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Not All Compliance Activities are Created Equal: Focus Your Review Process for Maximum Benefit

Not All Compliance Activities are Created Equal: Focus Your Review Process for Maximum Benefit


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Medical practices know they need an effective internal compliance review, but too often select a one size fits all policy, reviewing the same services for all clinicians, year after year. This wastes resources and distracts the practice from identifying errors and fixing them. This recorded webinar, which teams coding auditor Betsy Nicoletti with well-known healthcare attorney, David Glaser, will recommend to you an optimal internal review process that starts with reviewing data to identify which services to review. The webinar will also cover the key three risk areas that CMS and the OIG have identified. The webinar also provides specific actions if a refund is needed and they will recommend language for the accompanying letter.

Invest just 90-minutes to hear this expert team discuss what to do when you find documentation or coding issues and realize you need to make a refund. Medical practices struggle with how to calculate a refund, how to select a sample and how far they need to look back when an error is found. The Affordable Care Act mandated that refunds must be returned within 60 days of discovering them: when does the clock start ticking? The webinar will discuss how to handle co-pays and deductibles related to overpayments, and as a bonus, what to do about private payers.

Learning objectives:

  • Prioritize and select review activities based on analyzing practice data
  • Describe three areas of interest identified by the OIG or CMS
  • Assess current compliance plan activities
  • Identify internal risk
  • Develop a plan if a refund is needed

Meet Our Expert Speakers:

David GlaserDavid M. Glaser, is a shareholder in Fredrikson & Byron's Health Law Group. David assists clinics, hospitals, and other health care entities negotiate the maze of health care regulations, providing advice about risk management, reimbursement, and business planning issues. He has considerable experience in health care regulation and litigation, including compliance, criminal and civil fraud investigations, and reimbursement disputes. David's goal is to explain the government's enforcement position, and to analyze whether this position is supported by the law or represents government overreaching.

 

Justin ChambleeBetsy Nicoletti is the co-founder of Codapedia.com, a free website devoted to physician reimbursement. She is also the author of The Field Guide to Physician Coding 2nd Edition and Auditing Physician Services. She developed The Accurate Coding System™ to help doctors get paid for the work they do. As a certified coder, Betsy simplifies complex coding rules for practitioners and engages physicians in a positive and respectful way, which encourages attention and accuracy in their coding. Besides doing auditing and compliance work, she is a speaker, writer and consultant in coding education, billing and accounts receivable management.