Legally, your billing is no longer as simple as sending out an invoice and getting paid for your services. Even simple, honest mistakes in your billing can lead to massive financial penalties. You could even be required to repay reimbursements you’ve previously received, or end up in jail (really). And if you think it can’t happen to you, think again…
Billing laws and regulations continue to be more complicated each year. For example: Did you know that there are currently 47 states that have laws requiring you to seek payment from health plans you contract with and not from their patients? Or that if you are out-of-network you can still be held liable if you don’t comply? What makes it worse is that CMS and private payer auditors are actively watching and waiting for you to slip up.
But, with a little help, you can take action to stay off audit radars, avoid a stressful audit and massive penalties.
That’s where attorney and coder, David Vaughn, CPC, JD, can help. As both a Certified Professional Coder® and a healthcare attorney, David is uniquely qualified to provide you with the practical advice you need. He presented a 60-minute online training session, Avoid Billing Legal Nightmares, that will give you the tools you need to avoid these dangerous missteps.
David is one of a limited number of healthcare attorneys in the United States who is also a Certified Professional Coder®, certified by the American Academy of Professional Coders® (AAPC®). David has served on the Legal Advisory Board of the AAPC and has written several coding and compliance books and manuals. He is also a national speaker on the legal implications of billing and coding. He also has a national healthcare law practice, and has represented over 2,000 physicians in approximately 40 states in over 10 physician disciplines.
Here are just a few of the step-by-step, plain-English strategies you’ll receive by viewing David’s session:
- Requirements to avoid criminal prosecution
- The difference between professional courtesy and insurance only
- When you can offer professional courtesy
- When you can offer write off co-pays or deductibles
- Identify the possible punishment and penalties for improper balance billing
- How the Stark and Kickback statutes are implicated in balance billing
- How to legally write off some balances when billing out of network
- And so much more…
Putting your head in the sand and avoiding these complex legal billing issues is not an option. There are actual cases where physician practices tried to do everything right and still got into trouble. For example, a CA physician got 5 days in Jail and a $562,500 fine, another practice was required to repay $4.3 million after being sued by an insurance carrier for balanced billing, and a pulmonology practice paid $10K in fines and had to repay $2.5 million in collected funds.
Don’t let this happen to you. Professional courtesy, insurance only, out-of-network write-offs, and balance billing can turn into very real legal nightmares and can happen to just about anyone, unless you take action now.
It’s essential that you really understand how to correctly maneuver through the legal pitfalls of billing for your services, or you could end up like the physicians in the cases above. Don’t take a chance, sign up today.
David is one of a limited number of healthcare attorneys in the United States who is also a Certified Professional Coder®, certified by the American Academy of Professional Coders® (“AAPC®”).
David has served on the Legal Advisory Board of the AAPC and has written several coding and compliance books and manuals. He is also a national speaker on the legal implications of billing and coding. He also has a national healthcare law practice, and has represented over 2,000 physicians in approximately 40 states in over 10 physician disciplines. His practice consists of representing providers in federal and state prosecutions, qui tam cases, and Medicare and third-party payer audits. He also conducts audits and provides education to providers.
He graduated from Mississippi College with Special Distinction (Magna Cum Laude) in 1974, graduated from LSU Law School in 1977, and has been a certified coder since 1999.
The webinar was presented well. It is a perfect webinar for new managers or new staff in a medical office.
Sandy Hill
Reimbursement Cycle Administrator, Muskegon Family Care
The webinar was very informative and gave real cases to help understand the situation.
Jenna Jepson
Coder, Desert Bloom Family Medicine
Spoke very clearly and easy to understand.
Diana Gibbons
Financial Services, Midwest Orthopaedic Consultants
Overall great content! So much fraudulent billing goes on with dental claims (most dentists opt out of Medicare).
Kathy Forbes
Owner, Professional Dental Seminars, Inc.
Loved the speaker and the material was easy to follow. This was my best one yet!
Patti Winch
Billing Specialist, Interventional Spine and Sports Medicine
