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 44+ 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 of audit radars, avoid a stressful audit and massive penalties.
That’s where attorney, Heidi Kocher, BS, MBA, JD, CHC, can help. Heidi is uniquely qualified to provide you with the practical advice you need. During her 60-minute online training session, she will give you the tools you need to avoid these dangerous missteps.
Here are just a few of the step-by-step, plain-English strategies you’ll receive by taking advantage of Heidi’s session:
- Uncover how to legally write off some balances when billing out of network
- Meet billing requirements to avoid criminal prosecution
- Pin down the difference between professional courtesy and insurance only
- Determine when and if you can really offer professional courtesy
- Identify the possible punishment and penalties for improper balance billing
- Avoid violating Stark and Kickback statutes due to balance billing
- Identify when and if it is okay to write off co-pays or deductibles
- And so much more…
Putting your head in the sand and avoiding these and other 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 have a solid understanding of 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 for this must-attend online training session today.
Heidi has 20 years of experience in health care legal and compliance related issues. Her experience includes positions at a large hospital corporation, serving as a compliance officer for a sleep lab/DME company and a compliance director, chief privacy officer and interim chief compliance officer at a medical device manufacturer.
In addition, she has represented and advised critical access and long-term care hospitals, physician groups, home health agencies, DME companies, pharmacies (including compounding pharmacies), non-profit organizations, and licensed individuals. As a result, she understands the complexities and challenges that providers large and small face in complying with increasingly varied and complex laws.
She is an expert in all aspects of compliance and privacy programs, including developing and deploying policies, procedures and training. Her experience includes implementing the various requirements and aspects of a Corporate Integrity Agreement, responding to and defending audits from Medicare, Medicaid and private insurers up through the ALJ level, guiding clients through voluntary self-disclosures, seeking advisory opinions from the OIG, and defending FDA audits.
Heidi developed criteria for and implemented an aggregate spend system, permitting a medical device manufacturer to timely report correct information under the Physician Open Payments Acts (also known as the Physician Payments Sunshine Act).
In addition, she is experienced in developing and implementing a compliance program to address Foreign Corrupt Practices Act requirements, including Eucomed guidelines. She also has significant reimbursement experience, addressing coverage policy issues, challenging denials, recoupments, and loss of billing privileges, obtaining HCPCS codes, and other reimbursement related issues.
The Webinar was very informative; Well spoken and started on time.
Very thorough and concise