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Live Webinar

90-minute live streaming program
  • September 16
  • 1:00 - 2:30 pm EST

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Medical Record Audits: The Must Know About Commercial and Government Provider Reviews and Repayments

September 16

Gain an understanding of what is needed to stay compliant with medical record audits.

Many physicians and other health care providers do not fully understand the implications and consequences of a payor audit, particularly when the payor is the federal government. Appropriate documentation is required to avoid recoupment and fines when payers audit medical records. What should you do when you discover a significant billing error or a coder complains about a provider’s billing patterns? This topic helps health care organizations, providers, and billers understand the trends in payer audits on professional services, including the latest CMS probe and educate reviews. Learn what’s important in the documentation and what to do to prevent an unfavorable audit and discover how to utilize your health care attorney and independent reviewers to strengthen your compliance program and deal with overpayment issues.

Learning Objectives

  • You will be able to discuss areas where you may potentially have a compliance risk.
  • You will be able to describe the need for routine and independent chart reviews.
  • You will be able to explain what you can do to minimize risks.
  • You will be able to identify how you can address overpayment issues.

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Why Lorman?

Over 32 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Agenda

What Causes the Initiation of a Billing Review (Internal vs. External)?

Should the Commencement of the Billing Review Be Under the Attorney-Client Privilege?

Utilizing Internal vs. External Reviewers to Perform the Billing Review

Conducting the Review Based Upon Operational Oversight vs. Attorney Oversight

Differences Between Medicare/Medicaid and Third-Party Payers

Repayment Based Upon Reprocessing of Claims vs. the Requirements for Self-Reporting to Applicable Payers

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Why Lorman?

Over 32 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Credits

OnDemand Webinar

This course was last revised on March 28, 2019.

Call 1-866-352-9540 for further credit information.

  • AHIMA 1.5 including Clinical Data Management 1.5
     
  • This program has been approved for 1.5 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.
     

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

Live Webinar Registration

  • AAPC 1.5
     
  • This program has prior approval of AAPC for 1.5 Core A continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.
     
  • ACHE 1.5
     
  • The American College of Healthcare Executives no longer pre-approves courses or organizations. Participants in this program wishing to have the continuing education hours applied toward ACHE Qualified Education credit should indicate their attendance when submitting an application to the American College of Healthcare Executives for advancement or recertification. ACHE Qualified Education credit must be related to healthcare management (i.e., it cannot be clinical, inspirational, or specific to the sponsoring organization). It can be earned through educational programs conducted or sponsored by any organization qualified to provide educational programming in healthcare management. Programs may be sponsored by ACHE, chapters or other qualified sources, whether the programming is face-to-face or distance offerings (webinars, online seminars, self-study courses, etc.).
     
  • AHIMA 1.5 including Clinical Data Management 1.5
     
  • This program has been approved for 1.5 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.
     
  • AL CLE 1.5
     
  • This course or a portion thereof has been approved by the Alabama State Mandatory Continuing Legal Education Commission for a maximum of 1.5 hours credit.
     
  • AR CLE 1.5
     
  • This course has been approved for 1.5 hours of CLE by the Arkansas CLE Board.
     
  • Arizona CLE 1.5
     
  • The State Bar of Arizona does not approve or accredit CLE activities for the Mandatory Continuing Legal Education requirement. This activity may qualify for up to 1.5 hours toward your annual CLE requirement for the State Bar of Arizona.
     
  • CA MCLE 1.5
     
  • Lorman Business Center, Inc. is a State Bar of California approved MCLE sponsor and this course qualifies for 1.5 CLE hours of participatory credit.
     
  • CT CLE 1.5
     
  • Neither the Connecticut Judicial Branch nor the Commission on Minimum Continuing Legal Education approve or accredit CLE providers or activities. This course has been approved for CLE credit in jurisdictions aside from CT and therefore it automatically meets the content and delivery requirements in Connecticut. Credit is based on a 60 minute credit hour and shall be awarded as follows: 1.5 CLE credit(s).
     
  • GA CLE 1.5
     
  • This program has been approved by the Georgia Commission on Continuing Lawyer Competency for 1.5 CLE hours.
     
  • HI CLE 1.5
     
  • This program was approved by the Hawaii State Board of Continuing Legal Education for 1.5 CLE credit hours.
     
  • IL CLE 1.5
     
  • This course was approved for a total of 1.5 hours of MCLE Credit by the Illinois MCLE Board.
     
  • ME CLE 1.5
     
  • This course has been approved by the State of Maine Board of Overseers of the Bar. Lawyers who complete this course shall receive 1.5 hours of CLE credit under M. Bar R. 12.
     
  • MS CLE 1.5
     
  • This program has been approved by the Mississippi Commission on Continuing Legal Education for a maximum of 1.5 credit hours.
     
  • NH MCLE 1.5
     
  • NH MCLE does not approve or accredit CLE activities for the NH Minimum CLE requirement. Lorman Education Services believes this course meets the requirement of NH Supreme Court Rule 53 and may qualify for CLE credit(s). Program Length: 90 Minutes.
     
  • NJ CLE 1.8
     
  • This program has been approved by the Board on Continuing Legal Education of the Supreme Court of New Jersey for 1.8 hours of total CLE credit.
     
  • NV CLE 1.5
     
  • This program has been approved by the Nevada Board of Continuing Legal Education for 1.5 CLE hours.
     
  • PA CLE 1.5
     
  • This Distance Learning program has been approved by the Pennsylvania Continuing Legal Education Board for 1.5 hours of substantive law, practice and procedure CLE credit.
     
  • RI CLE 1.5
     
  • This program has been approved by the Rhode Island Mandatory Continuing Legal Education Commission for 1.5 hours of CLE credit.
     
  • TN CLE 1.5
     
  • This program has been approved as a distance learning format by the Tennessee Commission on Continuing Legal Education for a maximum of 1.5 hours of credit.
     
  • VT CLE 1.5
     
  • This program has been approved by the Mandatory Continuing Legal Education Board of Vermont for 1.5 hours of CLE credit.
     
  • WA CLE 1.5
     
  • This program has been approved by the Washington State Board of Continuing Legal Education for 1.5 hours of Law & Legal Procedure credit.
     
  • WI CLE 1.5
     
  • This program has been approved by the Board of Bar Examiners for 1.5 hours for use toward the Wisconsin Mandatory CLE requirement.
     
  • WV MCLE 1.8
     
  • This program has been approved by the West Virginia State Bar MCLE Commission for 1.8 MCLE hours.
     
  • HFMA 1.5
     
  • This course is approved by HFMA for certification maintenance of continuous educational points and will equal 1.5 points of classroom instruction.
     

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

Audio & Reference Manual

  • Arizona CLE 1.5
     
  • CA MCLE 1.5
     
  • CT CLE 1.5
     
  • GA CLE 1.5
     
  • HI CLE 1.5
     
  • IL CLE 1.5
     
  • ME CLE 1.5
     
  • MT CLE 1.5
     
  • NJ CLE 1.8
     
  • NV CLE 1.5
     
  • VT CLE 1.5
     
  • WA CLE 1.5
     
  • WV MCLE 1.8
     
The CLE Code is ONLY a requirement when applying for CLE Credit in California (for participatory credit), Kansas, New Jersey or New York. Other states do not need to supply the CLE Code to apply for CLE credit.

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

MP3 Download

  • Arizona CLE 1.5
     
  • CA MCLE 1.5
     
  • CT CLE 1.5
     
  • HI CLE 1.5
     
  • IL CLE 1.5
     
  • ME CLE 1.5
     
  • MT CLE 1.5
     
  • NJ CLE 1.8
     
  • NV CLE 1.5
     
  • VT CLE 1.5
     
  • WA CLE 1.5
     
  • WV MCLE 1.8
     
The CLE Code is ONLY a requirement when applying for CLE Credit in California (for participatory credit), Kansas, New Jersey or New York. Other states do not need to supply the CLE Code to apply for CLE credit.

This program does NOT qualify, nor meet the National Standard for NASBA accreditation.

Who should attend?

This live webinar is designed for medical records directors, health information directors, coders, business managers, office managers, nurses, hospital administrators, billing managers, social workers, counselors, release of records professionals, compliance managers and attorneys.

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Why Lorman?

Over 32 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Faculty

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®
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]
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Why Lorman?

Over 32 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

All of your training, right here at Lorman.

Pay once and get a full year of unlimited training in any format, any time!

  • Live Webinars
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  • State Specific Credit Tracker
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Questions? Call 877-296-2169 to speak with a real person.

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Product ID: 406182
Published 2019
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