Promote Yourself: Financial Compliance

This course discusses coding and payment systems, which establish the potential revenue of the physician practice. Other topics include fee schedules and relative value systems as well as compliance and rules for teaching physicians.

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.

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.

This course discusses the regulation and accreditation of the healthcare field. It provides overviews of various legislation, such as the HMO Act of 1973, the Employee Retirement Income Security Act of 1974 (ERISA), state regulations, and the Patient Protection and Affordable Care Act (PPACA). It also discusses regulatory and crediting bodies, including the Joint Commission, URAC, and the National Committee for Quality Assurance (NCQA).