Protecting sensitive information has become a significant challenge. Privacy breaches and data security incidents are in the news cycle too often. Compliance with HIPAA is critical and failure to protect patient data results in fines and sometimes, legal consequences, not to mention the impact on business operations and your professional reputation. Billing and coding errors can lead to fraudulent billing, leaving the practice vulnerable to monetary penalties, payer audits, and potentially, to criminal charges under the False Claims Act. Detecting and preventing fraud and abuse requires effective internal controls, a comprehensive compliance program, and routine self-audits.
Employment contracts or physician service agreements must comply with applicable laws and regulations to avoid potential violations related to fair market value compensation or improper inducements for referrals. Non-compliance with the Anti-Kickback statute or Stark law can result in penalties plus exclusion from federal reimbursement programs.
Healthcare providers and practice leaders must be proactive in protecting the organization. It can be challenging to keep up with ever-changing state and federal standards and guidelines. However, lack of knowledge is not a valid defense when facing a non-compliance charge. Identifying risk areas and proactively addressing them will help you cultivate a culture of compliance that minimizes the risks of non-compliance and preserves quality of care and ethical business conduct in your healthcare practice.
Highlights
- OIG General Compliance Program Guidance
- Mobile Device security
- How to properly dispose of PHI and ePHI
- Coding and documentation accuracy
- What to do when an auditor contacts your office
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Jan Hailey
MHL, CMC, CMCO, CMIS, CMOM, CMCA E/M
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Jan Hailey has more than 30 years of experience in healthcare. She is proficient in administration, coding, and billing roles, and teaches medical office professionals around the country how to excel in their careers. Jan has also been instrumental in the development of PMI's Workforce Initiatives program.
Jan's affinity for teaching has helped countless healthcare providers and medical office professionals over the years. During her expansive career, she has served as Director of Quality for Saint Joseph Physician Network located in Mishawaka, IN, and Director of Care Management with Select Health Network, an entity of Saint Joseph Health System. As Care Management Director, Jan led the physician network and comprehensive interdisciplinary team across the health system working closely with providers, management, staff, community, and payers to develop strategies for process improvement, gap closures, and patient experience. She developed a documentation improvement program and a Hierarchical Condition Category (HCC) coding education program to predict future healthcare utilization by accurately reporting patient complexity.
Prior to joining Saint Joseph, Jan was the Director of Quality, Coding, and Compliance for one of the largest health systems in Northern Indiana. She has a Master of Health Leadership and four professional certifications in office management, coding, insurance processing, and compliance. She is a member of WPS Government Health Administrators (Medicare) Provider Outreach and Advisory Group.
Participants will learn how to implement effective compliance strategies to guide their healthcare practice team in the proper direction.
No prerequisites required.
Self-paced online program includes unlimited review of previously recorded instruction and the downloadable PowerPoint handout for 6 months.
Comments from past participants:
"It was a comprehensive overview - very informative!"
"I found it to be informative, especially about changes that will be coming."
"It is useful information with good details."
Prod ID: 490
