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Video

  • 13 minutes

What Causes the Initiation of a Billing Review

 

Should the commencement of the billing review be under the attorney/client privilege?

There are many sources that initiate a billing review. Some billing reviews are prompted by an internal source and others are from an external source. Billing reviews can be initiated from compliance hotline phone calls, direct reports to executives, and possible whistle-blower situations which must be handled very carefully. This video reviews the different sources that could initiate a billing review; as well as discusses attorney/client privileged reviews.

Runtime: 13 minutes
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Agenda

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Faculty

Robert A. Wade, Esq.

Robert A. Wade, Esq.

Barnes & Thornburg LLP

  • Partner in the office of Barnes & Thornburg LLP
  • Practice emphasizes all aspects of health care compliance, including developing, monitoring and documentation of an effective compliance program
  • Currently serves as the compliance expert to the Board of Commissioners of Halifax Health advising the hospital on all aspects of their corporate integrity agreement
  • Has experience in representing health care clients with respect to issues being investigated by the Department of Justice and the Office of Inspector General and negotiating and implementing Corporate Integrity Agreements
  • Assists clients in documenting and defending financial arrangements between health care providers, including referring physicians, as being fair market value and commercially reasonable
  • Has operationally practical experience having served as a general counsel and organizational integrity officer for a multihospital system for 6½ years
  • Conducts regular seminars and workshops on numerous health care law which includes the False Claims Act, Stark Law, and the Anti-Kickback Statute
  • Wrote several publications related to the areas of health care law
  • Best Lawyers In America®, health care law, 2009-2014; Indiana Super Lawyers, 2009-2015
  • J.D. degree, summa cum laude, Ohio State University, Moritz College of Law, Columbus, Ohio; B.A. degree, summa cum laude, Bowling Green State University
  • Can be contacted at 574-237-1107 or [email protected]
Carol Hoppe, CPC, CCS-P, CPC-I

Carol Hoppe, CPC, CCS-P, CPC-I

MedLucid Solutions, LLC

  • President and CEO of MedLucid Solutions, LLC
  • Provides clear solutions for medical practices
  • Assists clients with all aspects of coding, billing, and A/R management for professional health care services, including chart reviews, education, and interim management support
  • Conducts regular seminars and workshops on numerous topics, including E/M documentation guidelines, annual coding updates, and specialty specific coding sessions for clinicians and staff
  • Written several publications related to billing and A/R management
  • Certified Professional Coder (CPC) and a Certified Professional Coding Instructor (CPC-I), American Academy of Professional Coders (AAPC); Certified Coding Specialist Physician Based (CCS-P), American Health Information Management Association (AHIMA), AHIMA approved ICD-10-CM trainer
  • Taught medical billing and coding as an adjunct instructor at Sanford Brown College, Indianapolis; online adjunct instructor at Ultimate Medical Academy
  • Current member of the WPS Medicare Part B J8 Provider Outreach and Education Advisory Group (POE AG) and the AHIMA CCS-P Exam Development Committee
  • Billing and coding representative for the Indiana State Medical Association
  • B.S.M. degree, summa cum laude, Indiana Wesleyan University
  • Can be contacted at 317-537-7553, [email protected], www.medlucidsolutions.com or LinkedIn® and Facebook®
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