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May 2019 News Flash

May 31, 2019

In this issue

  1. Fulcrum’s Infection Prevention Study published!
  2. Fulcrum Health Is A National Level Advocate
  3. Informed Consent
  4. Review Billing Practices
  5. Patient Communication
  6. Moving or Retiring? Let us Know!

Fulcrum’s Infection Prevention Study published!

Thank You!We are excited to announce that our Infection Prevention Study was published in the online issue of Chiropractic Economics! Read more on the study here .

Thank you to the 30 clinics who volunteered to be part of a study looking at what infection control practices would best suit the chiropractic offices. The clinics received testing product kits that included hand sanitizers, gloves, sharp containers and table disinfectants. After testing they supplied opinions on the products and had the clinics retested for potential infectious organisms.

Some key discoveries were the need for hand sanitizers in every room and to check the expiration date, products for table disinfectants, cleaning toys, disposal of sharps before they become ¾ full and keep clean linens in a closed cabinet.

Fulcrum Health Is A National Level Advocate

PMMAWe are excited to announce that Fulcrum Health’s CEO, Patricia Dennis, has been newly elected to AAPAN’s Board of Directors! This designation allows her to serve as a professional advocate to network providers. Click here to read more. She is also a Board Member of PMMA.

The Physical Medicine Management Alliance (PMMA) is an AAPAN Board Committee that consists of organizations representing care management companies who specialize in physical medicine, musculoskeletal care and wellness. These organizations focus on partnering with provider specialists to facilitate care delivered via specialty services that include, but are not limited to, Physical and Occupational Therapy, Chiropractic Care, Podiatry, Speech Therapy and Integrative Care.

PMMA Provides:

  1. Industry leadership and guidance in musculoskeletal and therapeutic care management
  2. Singular, authoritative voice representing common interests
  3. Robust advocacy at the federal and state legislative and regulatory levels
  4. Influence and input on public policy
  5. Insights and opportunities for dialogue between industry leaders
  6. Educational and marketing efforts focused on promoting the value proposition of evidence-based conservative care to stakeholders
  7. Collaboration with synergistic associations to leverage advocacy efforts

Their most recent publications:

Please visit our website to learn more – Articles can be found here.

PMMA’s affiliation with the American Association of Payers, Administrators and Networks (AAPAN) further strengthens Fulcrum’s positioning as a successful industry advocate on both the federal and state levels.


Informed Consent

Informed consent is a topic that’s often talked about. It is through this discussion that doctors are able to educate patients about recommended treatments.

Doctors may be accused of negligence or battery if they fail to obtain the patient’s proper informed consent before rendering treatment, and they may be sued for not providing information regarding potential complications.

Components of informed consent include a discussion about the risks, benefits and alternatives of the proposed treatment. After the discussion, the doctor should have the patient sign a document that confirms the discussion and that the patient was given the chance to ask questions and have them answered.

An effective informed consent process should include these steps:

  • Provide the patient with sufficient time and information to make decisions about the risks, benefits and anticipated outcomes of the proposed treatment.
  • Present the patient with alternatives, including referral options or receiving no treatment at all. If you make a recommendation, explain your reasoning and why you believe it is a valid suggestion.
  • Discuss any foreseeable risks or complications that may arise from the proposed course of care, as well as the potential risks if the patient refuses care.

Make sure to document both the discussion and the patient’s decision, including a written informed consent (or refusal) to support the verbal response.

You should note the following in your records (and provide the patient with a copy):

  • Names of individuals present (patient, family, caregiver) during the discussion.
  • The treatment recommended.
  • Potential risks that were discussed of not following the treatment.
  • Any questions the patient or related parties asked and the answers you provided.

In the case of refusal, also note:

  • The patient’s reason for refusal of the recommended care.

If the patient returns for further treatment, continue to:

  • Advise the patient about the condition and risks, as long as the condition exists and the patient refuses treatment.
  • Advise the patient if other conditions may be affected by their continued refusal of the recommended treatment.
  • Document that the patient continued to refuse the recommended treatment.

NCMIC offers information on informed consent:


Review Billing Practices

UpdateEffective July 1, 2019 , eviCore will enforce best practice standards when submitting replacement or voided paper claims.

Specifically, when resubmitting a claim, the appropriate bill frequency code along with the original claim number will be required.

The available codes include:

  • 7 – Replacement of a prior claim
  • 8 – Void/Cancel of prior claim
  • The bill frequency code is not required for original claim submissions.

The bill frequency code should be entered into the “Resubmission Code” area of box 22 and the claim number from the original claim’s Remit should be entered into the “Original Ref No” area of box 22.

Please review your billing practices prior to July 1, 2019 to ensure that your office staff is aware of the correct use of codes. Claims received on or after July 1, 2019 with the words, “CORRECTED”, “VOID”, or similar terminology stamped or written on the claim, will be denied as a duplicate submission.

The National Uniform Claim Committee (NUCC) has developed a CMS-1500 Reference Instruction Manual detailing how to complete the claim form in a nationally standardized manner. To access the instruction manual visit,

If you have any questions regarding this message, please call (877) 638-7719.

Patient Communication

QuizSee below for a fun but important quiz on the value of doctor-patient communication

You will be presented with videos and statements containing advice, which you will then mark as ‘helpful’ or ‘unhelpful’. A rationale behind the correct answer will then appear.

A second video will also be presented after you answer. Please note that it may contain examples of either helpful or unhelpful advice, opposite to that of the first video. After viewing the second video, you may move onto the next question.

Start Quiz Here!

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!