November 2022

Fulcrum's Symposium and Awards Celebration was held in Bloomington, MN on October 27, 2022!

A special thank you to the wonderful presenters at the symposium.

´╗┐Attendees enjoyed hearing the history of pain psychology and implications and applications for practice, the providers role to prevent needless work disability, expanding patient solutions through team-based care, and the latest in surgical interventions for knees and hips.

The ChiroCare Centers of Excellence enjoyed an appreciation breakfast with speaker, Dr. Cowl, from Mayo Clinic.

Speaker presentations will be available in Mid-December, please visit Fulcrum Health - Media Room and Partners in Distinction award winners to be featured in December newsflash.

Questions about Continuing Education Credits?

Fulcrum Health Symposium continuing education credits are provided through Northwestern Health Sciences University. Transcripts for the continuing education credits related to Fulcrum's symposium will be emailed to participants by mid-January.

The emailed transcripts will come from This same email address can be used if you have any questions about the continuing education credits.

Clinical Corner

Therapeutic Effect of Services

Service Utilization:

Passive therapeutic modalities should only be considered when necessary to prepare the patient for activity and are most appropriate during the first few weeks of acute care.

Passive modalities are NOT clinically appropriate and/or necessary in the management of musculoskeletal conditions when:

  • Greater than one passive modality with a similar/redundant therapeutic effect is used involving the same body region(s).
  • Risks outweigh patient safety by the application of the modality.
  • The modality can be safely self-administered.
  • Continued use beyond the acute phase.
  • Used largely for the comfort and convenience of the patient, or as part of the routine office protocol.


Questions to consider:

  • Does my documentation support the necessity to use a CMT, traction, US, and EMS to the same body region on the same visit?
  • Does my documentation support the necessity to use ANY passive modalities beyond the acute phase of care?


Documentation and coding tips:

  1. Choose the treatment goal: Pain Reduction, Activity Improvement, Increased Stability, etc.
  2. Choose the physiological effect: Increased joint function, increased soft-tissue mobility, etc.
  3. Choose the intervention: CMT, Modality/Procedure, Exercise, etc.
  4. Reassess: Was the intervention successful in achieving the desired physiological effect?
  5. Reinforce with exercise and home care.
  6. Include time for timed therapies
  7. Clearly document which joint is being treated and this consistent with the diagnosis, examination, and patient presentation

Annual Provider Letter

Each December, Fulcrum sends out an Annual Provider Letter to the network, informing providers about upcoming changes, important deadlines, and new available resources, etc. Please watch for this letter in your USPS mail within the next week! 

This letter is also available to you digitally on the home page of Fulcrum's Provider Portal.


If you have any questions about the material included in the letter, please contact

Accepting 2023 ChiroCare Centers of Excellence Applications!

We are now accepting applications from ChiroCare network providers who believe their clinics meet the Centers of Excellence criteria. The application period closes March 1, 2023.

Fulcrum is excited to announce that the CCoE Self-Assessment, Application, and Attestation can now be completed online for administrative ease. Please log into, go to Learning Hub tab and then the CCoE tab to access the necessary documents to apply.


Current CCoE's do not need to re-apply. Verification review of records begins February 2023.


We encourage you to take a close look at the CCoE program overview. The self-assessment tool will assist with determining your readiness to apply.

If you have any questions about the ChiroCare Centers of Excellence program, please contact Dr. Vivi-Ann Fischer

We appreciate your continued partnership!