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What are the provisions of the False Claims Act in healthcare reimbursements?
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- What is the impact of the Anti-Kickback Statute on healthcare reimbursement and referralsWhy do insurance companies practice things like restricting provider choice, gatekeeping, and pre-authorization?A physician asks the medical biller to change the date of service on a Medicare claim because it has passed the timely filing limit and was not previously submitted for payment. Is this fraud or abuse if the claim is then submitted? Why?
- Who would be impacted by such events claims production and claims submission in healthcare?What are two ways a healthcare provider could violate the HIPAA law, and what are alternative actions the healthcare provider could use to protect client confidentiality?What is the difference in the reimbursement cycle among long-term care facilities as compared to most other healthcare facilities?
- How is the Anti-Kickback Statute different from the Physician Self-Referral Law?The Physician Self-Referral Law, also known as the “Stark Law,” generally prohibits a physician from making referrals to an entity for certain healthcare services, if the physician has a financial relationship with the entity. How can a physician get around the Physician Self-Referral Law?What are the three common regulatory requirements for federal, state, and third-party health insurance payers
- What are common types of medicare fraud? Provide examples of each.Are telehealth and telemedicine services billable to the patients insurance coverage the same as face encounters in the office or hospital setting?What are medical errors and their causes? How do medical errors increase the liability for medical malpractice? What can be done to decrease medical errors and medical liability?
