Routinely writing-off co-pays will land you in hot water with the OIG. They are just waiting to fine you millions.
Practices are paying huge fines for routinely using waivers and writing off deductibles. Understanding when and what amounts you are allowed to write off when your provider is out-of-network or the patient has a financial hardship is really hard. There are a lot of legal rules that can trip you up costing you massive penalties and even jail time.
But, with a little help, you can take actions that will keep you off auditors’ radars – and avoid a stressful audit and massive penalties.
That’s where attorney, Heidi Kocher, BS, MBA, JD, CHC, can help. During her 60-minute online training session on Wednesday, January 27th at 1pm ET, she’ll show you the CMS, OIG, and federal rules you are required to follow right now, as well as state specific requirements.
She’ll walk you through EXACTLY when and how to use waivers, balance billing, and write offs so you hold onto your reimbursements and out of legal trouble.
Here are just a few of the step-by-step billing errors avoidance tactics you’ll receive by attending Heidi’s upcoming session:
- Uncover how to legally write off some balances when billing out of network
- Meet billing requirements to avoid criminal prosecution
- Stop OIG fraud charge from your use of routine waivers and write-offs
- Pin down the difference between professional courtesy and insurance only
- Implement policies to monitor your write-offs and bad debt
- Determine when and if you can really offer professional courtesy
- Identify the possible punishment and penalties for improper balance billing
- Train staff to avoid discount compliance do’s and don’ts
- Avoid violating Stark and Kickback statutes due to balance billing
- Proven tips to keep your billing compliant and legal
- Identify when and if it is okay to write off co-pays or deductibles
- And so much more…
Alert: CMS and private payer auditors are actively watching and waiting for you to slip up. 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 California physician got five 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 $10,000 in fines and had to repay $2.5 million in collected funds.
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 innocent billing errors 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.