Gain an understanding of what is needed to stay compliant with medical record audits.
Many physicians and other health care providers do not fully understand the implications and consequences of a payor audit, particularly when the payor is the federal government. Appropriate documentation is required to avoid recoupment and fines when payers audit medical records. What should you do when you discover a significant billing error or a coder complains about a provider's billing patterns? This topic helps health care organizations, providers, and billers understand the trends in payer audits on professional services, including the latest CMS probe and educate reviews. Learn what's important in the documentation and what to do to prevent an unfavorable audit and discover how to utilize your health care attorney and independent reviewers to strengthen your compliance program and deal with overpayment issues.
Add to Wishlist
More Program Information
Why Lorman?
Over 37 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.
Agenda
What Causes the Initiation of a Billing Review (Internal vs. External)?
Should the Commencement of the Billing Review Be Under the Attorney-Client Privilege?
Utilizing Internal vs. External Reviewers to Perform the Billing Review
Conducting the Review Based Upon Operational Oversight vs. Attorney Oversight
Differences Between Medicare/Medicaid and Third-Party Payers
Repayment Based Upon Reprocessing of Claims vs. the Requirements for Self-Reporting to Applicable Payers
Add to Wishlist
More Program Information
Why Lorman?
Over 37 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.
Credits
OnDemand Course
This course was last revised on September 16, 2019.
Call 1-866-352-9540 for further credit information.
No Credit AvailableThis program does NOT qualify, nor meet the National Standard for NASBA accreditation.
Add to Wishlist
More Program Information
Why Lorman?
Over 37 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.
Faculty
Carol Hoppe, CPC, CCS-P, CPC-I
MedLucid Solutions, LLC
- President and CEO of MedLucid Solutions, LLC, providing clear solutions for medical practices
- Assists clients with all aspects of coding, billing, A/R and practice management for professional health care services, including chart reviews, education, practice assessments, practitioner shadowing, and interim management support
- Conducts regular seminars and workshops on numerous topics, including E/M documentation guidelines, annual coding updates, and specialty specific coding sessions for clinicians and staff
- Certified Professional Coder (CPC) and a Certified Professional Coding Instructor (CPC-I), American Academy of Professional Coders (AAPC); Certified Coding Specialist Physician Based (CCS-P), and American Health Information Management Association (AHIMA)
- Taught medical billing and coding as an adjunct instructor at Sanford Brown College, Indianapolis; online adjunct instructor at Ultimate Medical Academy
- Published author on articles related to billing, coding and A/R management
- Current member of the WPS Medicare Part B J8 Provider Outreach and Education Advisory Group (POE AG)
- Billing, coding and practice management representative for the Indiana State Medical Association
- B.S.M. degree, summa cum laude, Indiana Wesleyan University
- Can be contacted at 317-537-7553, [email protected], www.medlucidsolutions.com or on LinkedIn® and Facebook®
Robert A. Wade, Esq.
Barnes & Thornburg LLP
- Partner in the office of Barnes & Thornburg LLP
- Practice emphasizes all aspects of health care compliance, including developing, monitoring, and documentation of an effective compliance program
- Served as the compliance expert to the Board of Commissioners of Halifax Health, advising the hospital on all aspects of their corporate integrity agreement
- Has experience in representing health care clients with respect to issues being investigated by the Department of Justice and the Office of Inspector General and negotiating and implementing Corporate Integrity Agreements
- Assists clients in documenting and defending financial arrangements between health care providers, including referring physicians, as being fair market value and commercially reasonable
- Has operationally practical experience, having served as a general counsel and organizational integrity officer for a multihospital system for 6 1/2 years
- Host of Stark Integrity: The Stark Law and Compliance Podcast
- Conducts regular seminars and workshops on numerous health care laws, which includes the False Claims Act, Stark Law, and the Anti-Kickback Statute
- Wrote several publications related to the areas of health care law
- Best Lawyers In America®, health care law, 2009-2014; Indiana Super Lawyers, 2009-2015
- J.D. degree, summa cum laude, Ohio State University, Moritz College of Law, Columbus, Ohio; B.A. degree, summa cum laude, Bowling Green State University
- Can be contacted at 574-237-1107 or [email protected]
Add to Wishlist
More Program Information
Why Lorman?
Over 37 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.
All of your training, right here at Lorman.
Pay once and get a full year of unlimited training in any format, any time!
- OnDemand Courses
- Live Webinars
- MP3 Downloads
- Course Manuals
- Executive Reports
- White Papers and Articles
Additional benefits include:
- State Specific Credit Tracker
- All-Access Pass Course Concierge
Questions? Call 877-296-2169 to speak with a real person.
Access to all training products for one year
$699/year
Unlimited Lorman Training
With the All-Access Pass there is no guessing what you will need for your yearly training budget. $699 will cover all of your training needs for an entire year!
Easy Registrations
Once you purchase your All-Access Pass you will never be any further than one-click away from attending any Lorman training course.
Invest in Yourself
You haven't gotten to where you are professionally by luck alone; it's taken a lot of hard work and training. Invest in yourself with the All-Access Pass.
