physical Therapy Assistants
- Physical Therapy Aides
- Physician Assistants
- Medical Assistants
- Chiropractors and Chiropractic Assistants
- Acupuncturists
Chapter Four - Reviewing the Medical File
- Initial Review Procedures
- Doctor's Narrative Report
- Radiology Report
- Handwritten Exam Notes
- Doctor's Diagnosis
- Treatment Plan
- Physical Therapy Evaluation
- Treatment Record
- Progress Notes
- Sign-In Sheets and Patient Registers
- Patient/Accident Information Forms
- Billing Statements
Chapter Five - Understanding CPT Codes
- Current Procedural Terminology (CPT)
- Catagories
- Evaluation/Management
- Key Components
- Contributing Factors
- Upcoding
- Radiology
- Unbundling
- Physical Medicine/Modalities
- Duplicative Therapy
- Common Billing Codes
Chapter Six - Excerpts From the Healing Arts Statutes
- Business & Professions Code
- California Chiropractic Initiative Act
- Medical Practice Act
- Physical Therapy Practice Act
- Nursing Act
- Acupuncture Practice Act
- Moscone-Knox Professional Corporations Act
Chapter Seven - Accepted Standards of Practice
- California Code of Regulations
- Mercy Conference Standards
- Physical Therapy Guidelines
Chapter Eight - Physical Therapy Equpment & Modalities
- Modalities, Procedures & Equipment
- Common Medical Terms