Compliance Officer Training includes the following: 

• OIG Compliance Guidance for Individual and Small Group Practices, Hospitals and Third Party Billing Companies. Additionally, OIG Compliance Guidance for Hospitals and General Compliance Guidance will be addressed. 

• Discussion of the importance of written policy and procedures. 

• Healthcare Risk Areas such as: medical record documentation, conflict of interest, medical necessity, Advance Beneficiary Notice, overpayments, billing of non-covered services, joint ventures, gain-sharing arrangements, discounts / professional courtesy, rental of office space, Corporate Integrity Agreements, The Joint Commission, mail and wire fraud, exclusions program, Federal Sentencing Guidelines, and unlawful advertising

• Discuss the Corporate Compliance Program

• Laws and Regulations including: Fraud and Abuse, Stark Law, Physician self-referral law, HIPAA, False Claims Act, EMTALA, Anti-kickback Statute, Mail and wire fraud, RICO, OHSA, CLIA, Civil Monetary Penalties, Guidelines for Teaching Physicians, Gifts and gratuities, and the Self Disclosure Protocols

• HIPPA: The Privacy Rule, The Security Rule, Breach Notification guidance, The Enforcement Rule, Covered Entities and Business Associates, and Special HIPAA Topics

• OSHA: Hazard Communication, Personal Protective Equipment (PPE), Respiratory Protection for Healthcare, Bloodborne pathogens, Safety and Health Programs, Workplace Violence, and Record Keeping. 

• Human Resource Risk: Compliant job descriptions, Interview questions, Data Security, U.S. Eligibility to Work, EEOC, U.S. Department of Labor, FMLA, and Federal Record Retention Requirements

• Reimbursement, Billing, and Risk Mitigation: The No Surprises Act, Internal Auditing Process, Claims Denials, Payer Contracts, and Utilizing Technology

• Internal Investigations and Audits: Discuss the benefits, creating an internal audit, how to conduct the audit, organizing the data and reporting the findings.

• Creating a compliance plan including: standards and procedures, compliance oversight structure, education and training, communications, monitoring and auditing, disciplinary action, and responding to detected offenses

• How to perform an audit for coding, billing, reimbursement, compliance, etc.