Be Prepared for Increased RAC CERT and Private Payers Audits

Event Information
Product Format
Prerecorded Event
Elin Baklid-Kunz, MBA, CHC, CPC, CPMA, CCS
60 minutes
Product Description

When the auditor comes for you, don’t be caught unaware.

Are you prepared for an increased audit activity in 2013? Don’t fall prey to scrutiny. This expert audio conference will examine the latest audit issues, including the 2013 OIG Work Plan for physicians. You’ll hear about audit topics every physician’s office needs to know. Additionally, you’ll learn the latest CERT findings.

Additionally, presenter Elin Baklid-Kunz, MBA, CPC, CCS, will provide handouts, including a RAC reference tool for physicians and documentation tips for common coding issues. You’ll be grateful every ‘i’ is dotted and ‘t’ crossed before the auditor knocks on your door with a magnifying glass.

This session will help you:

  • Ensure you’re fully informed about the 2013 Compliance Update and the latest enforcements.
  • Increased Efforts to Detect Fraud & Abuse & Who is Auditing ?
  • How physicians are targeted for audits?
  • Top Physician Audit Targets & E/M Risk Areas.
  • Activity Updates on Public/Private Fraud Prevention Partnership.
  • Documentation Tips: Common Coding Issues, Instructions on How to Download Medicare’s E/M Data for Bell Curves, CMS Fact Sheet.
  • CERT Changes in Reporting Requirements.
  • How the RAC Program Works - Automated and Complex, Semi-Automated Claim Review, Data mining.
  • Medical Necessity and Utilization Management Issues.
  • RAC Medical Record Limitations For Physicians.
  • RAC Appeal Time Frames.
  • 2013 OIG Work Plan & E/M Services.
  • Incident-to Basic Requirements, Risk Areas & Error Rate for Incident-to Services Performed by Non Physicians.
  • Place of Service Coding Errors.
  • Physician Certifications on Claim Form.
  • Top Physician Audit Targets.
  • How To Turn Comprehensive Error Rate Testing (CERT) into practical advice.
  • Understand how hospital RAC issues impact physician denials. 


  • Key Auditing Bodies :  
    • Zone Program Integrity Contractors (ZPIC).
    • Medicare Strike Force.
    • OIG HEAT.
    • Comprehensive Error Rate Testing (CERT).
    • Widespread Probe Audits (i.e. Cahaba CPT 99233).
    • Recovery Audit Contractors (RACs).
    • Medicaid Integrity Contractors (MIC).
    • Stop Medicare Fraud (SMF).
  • And much more…

Who should attend?
Compliance Manager, HIPAA Officer, Chief Information Officer, Health Information Manager, Medical Office Manager, Medical Practice Lawyer, CFO, CEO, COO. Privacy Officer, Information Security Officer, Coding professionals, billing specialist, practice managers, Case Managers and Physicians

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About Our Speaker

Elin Baklid Kunz - Medical Billing Coding Expert


Kunz is a national speaker and published author on topics related to medical practice compliance, coding, reimbursement, chart audits and federal regulations. Her twenty years of healthcare experience includes six years as Director of Physician Services for a large health system, seven years in corporate finance and four years in compliance. She presents workshops for the American Academy of Professional Coders and delivers keynote presentations for Eli Research...   More Info
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