This Course experience brings total emersion in compliance issues within an interactive group setting, and produces the knowledge, strategies and momentum for measurable and lasting success.
DAY ONE: provides a general overview of a compliant physician environment beginning with the OIG recommended Compliance Program for Physicians. We define the seven compliance program elements, began the construction of a Compliance Program and explore the operational effects of a compliance program from inception through the life-cycle of a practice.
DAY TWO: focuses on the coding-billing-reimbursement aspects of a physician’s environment, or what we refer to as: “Where compliance meets the codes”. We explore incident-to regulations, teaching physician regulations and other OIG identified risk areas of audits and investigations. We also include an example of a medical record audit and reporting, study the Provider Self-Disclosure Protocol, 3rd Party Billing Company Compliance Program and the current OIG Work Plan provisions.
DAY THREE: begins a study and discussion of regulations and statutes. We examine the processes of regulatory authorities and the more prevalent laws affecting a physician’s environment. i.e. The Affordable Care Act, MACRA, OSHA, CLIA, Anti-Kickback Statute, Safe Harbors, Stark I & II, Civil Monetary Penalties Law, the False Claims Act and the BBA of 1997.
DAY FOUR/FIVE: continues the examination and discussion of regulations and statutes. We address HIPAA Privacy and Security, the current Medicare Physician Fee Schedule revisions, laboratory certifications and the Laboratory Compliance Program. The last day concludes with a review of the completed Policy and Procedure Manual.
Exam day. Three hours are allowed for the exam which consists of 100 or 115 questions.