Biller And Coder Agreements: Critical Terms And Issues

Event Information
Product Format
Prerecorded Event
60 Minutes
Product Description

Basic Contract Terms And Conditions Summarized

With increased auditing and fraud, agency scrutiny of practice billings, billers and coders as well as health professionals are in the sights of regulators. So, practices and their billing and coding staff need to clearly articulate in their agreement what is expected of each party, and in particular, the overall responsibility retained by the clinic as to payers. At the same time, physicians and health care facilities increasingly rely on the expertise of billing and coding professionals and expect that they will be accurate and up-to-date in their knowledge of billing and coding rules.

It is imperative to both the professional or facility and the biller and coder to negotiate a detailed agreement. The contract should not only address the day-to-day issues like the services rendered and compensation, but also include, for example, how liability is allocated, when each party is indemnified and obligations of each party post-termination. Biller and coder contracts also need to be in compliance with applicable federal and state health care regulatory requirements, including HIPAA and applicable Medicare requirements.

Highlights of the session:

  • Biller and coder standards to be specified in the contract   
  • Basic contract terms and conditions summarized
  • Allocating errors between the biller/coder and health care provider
  • Specific terms in a HIPAA-compliant biller/coder business associate agreement
  • Addressing insurance, indemnity and third party liability
  • Critical post-termination provisions
  • PPACA, other law impacting contracts
  • Due diligence items
  • Goal- MD vs. biller/coder
  • Duties of biller/coder
  • Impact of other laws, guidance
  • Specific standard examples
  • Potential biller/coder liabilities and their allocation
  • Duty provisions: Issues
  • Payment: payment terms and related matters
  • Insurance provisions liabilities, indemnity clauses

Who should attend: Medical 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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