Practice Forms Archives

COVID-19 & Infectious Diseases Preparedness & Response Plan

The health and safety of employees during COVID-19 has been priority one for chiropractic practices. The need for proper documentation, adherence to policies, and continuous improvement of health and safety practices are critical as well. This Infectious Disease Prevention & Response Plan was developed to help document that your practice is in compliance with applicable guidelines (OSHA, FDA, WHO, CDC).

Evaluation and Management Quick Coding Tool

Quick and easy tool for students and professionals. Whether studying for class or a coding certification test. Use as a quick go-to desk reference for the professional starting out or for the guru that has the ultimate coding toolbox of useful resources.

Existing Patient History Update Writable

Streamline the history update process with this editable Patient Case History Update form. It qualifies for the comprehensive status associated with E/M coding standards and documents information geared for the practitioner concerned about the patient's overall condition.

HIPAA Patient Release and Authorization for Testimonial Use

The HIPAA Privacy Rule requires that you obtain valid, written authorization from a patient before you can publish any testimonial involving that patient on your website, social media platform, or through any other medium of communication (e.g., print, radio).

HIPAA Red Flag & Identity Theft Policies and Procedures

An estimated nine million Americans have their identities stolen each year. Identity thieves may drain accounts, damage credit, and even put health care treatment at risk. The Red Flags Rule requires your practice to implement a written identity theft prevention program designed to detect the “red flags” of identity theft in your day-to-day operations, take steps to prevent the crime, and mitigate its damage. Our Policies & Procedures document will help your practice spot suspicious patterns and prevent the costly consequences of identity theft.

HIPAA Security Policies & Procedures

Protect your practice, your staff, and your patients while you minimize your risk of HIPAA violations. Updated with the latest "Omnibus" Final Rule requirements, this editable Policy template is ready to be customized for your individual practices. A complete set of Policies and Procedures is mandatory for HIPAA compliance. If you are ever investigated or charged with a HIPAA violation, your Policies and Procedures are typically the first thing investigators want to see. Make sure you are ready!

New Patient Case History Writable

Impress your patients right from the start by gathering the information you need in a snap. This editable New Patient Case History form qualifies for the comprehensive status associated with E/M coding standards and documents information geared for the practitioner concerned about the patient's overall condition.

OIG Compliance Policies & Procedures Document

This customizable Practice Compliance document is based on the OIG Compliance Program Guidance. A must-have in practice documents the written standards, policies, and procedures that promote your practice’s commitment to compliance with applicable laws and regulations.

Staff Office Policy & Employee Manual

Getting your practice’s policies down in writing than in front of employees makes setting expectations easier but creating an employee handbook can be very time-consuming. This customizable template helps you effortlessly maintain the right tone at your practice while improving accountability. It includes Anti-discrimination, Benefits, Compensation, Compliance, Conduct and Standards, Safety and Security, Technology, Time Off policies, and more.

The Phases of Care Poster

This concise, colorful educational chiropractic poster print suitable for framing will help your patients better understand the phases of chiropractic care: Pain Relief, Scar Tissue Formation, Healing, Stabilization, and Wellness. It includes the Physiological Healing Calendar according to Guyton’s Textbook of Medical Physiology along with the Assessments and Criteria for Care at each Phase and the Assessments used to measure patients’ progress.

Massage Therapy Conversion Form

This form is used to document Manual Therapy and can also be used as a conversion tool for massage therapists.

DC Daily S.O.A.P. Notes

This comprehensive SOAP note allows doctors to quickly document patient visits and let them focus more on the patient. It includes the 3 items most commonly asked for in a post-payment audit. Consider it audit protection.

HIPAA Business Associates Agreement

This customizable form is a HIPAA requirement. It shields your practice from liability in the case of a breach of Protected Health Information (PHI) by your Business Associates.

Sample Notice of HIPAA Privacy Practices & Receipt Acknowledgment

These forms MUST be used for your practice to be HIPAA Compliant. Don't get caught in a HIPAA audit without providing these forms to your patients.

Staff Office Policy incl. Internet, Texting & Social Media

A written Office Policy is a must have to help implement a consistent approach to staff management. From a legal perspective, policies can be a fine tool in reducing perceptions of arbitrary treatment of employees.

Functional Capacities Evaluation & References

Use this form to document your Functional Capacities Evaluation. This battery of tests are safe, inexpensive, time efficient, reliable, and comparable to normative databases. Use it to set and track the progress of functional treatment goals.

OUR ALLIANCE PARTNERS

THE BENEFITS OF BECOMING A
BREAKTHROUGH COACHING PARTNER

As a leader in the Chiropractic profession, BTC has been extremely selective in forming its group of alliance partnerships. We encourage you to visit our partner's websites and to utilize their services and products. When you become a Member of Breakthrough Coaching you become part of a special "family" unlike any other in the Chiropractic Profession.

Practice Forms