Chase Babe Ruth’s Homerun Record with Dr. John Davila, DC – Chiro Hustle Podcast 202

Education

• Doctor of Chiropractic, Palmer College of Chiropractic, Davenport, Iowa, 1994
• Bachelor of Science, Palmer College of Chiropractic, Davenport, Iowa, 1994
• Physical Therapeutics, Palmer College of Chiropractic, Davenport, Iowa, 1994

Licensure

• Certified, National Board Chiropractic Examiners, Greeley, Colo., 1994
• Licensed Doctor of Chiropractic, State of South Carolina, 1994 (Lic. No. 1850)

Professional Associations

• Lifetime Member, International Chiropractors Association (ICA)
• ICA Medicare and Insurance Relations Committee, 2015-present
• ICA Representative to CMS Medicare Education Program for Chiropractic, 2015
• Chiropractic Advisory Board Member, MedPro Group, 2017-present
• Board Member, The Council on Chiropractic Practice, 2011-2014
• Peer Reviewer, 2013
• Member of Revision and Update Workgroup, 2013
• Board Member, South Carolina Technical Advisory Radiation Control Council, 2002-2013
• Past Member, American Chiropractic Association (ACA)
• Blue Cross Blue Shield-ACA Liaison, 2002-2006
• ACA Medicare Chiropractic Carrier Advisory Committee, 2003-2006
• Past Member, South Carolina Chiropractic Association (SCCA)
• President, 2001-2002
• Insurance Committee Chairman, 2000-2004

Professional Awards and Distinctions

• President's Cup Award, SCCA, 1999-2000
• Distinguished Service Award, SCCA, 2000-2001
• Chiropractor of the Year, SCCA, 2000-2001
• Chiropractor of the Year, SCCA, 2001-2002
• Chiropractor of the Year, SCCA, 2002-2003

Professional Consulting

President and CEO, Custom ChiroSolutions, Pawleys Island, S.C.

• Custom ChiroSolutions offers chiropractors sound consulting advice on documentation requirements, coding advice, reimbursement strategy, practice management, billing procedures, Medicare compliance, treatment programs, OIG compliant marketing, and other strategic and tactical custom solutions to help them run a successful practice. The company also provides auditing and oversight services for Doctors of Chiropractic who are required to obtain professional monitoring by their State board.

Past Consultant, Health Network Solutions, Cornelius, NC

• Created provider training manual for the network.
• Provided internal auditing program for network to audit and educate providers.
• Perform provider reviews for those who were outliers in order to increase compliance with their provider contract.

Past Vice-President of Corporate Compliance Services, Compliant Services & Solutions, South Daytona, Fla.

• Developed and provided customized training for HIPAA compliance and helping our profession guard against healthcare fraud and abuse.
• Private, expert defense consulting on medical necessity and corporate compliance.
• Performed reviews of provider contracts to educate providers on their contractual obligations to their networks.

Past Director of College Development, ProSolutions for Chiropractic, Canonsburg, Penn.

• Developed and provided customized training for utilization and implementation of the ProSoft documentation system.
• Created and provided business principles classes to support the college curriculum.
• Authored several articles on documentation and the importance of implementing electronic medical records.

Past Chiropractic Consultant, Blue Cross Blue Shield of South Carolina, Columbia, SC

• Trained review nurses on documentation standards and medical necessity issues related to Chiropractic care including the use of therapeutic modalities and procedures.
• Created and implemented independent appeal reviews related to issues of medical necessity.
• Consulted on scope of practice and coding issues for Blue Cross Blue Shield of South Carolina’s Fraud Unit.

Past Chiropractic Consultant, American Specialty Health (ASH), San Diego, Calif.

• Utilization and Review Committee Member
• Credentialing Committee Member
• ASH State Committee Member, South Carolina

Past Member, Carrier Advisory Committee, Palmetto GBA, SC Medicare, Columbia, SC

• Worked directly with medical affairs coordinator and medical director to rewrite the Local Medicare Review Policy and remove language that restricted reimbursement.
• Provided input on all Local Medical Review Policies that determine coverage policy for all Medicare beneficiaries in South Carolina.
• Provided continual training for review nurses on documentation standards and medical necessity issues related to chiropractic care.
• Worked directly with medical affairs coordinator and medical director to help create internal policy for utilization and medical necessity along with proper usage of CMT codes.

Past Chiropractic Consultant, Companion Property and Casualty Insurance Company, Columbia, SC

• Provided input on medical necessity issues that determined coverage policy for chiropractic in South Carolina.
• Provided continual training for review nurses on documentation standards and medical necessity issues related to chiropractic care.
• Created and implemented pilot program on efficacy of chiropractic treatment in the worker's compensation arena.

Published Works

• The Math of MIPS, e-Book, 2017
• The Top 10 Mistakes Chiropractors Make, e-Book, 2016
• Be Alert with ICD-10, Published by Chiropractic Economics, January 2016
• ICD-10 Is Not Scary (And Not About Billing), Published by Dynamic Chiropractic, August 2015
• Insurance Compliance, a Scalable Plan for Single Physician and Small Group Practices
  • This workbook is a step by step instruction guide on how to create a compliance manual for the single physician office. It takes the guesswork out of “scalability” and helps ease the implementation of a safe system to help prevent fraud and abuse
• Over twelve articles and insurance updates published by the South Carolina Chiropractic Association
  • Articles include Use of CMT for Medicare, Medicare, and Third-Party Insurance, Use of 97140 for Blue Cross and Blue Shield of South Carolina, Massage and the State Health Plan, OIG and Free Services, and Proving Medical Necessity.
• Importance of Medical Necessity and Documentation, Published by Practice Masters Incorporated.
  • This article is a step by step instruction guide to help the doctor utilize commonly used terms and guidelines to help prove medical necessity within their notes. It takes the guesswork out of “necessity” and helps ease the implementation of outcome assessment to help reduce overutilization and abuse.
• Clinical Practice Guidelines – Subluxation Chiropractic Practice, Fourth Edition, Published by The Council on Chiropractic Practice, 2013
• Included in the National Guideline Clearinghouse
• The True “Cost” of Compliance, Published by The American Chiropractor, October 2009
• Medicare Audits Becoming More Common in Deteriorating Economy, Published by The American Chiropractor, May 2009
• The Compliant Path to Practice Wellness, Published by Chiropractic Economics, March 2008
• Q&A for the Bulletproof Practice: Important Questions You Must Ask About Your Practice, Published by Logan College of Chiropractic, Logan Speaks, Summer 2007 and Winter 2008

Educational Relationships – Past and Present

Corporate

• AlignLife
• AMPED
• ChiroPassion Consulting
• Elevation Health
• Elite Coaching
• Maximized Living
• NextLevel
• Purposeful Connections
• Educational Institutions
• Continuing Education, Logan University
• Continuing Education, Palmer College, Florida Campus
• Presenter, Palmer College of Chiropractic-Center for Business Development
• Compliance Consultant, Parker University
• Class Instructor and Continuing Education, Sherman College of Chiropractic

State Associations/Events

• American Black Chiropractic Association
• ChiroFest
• Colorado Chiropractic Association
• Connecticut Chiropractic Council
• Florida Chiropractic Association
• Florida Chiropractic Society
• Georgia Chiropractic Association
• Georgia Chiropractic Council
• International Chiropractors Association of Indiana
• Kentucky Chiropractic Society
• Louisiana Chiropractic Association
• Maryland Chiropractic Association
• Michigan Association of Chiropractors
• Minnesota Chiropractic Association
• Mississippi Chiropractic Association
• Academy of Missouri Chiropractors
• Missouri State Chiropractors Association
• New Hampshire Chiropractic Association
• New Hampshire Chiropractic Society
• Association of New Jersey Chiropractors
• New York Chiropractic Council
• Ohio State Chiropractic Association
• Oklahoma Chiropractors’ Association
• Palmer Homecoming (Davenport, West and Florida Campuses)
• Palmetto State Chiropractic Association
• Parker Seminars
• Puerto Rico Chiropractic Association
• Sherman Lyceum
• South Carolina Chiropractic Association
• Tennessee Valley Chiropractic Association
• Washington State Chiropractic Association
• West Virginia Chiropractic Society
• Wyoming Chiropractic Association