The Federal government continues to increase its investigations and audits of the professional staff at healthcare
facilities with a focus on uncovering and prosecuting Medicare fraud. Every individual must know the rules to
help protect a facility. An accusation of fraud can have serious consequences on the institution's financial status,
patient care and reputation. To be effective, compliance education must be kept up to date and delivered at least
annually. This engaging, multimedia online course covers the rules and regulations that ALL Professional staff
must follow to minimize the risk of fraud and abuse in a facility.
- See Sample Screenshots -
Target Audience:
- Directors/Trustees
- Teaching Physicians
- Resident Physicians
- Community/Private Practice MD's
- Non-Physician Providers
- Clinical Staff
- Administrators
- Billing Staff
- Non-Billing Staff
COURSE OUTLINE
- FRAUD AWARENESS
- Common Types of Healthcare Fraud
- OIG Work Plan
- Managed Care
- The Offer
- Interactive Vignette: Potential Illegal Relationships between Physicians & Hospitals
- The Billing Dilemma
- Interactive Vignette: Duplicate Bills & Credit Balances
- HIPAA (introduction)
- CODING AND DOCUMENTATION
- Basic ICD-9
- Basic CPT
- Ambulatory Payment Classification (APC)
- Detailed Coding
- Documentation
- TEACHING PHYSICIAN RULES
- General Rules
- Documentation by Students
- Common Clinical Situations
- Special considerations for teaching physician billing)
- Surgeries and Procedures
- Teaching Setting Modifiers
- Chief Residents/Fellows
- Research Compliance Issues
- REFERRAL GUIDELINES
- Stark I & Stark II
- Stark II Final Regulations, Phase I
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