Andrew K Long asked:




From its infancy, microbiology has depended on several advances in the field by not only its founders, but by the giants in the field. The problem of isolating and culturing, or growing, microorganisms for study in the laboratory has seen many resolutions, and some of those are centered around the growth media used to enrich pathogens for further study.

The discovery of agar, the extract from a certain species of red seaweed, was an enormous breakthrough for the microbiological field, as the growth media prior to this discovery was inefficient for the proper culturing of organisms. Meat proteins and gelling materials were easily broken down by the organisms, thus becoming ineffective at successful growth. Agar solved this problem, as it is a firm yet clear gel that can have any chemical or material suspended within it, leading to specialized media we know of today.

Growth media comes in many forms, and each has its place in the microbiology laboratory. Broths are used for the proliferation of organisms, especially those that are fastidious and hard to grow on standard media types. Broths have a high content of nutrients that is not normally found in the organisms’ natural environment, giving better nutrition for reproduction of the organism.

Fastidious bacteria are notorious for inhibited growth on standard agar media plates. Broths incorporate special infusions that pathogens thrive in, such as beef or brain extracts. This is highly effective in culturing a large volume of the organisms needed for research or identification of disease from hard to grow pathogens.

Specialized agar media such as blood infused agar plates are effective for determining the hemolytic reaction that the organisms may produce. The breaking down of the blood cells suspended within the agar matrix can be easily seen after 18-24 hour incubation, for example, with Staphylococcus Aureus, on elf the causes of MRSA in humans. The gold-to-white, flat and concentric colonies will have a clear halo where the organisms have broken down and consumed, completely, the blood suspension. This is indicative of the harmful nature of this pathogen.

MacConkey agar is an effective media for the determination of gram-negative organisms such as Enterobacteriaceae like Escherichia coli. This organism has been responsible for contaminated foods and the deaths of human being due to the toxic nature of the by-products the organism secretes. On a MacConkey plate, the organism colonies take on an unmistakable pink cast, and the colony morphology has an added parameter used in identification. MacConkey agar has a dye indicator and sugars specific for gram-negative rods, and inhibitors to prevent any other organisms from growing on the agar.

Chocolate agar is not made from the confection, which gives it its namesake, but from the colour of the agar itself. It also is made from blood suspension within the agar, although the blood cells have been broken down to release nutrients into the agar, causing even the most fastidious organisms to proliferate.

There are other highly specialized agar mixtures, which can give positive identification of organisms that would otherwise require intensive culturing techniques. These culture mediums are prized by researchers and medical microbiologists worldwide for the successful isolation and identification of organisms.

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Yuval Lirov asked:




Dr. Ben Lerner, founder of Teach The World About Chiropractic and author of “One Minute Wellness,” discovered a convenient way to educate thousands of chiropractors about coding compliance and audit risk reduction. “Compliance maintenance requires special skills and military discipline,” says Dr. Lerner. “Webinars are ideal for audit risk management instruction because they deliver urgently needed education but require minimal investment in terms of time and cost.”

Webinar combines Internet and phone technology to bring together multiple geographically dispersed participants to interact in the same conversation while viewing the same visuals. Visuals may include slides or interactive computer application. Webinars are especially useful for remote training situations, where the student is asked to follow instructor’s direction immediately and compare the results in real time. Historically, live webinars attract 10 to 300 participants and dozens more access the archives.

Archived events may be viewed as PDF with MP3 audio or via the Web with streaming audio at a time that is convenient, making it simple and efficient for doctors to share valuable information with the rest of the team – or listen again to a session to pick up tips and hints that might have been missed the first time.

1. Who Needs a Webinar on Billing Audit Risk?

According to Improper Medicare FFS Payment Report (2003), “Chiropractors have the highest provider compliance error rate in Medicare, filing claims incorrectly 30.6% of the time.”

“No insurance company offers protection against potentially enormous penalties in case of post-payment audit,” says Jeff Randolph, Esq., Legal Counsel to the Association of New Jersey Chiropractors. The severity of provider penalties following post-payment audit have escalated in the past two to three years from relatively non-adversarial audits and occasional return of payments to very high fines, suspension or loss of license, and imprisonment.

If any chiropractic practice has a 30.6% chance of being audited and no insurance offers protection against audit risk, then the only rational way to protect the practice is to develop an in-house audit defense strategy.

The primary objective of a chiropractic audit webinar is to train practice owners and managers in simple and effective techniques to reduce both the risk for an audit and potential penalties in case of an audit.

The secondary objective of the webinar is to train practice owners and managers efficient practice management techniques, leveraging modern Internet-based Vericle technologies.

2. Target Audience

Chiropractic clinic owners and managers already using Vericle technologies would benefit the most from presented information because they would be able to apply the newly acquired knowledge immediately in their practice. Practice owners without access to powerful Vericle technology, would benefit from an in-depth discussion about rapid SOAP notes generation, effective and compliant coding, and automated audit exposure monitoring.

3. Expert Content

Prepared by the authors of “The Business of Healthcare Provider Audits” (forthcoming in Today’s Chiropractic), this specialized Webinar on Billing Audit Risk reflects years of cumulative experience of hundreds of doctors and post-payment audits. Hundreds of chiropractors have attended its live prototype seminar “How to Hang Onto Your Money,” developed initially for “Teach The World About Chiropractic.”

The benefits of participating in the medical billing audit risk webinar are three fold:
Improved efficiency of patient flow management, Higher revenue because of more effective billing, and Lower audit risk because of more effective coding and SOAP note compliance.
4. Professional Presentation

Experienced presenters engage the audience and clearly relate key messages. The material is delivered in small and easily digestible portions and accompanied with clear demonstrations using state-of-the-art Vericle technology.

5. Benefits
Effective meeting: Webinars eliminate phone tag, email overhead, and inconvenience of paper memoranda. Reduced cost: Webinars eliminate travel, hotels, facility rentals and catering. Typical fee is $200-$300 for program materials and access to live webinar or its recording. Improved reach: Webinars help reaching a large audience instantly regardless of physical distance between the participants. Intuitive interaction: Internet software allows presenters and attendees to interact and collaborate through live polls, question and answer periods, and document sharing. This allows getting a pulse on coding difficulties or Vericle feature priorities. Easy access: To attend a medical billing webinar, you need a phone number, login, and password, which you receive upon paying registration fees. Simple user interface: Standard web browser and phone are sufficient for participation. There is no complex functionality to learn to join the webinar. Followup: Upon completing the webinar, the attendees can always followup with a question over email or phone or register for the next webinar to reinforce understanding of the material. Promotion: The webinar is advertised on several websites and specialized magazine ads. Additionally, each communication with a registrant includes “invite-a-colleague” link. Simple registration: Medical billing audit webinar allows registration online, regular mail, phone, email, and fax, depending on participant’s preference.

Doctors and practice managers are looking for cost-effective and productive ways to learn better ways to manage their practice and revenue cycle. Increasing frequency of post-payment insurance audits and mounting severity of penalties, ranging from license suspension to heavy monetary fines, emphasize the need for effective and affordable education about compliant office management and audit risks. The key benefit of the webinar is its convenience – there is no travel required and important information is delivered in ninety-minute sessions that make it easy for even the busiest doctors to quickly gain important information on topics ranging from successfully implementing EMR systems, to understanding the real benefits and challenges of outsourced billing services, risk management of post-payment audits, and much more.

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