Perpetrating Fraud? Accurate Diagnosis, Documentation, Billing and Coding in Private Practice

Course Description

 Clinicians who fail to fully understand the laws, requirements and best practice standards around setting fees, documenting and billing for services, applying standardized place of service, modifier and CPT codes, and formulating accurate diagnoses leave themselves and their practice open to serious risk.

Whether practitioners knowingly and deliberately violate the law in order to circumvent reimbursement requirements or act on misinformation obtained from well-meaning, but ill-informed colleagues, supervisors or Facebook, fraudulent practices can leave practitioners vulnerable to insurance company clawbacks, allegations of unethical conduct and licensing board complaints.  

Centered around the core value of Integrity, the presenter will address the ethical, legal and financial implications of: improperly recording the services provided and fees charged and paid in the medical record; unfair and inequitable fee setting; and engaging in common fraudulent billing and collection practices.