Compliance Mistakes Made By Physician Practices

Event Information
Product Format
Prerecorded Event
Kim Garner-Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO, COC
60 minutes
Product Description

Common Sense Tips for Keeping Up With Changing Regulations

Compliance guidelines and regulations for physician practices are numerous and sometimes confusing.  Most small physician practices cannot afford to employ a full-time Compliance Officer – and the person handling compliance duties is often overwhelmed with other responsibilities. If the penalty is around $10,000 for each claim/service then can you afford things to “slip through the cracks” even if they are understood?

Join us for this Session – “Compliance Mistakes Made By Physician Practices” where expert Kim Huey from drawing on the experiences of health care attorneys and compliance professionals, will review the most common compliance mistakes made by small physician practices and how to avoid making those mistakes yourself.

Session highlights:

  • Understand the 7 components of a small practice compliance program as set forth by the Office of Inspector General
  • Identify and protect your practice in the areas identified as current targets by the OIG
  • Decide when to involve the practice attorney.
  • Prepare your staff to respond to a government investigation
  • Protect your practice from a whistleblower suit
  • Knowing the Medicare exclusions, especially if there is a possible penalty of $10,000 for each claim/service
  • When is it physician's responsibility to know Medicare (federal health care) policy
  • Mandatory compliance plans, but have they been clearly communicated by CMS?
  • Seven steps to compliance: explaining OIG Compliance Program Guidance for Individual and Small Group Physician Practices
  • Understanding why practices do not audit, is it because of the lack of guidance or the attitude of thinking audit being an expense?
  • Dissecting various audit areas defined by HHS
  • Repercussions of auditing with the wrong focus, auditing in-house only, and choosing the wrong auditor
  • Clearly defining the federal false claims act
  • Have you read the back of the CMS-1500 claim form, what does it mean?
  • Medicare claims processing manual section 30.6.1
  • Determining the scope of the audit areas
  • Explaining the CERT and the RAC issue
  • Auditing for diagnosis coding, choosing the right audit sample and time frame
  • Software program used by OIG to identify statistically valid random samples
  • The specific documentations that you need to look at when under an audit
  • Examples, references and much more...

Who should attend? Physicians and physician practice managers, billing supervisors, compliance managers.

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About Our Speaker

Kim Garner Huey - Health Care Management Expert

Kim Garner-Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO, COC, is an independent coding and reimbursement consultant, providing audit, training and oversight of coding and reimbursement functions for physicians.

Kim completed three years of pre-medical education at the University of Alabama before she decided that she preferred the business side of medicine. She completed a bachelor’s degree in health care management and went on to...   More Info
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