Fraud Compliance Part 1

Course overview

As a result of this presentation the participant will be able to... Module 1 Objectives: 1. Ensure proper documentation of services and the prevention, prompt detection, and appropriate corrective action to detect, address, and prevent fraud, waste, and abuse. 2. Identify the components of the Fraud Compliance Program. 3. State the role of the compliance officer and compliance committee. Module 2 Objectives: 1. Articulate the principles of the compliance reporting system 2. Handle external communication requests Module 3 Objectives: 1. Discuss key points of federal compliance related laws 2. Adhere to medical record retention requirements 3. Identify three principal federal antitrust statutes Module 4 Objectives: 1. Identify Company core compliance values 2. State the purpose of the Company Code of Conduct 3. Report a conflict of interest Module 5 Objectives: 1. Discuss harassment and discrimination occurring in the workplace 2. Identify the Company communication system for reporting workplace harassment and discrimination Module 6 Objectives: 1. Distinguish the requirements for Violence Prevention in the Workplace Program including: -The Committee -The Officer -The Plan -The Risk Assessment -The Training Program 2. Identify the procedures related to reporting, recording, and responding to incidents of workplace violence 3. Comply with the Company enforcement policy Module 7 Objectives: 1. Discuss how the Company demonstrates compliance through auditing and monitoring medical and financial records 2. Identify the Company system for responding to compliance issues 3. Describe the steps to be taken for any report or activity giving rise to an investigation Module 8 Objectives: 1. Identify elements of Company corrective action planning 2. Discuss the role of the compliance committee in development of a corrective action plan