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April 2019 News Flash

April 30, 2019

In this issue

  1. AcuNet Network Expansion!
  2. Fulcrum Health’s Annual Meeting is This Week
  3. Non-Covered Chiropractic Services
  4. Medical History Communication
  5. CMS to launch new direct-contracting pay models in 2020
  6. Moving or Retiring? Let us Know!

AcuNet Network Expansion!

Great River SymposiumFulcrum’s licensed acupuncturist, Deb Zurcher, DC, LAc, attended the Great River Symposium this month. She enjoyed meeting with fellow acupuncturists to discuss the need to expose acupuncture to a broader audience and to learn about new approaches to enhance our AcuNet providers practice . Together we have the power to do more. Dr. Zurcher looks forward to working with you as a provider in the AcuNet network!

If you or a colleague are interested in becoming an AcuNet provider :

  • No fee to join, no membership dues, no annual costs to participate
  • Receive referrals from ChiroCare, Fulcrum’s chiropractic network and from our online directory.

Please visit our AcuNet website, to learn more and join today!

Fulcrum Health’s Annual Meeting is This Week

Annual MeetingThis is a friendly reminder that Fulcrum Health’s Annual Meeting will take place this Thursday May 2, 2019, at our Plymouth, Minnesota office at 8:00 a.m. In an effort to be good stewards of our resources, this meeting will be available via phone. Please call (763) 204-8575 Ext. 8541.

Annual Meeting minutes will be made available following the meeting. In our May newsletter we will provide a link.

Click Here to access our 2018 Annual Report.


Non-Covered Chiropractic Services

In our series, we continue on the subject of Non-Covered Chiropractic Services. We would like to address Fulcrum’s policy around this process. Our policy states that contracted Fulcrum Health network providers must comply with all administrative requirements for billing members for non-covered services.

The policy, which reflects state and federal regulations, speaks to the specific purposes and procedures for obtaining written consent to evidence that providers have adequately notified patients and obtained documented acknowledgement of member liability for non-covered services for which they will be billed. Not performing this process according to policy increases your risk of potential regulation violations as well as creating issues on the back end, including appeals and complaints/grievances by the patient, and may result in services falling to provider liability.

A good number of issues and investigations we work on a daily basis could be mitigated by a thorough understanding of these requirements on the part of providers. Please review the policy carefully and reach out to us if you have any questions. The current version can be found here.

If you have any questions on the OIG Workplan, CMS regulations and/or Fulcrum’s policy, please feel free to contact Lariza Carlson at


Medical History Communication

Doctors transmit a message of caring and concern to patients when they can speak confidently about specific medical record information. Let your patients know you have viewed their medical history by verbally reviewing it with them. This simple step shows you care and improves patient satisfaction. Improving patient satisfaction is one of the three components of the Triple Aim.

Tips for improved medical history communication:

  • Regularly refer back to the patient’s chart when discussing their current condition. If symptoms are recurrent, make sure to share that observation with the patient.
  • Review the patient’s medical chart prior to entering the exam room. Patients appreciate the fact that their care provider knows about them and remembers them.

Ex. “I was looking through your chart this morning. When you were here

three months ago, we talked about XYZ. How is that going?”

  • If an error is found in the medical history portion of the chart, be sure to correct it promptly. Patients will become frustrated if they need to correct the same error over multiple visits.

CMS to launch new direct-contracting pay models in 2020

HHS (Health and Human Services) launched an ambitious, double-pronged strategy to shift primary care from fee-for-service payments to a global fee model where clinicians and hospitals could assume varying amounts of risk.

The first model aims at small primary-care practices, offering two options with a flat monthly fee per patient. Bonuses or penalties will depend on their ability to keep their patients “healthy and at home,” said Adam Boehler, director of the CMS’ Center for Medicare and Medicaid Innovation, or CMMI.

Larger practices and health systems would have additional choices, which could be very lucrative but pose steeper risks. Under the first “professional option,” providers would assume 50% of the risk, including savings and losses. Under the “global option,” providers would take on full risk.

For more information, visit:

Moving or Retiring? Let us Know!

Address Book IconIt is vital that you report any practice changes to ensure that we have your current address, phone, fax, and email address. Any changes or corrections to your TIN/name combination should be communicated immediately. TheProvider Update tool within ChiroCare Connect offers a quick and electronic means to report changes. Simply select the “Billing Information Update” option within the Provider Update tool.

Please contact our Provider Services team at 877-886-4941 with any questions about submission of updates.

We appreciate your continued partnership!