Collecting money from patients is essential to keeping your practice in the black, but not every medical billing and collection strategy is beneficial – in fact, some can get you into big trouble.
The reality is that many practices are handling patient collections all wrong from a compliance standpoint. Waiving the wrong copay, offering discounts to the wrong patients, and writing off patient balances for the wrong amounts are all violations that could land you in a web of legal trouble that may include fines, penalties and insurer exclusion.
Avoiding patient collections completely is also the wrong strategy. So what can you do? During this 3-Part online training series, four healthcare attorneys will walk you through exactly how to boost your cash flow by compliantly collecting copays, patient balances, deductibles and more without having to stress about whether you’re in compliance with the myriad laws surrounding these issues.
You’re entitled to payments for the services you’ve rendered, and these experts can show you how to do it the right way. Register for this 3-part training series right away.
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PART 1: Head Off Avoidable Balanced Billing Violations & Massive Fines
Available Immediately, Order the On-Demand Recording to Watch at Your Convenience.
Balanced billing laws and regulations continue to be more complicated each year. Many states now require you to get out-of-network payment from your health plan, not your patient. What makes it worse is that CMS and private payer auditors actively watch and wait for you to slip up. The only way to avoid being targeted is to master the complexities of balanced billing requirements.
This is where attorney Heidi Kocher, BS, MBA, JD, CHC, can help. During her 60-minute online training session, Heidi will show you the right and wrong way to write off patient amounts due. This training will help you more easily comply with CMS, OIG, and federal and state Balanced Billing rules.
Here are just a few of the step-by-step balanced billing law compliance tactics you’ll receive by attending this online session:
- Uncover how to legally write off some balances when billing out of network
- Meet billing requirements to avoid criminal prosecution
- Stop OIG fraud charges 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 dos 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…
PART 2: Copays: What to Charge, When to Waive & How to Collect More
Available Immediately, Order the On-Demand Recording to Watch at Your Convenience.
Improperly collecting copays for both private and government payers can lead to severe violations (although for different reasons). In fact, several court cases have found healthcare practices guilty of fraud for failure to collect copays and deductibles correctly. The punishment for these violations includes civil damages and forfeiture, civil monetary penalties, imprisonment, criminal fines, and payer exclusions.
This is where healthcare attorney Amanda Waesch, Esq., can help you protect your practice. Amanda has put together a 60-minute online training that will walk you through exactly how your practice can avoid copay collection violations and still receive the payments you are due.
Here are just a few of the tactics you’ll receive during this training that will help you better protect your practice from errors when collecting copays:
- Avoid costly violations due to discount, waiver, and write-off policies
- Offer prompt-payment discounts without breaching copay rules
- Pin down when NEVER to balance bill uncollected funds
- Effectively communicate collection policy to patients to slash risk
- Master financial hardship waiver requirements to head off costly errors
- Uncover how professional discounts can violate Anti-Kickback laws
- Utilize an Advanced Beneficiary Notice (ABN) to avoid penalties
- Bulletproof your copay/deductible collections policy to reduce compliance risk
- Prevent the No Surprises Act from reducing your rightful collections
- Determine what constitutes “routine” when issuing a copay waiver
- Identify copay/deductible collection policy mistakes and correct them
- Stop fraud allegations related to write-offs and bad debt
- Tap into payer contract “lowest rate” clauses to minimize liability
- Implement collection policy training dos and don’ts to protect against fraud
- And so much more…
PART 3: Stop Violating Professional Courtesy & Patient Discount Laws
Available Immediately. Order the On-Demand Recording to Watch at Your Convenience.
Writing off patient copays and offering colleagues professional courtesy discounts can quickly make you an OIG target. The problem is that both federal and state professional courtesy and patient hardship discounting laws are complex and confusing, and there are about a million ways to violate them.
Sure, there are legitimate reasons for you to waive patient copays or write off some or all of what they owe, but this can also look like inducement, which is illegal. And although it’s common to offer professional discounts, if not implemented correctly, it can be considered an enticement for future referrals violating the Anti-Kickback statute.
Even innocent discounting mistakes can land you in hot water with the OIG, and the ensuing penalties and fines can bury even the most financially healthy practice. Fortunately, with a little help, you can avoid scrutiny when dealing with professional courtesy discounts and avoid the headaches and stress that come with it.
Healthcare attorneys Ashley Watson, Esq. and Daphne Kackloudis, Esq., are here to help. During their 60-minute online training, you will learn the right and wrong ways to write off amounts due correctly and offer discounts to patients, business associates, fellow physicians, vendors, and others. Ashley and Daphne help you overcome the complexities of professional courtesy and patient hardship discounting laws and provide you with the tools you need to comply.
Here are just a few of the step-by-step strategies you’ll learn to comply with patient and professional courtesy discount rules by attending this info-packed online session:
- Identify which providers and family members never to offer discounts to
- Pin down the exact language you must include in your professional courtesy policy
- Differentiate the legal requirements of free services from discounted ones
- Secure the legal definition of “routine” waivers so you can avoid them
- Translate the False Claims Act legalese into actionable steps to avoid scrutiny
- Determine what “professional courtesy” actually entails in the OIG’s eyes
- Train staff to avoid discount compliance do’s and don’ts
- Define what the AMA means when advising physicians to “use their judgement”
- See how private payers define discounts and if their rules line up with Medicare’s
- Identify when you can write off copays vs. the entire patient bill
- And much, much more…
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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.
Amanda Waesch, Esq., is a healthcare Attorney at Brennan, Manna & Diamond. Her practice focuses on healthcare, employment law and healthcare litigation across the country. She advises healthcare providers including practices and hospitals on reviewing and litigating employment agreements; non-compete agreements and severance agreements. Her work has benefited physicians and administrators in drafting and reviewing employer handbooks, as well as management and training issues.
Daphne L. Kackloudis is a member of the firm, she heads BMD Columbus’ health care practice, and she chairs BMD’s Empowerment and Opportunity (DE&I) Committee. Daphne’s success –and that of her clients – is rooted in the nexus between traditional health care legal services and health care public policy. She has broad and deep experience in health care operations, service delivery, payment systems, and compliance, as well as Medicaid, public policy, and government affairs. Daphne advises health care trade associations and health care providers as outside counsel and in-house as a member of her clients’ senior leadership teams.
Ashley is a healthcare attorney in BMD’s Columbus office. She works with nonprofit and for-profit health care providers, health care trade associations, individuals, and businesses. Ashley is experienced in healthcare public policy and regulatory compliance, legislative and government affairs, grant administration, and healthcare program operations.
