Continuing Education Programs (CEU)

Overview: Many people work with various aspects of healthcare coding and billing but may not understand how providers generate their claim data, how they report the data to payors, and how payors use that information to reimburse providers. This webinar provides a high-level overview of all major aspects of healthcare coding, billing, and reimbursement. We discuss key data elements of the two major claim forms (CMS-1500 and UB04) and how that information tells the story of the patient’s encounter with the provider. We review the major coding systems including CPT, HCPCS, ICD-9, ICD-10, DRG, and APC, and examine how codes in each system are assigned and the purpose of each system. We review the typical process flow for how a provider submits a claim and gets reimbursed. We discuss the fundamentals of physician and hospital reimbursement, including a brief conversation of relative value units (RVUs) are and how they are used to reimburse providers.

This presentation will provide participants with a full understanding of the Theory of Mind and how it relates to Asperger Syndrome/High Functioning Autism. This concept can help explain why many individuals with this diagnosis act the way they do. Participants will learn of Baron-Cohen's attempt at assessing the Theory of Mind through the "Sally-Anne Test" and why this testing technique often creates a false negative allowing one to assume the skill is present when in reality it isn't. You will understand why this test doesn't provide the necessary information needed to address the core social deficits of this population. You will learn how perspective taking is a fundamental concern when treating Asperger Syndrome/High Functioning Autism. Participants will be provided with the latest research in Theory of Mind as it relates to how individuals with this diagnosis think and believe.

Overview: Nearly everyone worries, over 25% of people believe they worry too much, and about 6% of people will suffer from generalized anxiety disorder (GAD). GAD is particularly important to treat as frequently leads to depression, medical problems, and more distressing anxiety disorders like panic disorder and OCD. In this webinar learn why your efforts to manage anxiety and worry have likely failed and learn the 10 best evidence-based treatment strategies to effectively manage GAD. Why should you Attend: Until the mid 90's worry was very difficult to treat and most therapists still struggle with helping clients to manage their worry, anxiety, and depression. Therapists' and individuals' pitfalls of treatment are two-fold: 1) Fighting anxiety actually fuels anxiety and 2) Failure to address the anxiety spiral such that we wait until too late into the anxiety spiral to use coping strategies.

Overview: In this session Mr. Wolfe will discuss best practices for structuring and evaluating new compensation models. His presentation will also focus on regulatory requirements, key provisions, valuation considerations and potential pitfalls that should be avoided. Why should you Attend: Today health care organizations are focused on developing compensation models that position their physician enterprise for success. When health care organizations design a new compensation model, they must make sure the model complies with the Stark Law.This webinar will discuss how to perform this analysis. It will also discuss common compensation model structures in the industry. Areas Covered in the Session: Legal and Regulatory Overview (e.g., Stark, Anti-Kickback, etc.) Critical Components of Compliant Compensation Models Processes for Documenting Fair Market Value and Commercial Reasonableness Discuss Best Practices for Auditing Compensation Plan Implementation Common Compensation Models

Many professionals are frequently frustrated when presented with a client who has social deficits associated with Asperger Syndrome/High Functioning Autism. These individuals often manifest a variety of deficits that are typically beyond the scope of many well-intentioned therapists. Techniques that have been successfully used for years with clients who struggle with similar issues but do not have the Asperger Syndrome/High Functioning Autism are often ineffective when dealing with this population and leave both the client and professional frustrated. Frequently these clients develop significant stress due to faulty social-pragmatic communication. It is this stress that creates the subsequent behavioral issues resulting in emotional outbursts that many professionals find extremely difficult to manage.

Overview: In this session Mr. Wolfe will provide practical guidance regarding physician employment contracts,including key regulatory requirements, key provisions and common compensation and common compensation models. Why should you Attend: Today the health care industry is seeing unprecedented levels of physician employment. This webinar will discuss key business, legal and compensation issues that should be considered when drafting and negotiating physician employment agreements. The webinar will focus on key regulatory requirements, key provisions, compensation and valuation considerations and potential pitfalls that should be avoided. Areas Covered in the Session: Provide a Legal and Regulatory Overview Describe Best Practices for Developing, Implementing and Auditing Provider Employment Arrangements Review Processes for Documenting Fair Market Value and Commercial Reasonableness Discuss Common Compensation Models for Employed Physicians

Many health care organizations lease space to physicians and physician groups and this trend is expected to continue. Unfortunately, these leases carry substantial compliance risk if they are not structured and implemented correctly.The regulatory requirements leases under the health care fraud and abuse laws (Stark Law, Anti-Kickback Statute) are very complex. In recent years, several health care organizations have made compliance missteps which subjected them to substantial penalties and settlements with the government. It’s critical for health care leaders to understand the rules surrounding leases with physicians and groups so they can spot and address issues to help mitigate risk. Many health care organizations have developed policies and processes that outline the structures, rental rates and documentation that are required when

Overview: The webinar will focus on practical strategies and key takeaways from recent settlements and enforcement actions. Why should you Attend: Several of the recent Stark Law cases and settlements have highlighted the risks that result from flawed physician contracting. In this webinar,Mr. Wolfe will discuss why physician contracts must be in compliance with a Stark Law exception, and why compensation must be at fair market value and on terms that are commercially reasonable. He will also discuss developing best practices in the industry related to physician contracting and compensation model development.

This session focuses on the issues of managing health information when it may that of students and may involve substance abuse treatment information. HIPAA and FERPA allow a number of disclosures without consent that SAMHSA prohibits without consent. First we will explain how HIPAA relates to information management and release and explain the processes required for various releases of information under the HIPAA and FERPA rules, including release according to individual access requests, and under consents and HIPAA authorizations. While FERPA overrides HIPAA, both HIPAA and FERPA take a back seat to the rules under 42 CFR Part 2. When substance abuse treatment information is involved, first you need to understand how to identify it. We will discuss how to make it distinguishable from "regular"health information, so that the appropriate extra protections can be provided.

Hospitals must file a National Practitioner Data Bank report on any physician's surrender of privileges if an investigation is underway. This has always been a Data Bank reporting requirement, intended to discourage plea bargains which allowed physicians to avoid being reported if they agreed to waive hearing rights. Under the new Guidebook, expanded descriptions of "investigation" and "surrender" stretch what is to be considered a reportable surrender of privileges. OPPE and FPPE and other peer review can be affected, as are physicians ability to make practice decisions without inadvertently tripping Data Bank reporting triggers. Medical staff bylaws and policies need to be reworked under the new Data Bank Guidebook.

Overview: Several of the recent Stark Law cases and settlements have highlighted the risks of entering into contracts for physician leadership. In this webinar, Mr. Wolfe will discuss why these contracts must satisfy a Stark Law exception, and why compensation paid to physician leaders must be at fair market value and on terms that are commercial reasonable. He will also discuss key features of effective and defensible contracts. The webinar will include practical strategies that health care executives can use to enhance the defensibility of these arrangements, including potential features of an organizational policy. Why should you Attend: In recent years, the health care industry has seen unprecedented engagement of physicians leaders to serve as medical directors and in other administrative roles. With increasing emphasis on clinical quality and value this trend is only expected to accelerate.

This webinar will provide updated insights and better treatment for ADHD based on current research. It is important to understand that roughly 70% of those with ADHD have an additional diagnosis, and many of those individuals with comorbidity have an underlying condition that is solely causing the client to meet criteria for ADHD. As a result, it is important to learn how to identify the underlying symptoms and causes and to not treat the disorder as a category. In this workshop we will discuss different underpinnings of ADHD through imaging studies and areas of the brain that are most impacted in those with ADHD. This understanding will help clinicians and parents better target interventions. We will discuss lower order causes found in the orbitofrontal and subcortical areas, as well as higher order weaknesses such as working memory and mental flexibility.

This webinar for HIPAA Covered Entities and Business Associates will explain: What a complete HIPAA Risk Analysis - Risk Management program is and how to do one. How to automate, simplify, document and complete your HIPAA Risk Analysis - Risk Management by an interactive, intuitive process: To identify and analyze Risks to all Protected Health Information (PHI) - not just Electronic Protected Health Information (EPHI) Manage Identified Risks Implement your specific, customized Risk Management Plan Archive your Risk Analysis - Risk Management- Risk Management compliance for ready reference and inspection by OCR Craft your next HIPAA Risk Analysis - Risk Management from the data entered in the archive - modify and supplement with no need to start from scratch.

Overview: Trigger point injections-use of ultrasound guidance-are payers covering this? Are there limitations on how many trigger points can be performed in a specified period of time? Chemodenervation for chronic migraine headache and spasmodic torticollis-proper -documentation/billing of medication administered is essential Genicular Nerve block and destruction-Why do you not code these differently? Facet/MBB block and destruction-How do you correctly count the levels? What modifiers do you use? How do you code a "periarticular" injection? Transforaminal Epidural Steroid/Selective nerve root block-bilateral versus multi-level coding Stellate Ganglion and Lumbar Sympathetic blocks-don't forget to bill for fluoro Intercostal nerve block versus paravertebral (TAP) block

Overview: One errant email or text message can cost you tens of thousands of dollars in HIPAA fines and penalties and it doesn't matter who you're communicating with: patients, staff, providers or with insurance carriers. A violation is a violation. And if you think it couldn't happen to you, think again. Text and email HIPAA violations are not always caused by what you might think. For example, you may think you are safe as long as you don't text patients - you're wrong. Many violations generally occur between providers messaging their staff. You can avoid getting hit with a HIPAA audit and violations with a few simple changes to your current processes. But you have to be able to identify the danger zones. National HIPAA expert, John Brewer, will walk you through how to escape being hit with HIPAA emailing and texting violations.

Overview: This webinar will explain about Ransomware attack on a Covered Entity or BA that encrypts PHI is presumed to be a HIPAA Breach according to the U. S. Department of Health and Human Services (HHS). Ransomware including new, more treacherous varieties used by cyber-criminals to attack the Healthcare Industry HIPAA Rules that apply to Ransomware attacks "Social Engineering" tricks criminals use to sneak Ransomware into Electronic Information Systems What to do if your organization suffers a Ransomware attack Best practices to: Prevent Prepare Respond Recover from Ransomware Attacks Why should you Attend: Healthcare is the biggest target for Ransomware attacks in 2017. New types of Ransomware are particularly dangerous. They not only lock up your information system - they steal Protected Health Information (PHI).

Overview: This lesson will be addressing how practice/business managers (or compliance offers) need to get their HIPAA house in order as HIPAA is now fully enforced and the government is not using kid gloves any more.It will also address major changes under the Omnibus Rule and any other applicable updates for 2016 and beyond. There are an enormous amount of issues and risks for covered entities and business associates these days as it relates to patients ability to sue you and the Federal governments audit process. I will speak on specific experiences from over 17 years of experience in working as an outsourced compliance auditor, expert witness on HIPAA cases, and thoroughly explain how patients are now able to get cash remedies for wrongful disclosures of private health information. More importantly I will show you how to limit those risks by simply taking proactive steps and utilizing best practices

Overview: Incident-to coding for your non-physician practitioners (NPPs) services in conjunction with a supervising physician continues to generate confusion- and 2018 will be no exception. So, it's no surprise that these claims generate higher than average denials, and lead to hefty penalties for physician practices ranging from $163K to $1.5 million - but they don't have to. Obviously, being paid 100% vs. 85% for your NPPs services is the goal. However, correctly maneuvering through complex incident-to guidelines so you can avoid audits and fines is anything but easy. That's where expert coder, Rhonda Granja, B.S., CMC, CMOM, CMA, CPC, comes in. Rhonda has put together a 60-minute training session to help you cut through the confusion of these difficult coding situations. Even if you don't see Medicare patients, you should still take note. Private carriers usually end up following suit with CMS at some point.

Overview: In this session Mr. Wolfe will provide an overview of the regulations that impact health care leases. He will also discuss best practices for negotiating and drafting leases on behalf of health systems, hospitals, medical groups and physician practices. The webinar will focus on regulatory requirements, key provisions, valuation considerations and potential pitfalls that should be avoided. Why should you Attend: As health care organizations develop leasing arrangements with referring physicians, it's critical that they understand the key business, legal and regulatory considerations and trends that Mr. Wolfe will discuss in this webinar. For example, a new exception for timeshare arrangements recently went into effect under the Stark Law.Any health care organizations looking to enter into a new timeshare leasing arrangement should understand the requirements of this new timeshare exception.

Covered entities and business associates have very specific requirements under the HIPAA Privacy Rule, HIPAA Security Rule and Breach Notification Rule. Enforced by the Office for Civil Rights (OCR) HIPAA appears to be constantly changing, not based on new regulations, but guidance and newsletters from the OCR, Office of the Inspector General, Office of National Coordinator and CMS. In addition, OCR adopts many of the publications from the National Institute of Standards and Technology (NIST). Without a clear understanding of how to apply the standards in your office, you will most likely be in violation of some aspect of HIPAA every day. Small matters such as not posting your Notice of Privacy Practices (NPP) in your waiting room or not listing electronic exchanges on your Notice.