Risk 131 - 133

Course overview

Hour 1 Utilize proper compliant documentation Evaluate federal guidelines regarding discounting and or hardship Apply guidelines to ensure accuracy for both active and maintenance treatment Hour 2 Analyze charges and documentation on a daily or per visit basis to ensure accuracy and compliance Compile accurate and comprehensive responses to documentation or record requests Recognize and avoid confusing HIPAA privacy issues that can cost you time and money Identify key areas that lack written policies causing increased risk in the practice Evaluate your current written procedures and appraise the need for additional content Hour 3 Identify various types of billing irregularities and impact on healthcare expenditures. Distinguish upcoding from bundling within the context of irregular billing schemes. Demonstrate how and when exceeding a states scope of practice becomes the unauthorized practice of medicine. Explain the restrictions states scopes of practice place on healthcare providers authority to treat and diagnose patients. Discuss how invoicing unrendered medical services impacts third party payers. Interpret chiropractic boards positions on testimonial advertising and how best to comply. Hour 4 Identify what constitute a false claim under the False Claims Act. Discriminate a kickback from a self-referral. Trace how antikickback legislation arose and examine its prohibitions. Explain the enactment of Stark legislation arising on the heels of antikickback bans. Assess providing nutritional counsel within the context of the practice of medicine. Evaluate identity theft and its impact on patients providers and the cost of healthcare. Discriminate between illegal copayment waivers from proper hardship waivers. Discuss court cases instancing successful prosecution of healthcare fraud.