Biller and Coder Malpractice Liability: When Things Go Bad

Event Information
Product Format
Prerecorded Event
60 Minutes
Product Description

Find Out Legal Standards That Apply When Judging Biller or Coder Malpractice

With the ever increasing chance of  a practice or facility getting  audited, it is inevitable that the billing and coding of claims will come under scrutiny. In situations, where payment is recouped or fraudulent coding or billing practices are alleged, providers may allege that billers or coders are in part or in whole responsible. It is often difficult to determine whether providers, billers or both should be held liable in a particular case. Factors to consider include applicable law and standards, contract terms and the facts in the particular case. Likewise, if a biller or coder is fully performing their duties in accordance with accepted standards, there may be less cause for responsibility.  Insurance policies (with Biller and coder malpractice) will also dictate the extent of coverage and coverage limits and exclusions. Providers may be surprised to learn, however, such coverage may not fully reimburse lost payments.

In this audio session, Wayne J. Miller - Esq. will discuss the following topics:

  • What should and should not be the biller’s responsibility?
  • When should a provider not be liable for a bad code decision?
  • Legal standards that apply when judging biller or coder malpractice
  • Biller contract provisions that may dictate who’s responsible
  • Will insurance cover a coding error, and what can the provider recover?
  • Best practices for minimizing liability claims

Who should attend : Billers, Coders, Practice Managers, Physicians, Medical Groups, And Health Care Facilities

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About Our Speaker

Wayne J. Miller - Healthcare Compliance Expert

Wayne J. Miller, Esq., is a founding partner of the Compliance Law Group, Los Angeles, a law firm focused on health care industry legal compliance for clients nationwide. Wayne has practiced healthcare business and regulatory law throughout his 30-year career. His firm represents a wide range of healthcare industry clients throughout the nation. He is a frequent speaker for The Coding Institute national teleconferences on healthcare reimbursement, transactional and regulatory...   More Info
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