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Is your practice protected from fraud? Are you sure that you are coding properly? This guide will go into detail on the laws and penalties associated with health care fraud and abuse. It will also equip you with information on Medicare and Medicaid and proper coding techniques. Upon reading this publication, you will also be able to identify and implement an appropriate compliance plan that ensures adherence to the laws, regulations, and guidelines that control business activities in solo and small-group practices. Released: Aug. 6, 2012
Expires: Aug. 6, 2015 Target Audience:
This program has been developed for physicians in all specialties. Course Objectives
Upon completion of this course, physicians should be able to: • Explain the definition, history, laws, and penalties associated with health care fraud and abuse. • Discuss fraud and abuse detection and education efforts employed by the Medicare and Medicaid programs. • Identify and implement an appropriate compliance plan/program that ensures adherence to the laws, regulations, and guidelines that control business activities in solo and small-group practices. Sponsor Thanks to the Texas Medical Liability Trust (TMLT) for the generous support of this program.
4 AMA PRA Category 1 Credits™ (Enduring) - The Texas Medical Association is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The Texas Medical Association designates this enduring activity for a maximum of 4 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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4 ETHICS - This course has been designated for 4 credit(s) of education in medical ethics and/or professional responsibility.
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3 TMLT - Physicians who are insured with Texas Medical Liability Trust (TMLT) may earn professional liability insurance discounts by participating in approved continuing education activities. TMLT policyholders who earn 3 TMLT credits within 12 consecutive months will earn a 3-percent discount (not to exceed $1,000), which will be applied to their next eligible policy period.
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Amanda Beth Hill, JD
, Director of Patient and Provider Relations
Amanda Hill is an attorney, writer, and speaker in Austin, Texas. She advises, counsels, and works on complex issues for physicians and practices. Amanda speaks to health care companies, hospitals, and businesses about improving patient satisfaction, improved communication, physician leadership, risk management issues, and overall motivation and staff longevity. A former General Counsel and Director of Patient and Provider Relations for a large multi-specialty medical clinic in Austin, Texas, she is very familiar with compliance, peer review, and in-house legal matters. She created an extensive training program for physicians called "The Physician's Academy" that dealt with physician marketing, efficiency, reducing burn-out, and dealing with difficult patients. She is passionate about working with doctors, making sure they are well informed about legal risks and can move forward toward successful patient practices. In her free time, Amanda enjoys writing, being a mother to two small children, gardening, and volunteering in her local church.
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I will make sure the patient states the chief complaint to the medical assistant and that it is the same thing patient tells me when I walk in the room. - Jose (Pearsall, TX)
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specific information about supervision of trainees and mid-level providers, in re: how to avoid charges of fraud - Amy (Dallas, TX)
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- Rachele (Houston, TX)
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I will be careful in my coding and billing practices and make sure they are as accurate as possible. I found the info on types of reviews most interesting. No other recommendations for course improvement or other courses. - Victor (Mesquite, TX)
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- Jack (Houston, TX)
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- Malcolm (College Station, TX)
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- Michael (Dallas, TX)
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I will establish a compliance program. How to establish and maintain a compliance program was helpful. - William (Ketchikan, AK)
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Better documentation, formation of a compliance program - Sidney (Dallas, TX)
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More on what to do if audited would be helpful. Will keep working to document reason and plan for a patient's visit. - Jay (Dallas, TX)
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- Rosanna (Spartanburg, SC)
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- Gary (Georgetown, TX)
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7. Designate a compliance officer in the practice.
8. The different federal agenencies and regulatory laws.
10. More on EHR - Garry (Sugar Land, TX)
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- Jack (Tuscola, TX)
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- Shahnaz (El Paso, TX)
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Valuable information for the daily practice - Awilda (New Braunfels, TX)
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- Marwan (Garland, TX)
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