Compliance and Ethics in Medical Billing
( 25 Modules )

Module #1
Introduction to Compliance and Ethics in Medical Billing
Overview of the importance of compliance and ethics in medical billing, and the consequences of non-compliance.

Module #2
Understanding HIPAA and Privacy Laws
In-depth review of HIPAA regulations, privacy laws, and how they impact medical billing.

Module #3
Fraud and Abuse Laws
Examination of fraud and abuse laws, including the False Claims Act and Stark Law.

Module #4
Compliance Program Development
Guidance on developing an effective compliance program, including policies, procedures, and training.

Module #5
Coding and Billing Compliance
Best practices for accurate coding and billing, and how to avoid common compliance pitfalls.

Module #6
Claim Submission and Payment Compliance
Review of claim submission and payment processes, and how to ensure compliance with regulations.

Module #7
Medicare and Medicaid Compliance
Detailed review of Medicare and Medicaid regulations, including billing, coding, and reimbursement rules.

Module #8
Commercial Payer Compliance
Review of commercial payer regulations, including billing, coding, and reimbursement rules.

Module #9
HIPAA Security and Breach Notification
In-depth review of HIPAA security regulations, breach notification requirements, and risk management strategies.

Module #10
Compliance Officer Role and Responsibilities
Overview of the role and responsibilities of a Compliance Officer in medical billing.

Module #11
Conducting Compliance Audits and Reviews
Guidance on conducting effective compliance audits and reviews, including risk assessments and corrective actions.

Module #12
Compliance Training and Education
Best practices for compliance training and education, including employee training and awareness programs.

Module #13
Ethical Considerations in Medical Billing
Examination of ethical considerations in medical billing, including conflicts of interest and dual relationships.

Module #14
Reporting Compliance Concerns and Violations
Guidance on reporting compliance concerns and violations, including internal reporting mechanisms and whistleblower protections.

Module #15
Compliance and Ethics in Electronic Health Records (EHRs)
Review of compliance and ethics considerations in EHRs, including data integrity and confidentiality.

Module #16
RAC and ZPIC Audits
Overview of RAC and ZPIC audits, including preparation, response, and appeal strategies.

Module #17
OIG and DOJ Investigations
Guidance on responding to OIG and DOJ investigations, including subpoena responses and settlement negotiations.

Module #18
Compliance and Ethics in Medical Billing Case Studies
Real-world case studies of compliance and ethics issues in medical billing, and lessons learned.

Module #19
State-Specific Compliance Requirements
Review of state-specific compliance requirements, including licensure, certification, and accreditation regulations.

Module #20
Compliance and Ethics in Telehealth and Telemedicine
Examination of compliance and ethics considerations in telehealth and telemedicine, including HIPAA and reimbursement regulations.

Module #21
Compliance and Ethics in healthcare IT and Data Analytics
Review of compliance and ethics considerations in healthcare IT and data analytics, including data privacy and security regulations.

Module #22
Compliance and Ethics in Medical Billing Leadership
Guidance on leaderships role in promoting a culture of compliance and ethics in medical billing organizations.

Module #23
Compliance and Ethics in Medical Billing Best Practices
Review of best practices for promoting compliance and ethics in medical billing, including policies, procedures, and training.

Module #24
Compliance and Ethics in Medical Billing Resources
Overview of compliance and ethics resources available to medical billing professionals, including industry associations and government agencies.

Module #25
Course Wrap-Up & Conclusion
Planning next steps in Compliance and Ethics in Medical Billing career

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Compliance and Ethics in Medical Billing ( 25 Modules )

Compliance and Ethics in Medical Billing
( 25 Modules )