Compl: Billing Risks
This course covers a set of four compliance risk areas identified by the Office of Inspector General (OIG) that healthcare providers need to be aware of before they submit healthcare claims to federal agencies for approval. The course also discusses the nature of these risks and the potential sanctions and consequences for healthcare providers if they take these risks while submitting claims to federal agencies.
Compl: Compliance and HIPAA Regulations
This course addresses the rise of corporate compliance programs in healthcare organizations, including their complexity and importance. It reviews the components of corporate compliance programs and the role of a compliance officer to know the statutes and regulations that govern all federal programs, and to operate within them. You'll know more about the Health Insurance Portability and Accountability Act (HIPAA), including electronic transaction code sets, and privacy and security components.
Compl: Fraudulent Acts and Other Compliance Risks
This course defines fraud and abuse as it relates to Medicare and Medicaid. It explains the components of an effective compliance program and describes violations of False Claims regulations and associated penalties. This course explains the key provisions of the Health Insurance Portability and Accountability Act (HIPAA). It explains how a healthcare organization qualifies for tax-exempt status and how such an organization may generate unrelated business income that may be taxable.
Compl: The Outpatient Prospective Payment System
This course provides a general discussion and overview of reimbursement provided by Medicare under the outpatient prospective payment system. It also discusses the use of ambulatory payment classifications in the outpatient prospective payment system. The course can be used as a basis for understanding compliance issues relating to the OPPS.