Public Health

This course covers the fundamentals of medical billing, coding, and reimbursement by explaining how all of these components work together. Emphasis will be placed on the practical application of the latest industry knowledge and standards, with the goal of helping those who work with medical claims and claims data stay ahead of the game. Participants will learn about the following: The claim flow process from registration through adjudication and payment How physicians and hospitals set and manage charges Critical data elements on the two major claim forms and what they mean How and why the major coding systems are utilized How various reimbursement methods are used by payors

Overview: Disruptive activity by practitioners in the hospital takes many forms. When it happens, it is important that the hospital and/or the medical staff take appropriate steps to see that it does not affect patient care or disrupt operations. Why you should Attend: Hospital executives, medical staff officers, and peer review committee members and support staff should attend to learn how to deal effectively with the disruptive practitioner. You will also learn how to prepare for the day when it becomes necessary to terminate such a practitioner's privileges and medical staff membership. You will also gain an understanding of how to develop provisions in the medical staff bylaws to deal with the disruptive practitioner and how to develop a clear and concise policy regarding disruptive behavior.

Overview: We will review the various elements of the physician employment agreement, focusing on the pitfalls and the problems that can develop when the agreement does not clearly define the relationship, and/or when the parties do not fully understand what is being agreed to,Such items as term and termination, termination for cause, duties of the physician, call, non-compete, and compensation are all items that should be clearly set out in the agreement and fully understood by the parties. Why you should Attend: Formal written contracts establish the legal relationship between the parties; they state the terms and conditions of that relationship and the rights and obligations of each party. They confirm the intentions and relationships of the parties as they enter into this relationship, and they eliminate uncertainties regarding mutual rights, obligations, and relationships.

Overview: In 2013, The US Department of Health and Human Services made major changes to rules implementing The Health Insurance and Portability Act of 1996 (HIPAA) and Health Information Technology for Economic and Clinical Health Act of 2003 (HITECH). Among the many areas impacted by these rules (billing, marketing, research, IT security, etc.) is fund raising. The amendments significantly modify the methods and practice that hospitals, their institutionally related foundations, and other healthcare charities may or must employ when using ANY patient or client information for fund raising.

The international agreement to assemble all Quality, Safety and Efficacy information for a drug or biologic product into a common format (called the CTD - Common Technical Document) has improved the speed and efficiency for companies working in global development programs and clarified expectations by regulatory bodies. Reformatting for multiple submissions is substantially limited. The CTD has improved the regulatory review processes and enabled implementation of good review practices. The eCTD has increased efficiency for reviewers and improved submission times. Beginning in May 2017, the eCTD will be required in the US for all marketing applications.

This course covers the requirements for conducting Clinical Studies across the EU via the requirements of the EU Clinical Trial Regulation (for Drugs & Biologics). The course also covers recent updates on EU-GCP associated with the new regulatory framework and highlights of the new EU Pharmacovigilance Directive, as it relates to studies and helpful tips into working with the European regulators. The webinar covers the impending changes coming with the EU Parliament passage of the EU Clinical Trial Regulation, which will affect all trials conducted across the EU [new and ongoing].

This seminar will begin with a general discussion of technical writing and its role within the life sciences. Technical writers produce a variety of technical documents that are required to manage and direct regulated operations and to meet regulatory requirements. We will spend some time in this seminar discussing those document types, their importance, and the consequences of the messages are unclear or misunderstood.

This course covers the requirements for conducting Clinical Studies across the EU via the requirements of the EU Clinical Trial Regulation (for Drugs & Biologics). The course also covers recent updates on EU-GCP associated with the new regulatory framework and highlights of the new EU Pharmacovigilance Directive, as it relates to studies and helpful tips into working with the European regulators. The webinar covers the impending changes coming with the EU Parliament passage of the EU Clinical Trial Regulation, which will affect all trials conducted across the EU [new and ongoing].

Overview: Today health information needs to be shared more than ever, but how can that be done most easily within the limits of HIPAA? One way is to de-identify the information. Once PHI has been de-identified, it is no longer protected under HIPAA and may be shared freely without limitation. The problem is that it is not easy to truly de-identify information and if it is not done correctly, the sharing of the information may be considered a breach that requires reporting to HHS and the potential for penalties and corrective action plans.

Overview: In this session Mr. Wolfe will provide an overview of the Stark Law, including its 2016 changes. He will also discuss best practices for negotiating and drafting administrative arrangements 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.

Overview: 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 when designing a new model. Why you should Attend: Today health care organizations are focused on developing compensation models that will 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 the potential impact that changes to the Stark Law may have if they are introduced by the government later this year.

Overview: This webinar will discuss the Health Care Quality Improvement Act (HCQIA) in detail, including the standards that must be met to achieve immunity under the act. The HCQIA itself will be reviewed, including a detailed look at the Congressional purpose for the act. The legislative history of the act will be reviewed to gain an understanding of the intent of Congress in passing the act. Next will be a review of the standards under the act. We will conduct a detailed review of each of the standards and the actions that are required to meet the intent of the standards. Specifically, there are four standards under the act that must be met. We will review each of these with an eye toward court interpretation of what actions an organization must take to achieve the protections granted by the act.

Overview: In this session Mr. Wolfe will provide an overview of key developments in physician compensation in 2020. Why you should Attend: It has been a whirlwind year for physician compensation in the U.S. Since last year, the government has issued new proposed Stark and Anti-Kickback rules, declared a public health emergency, paused elective procedures and issued Stark blanket waivers to assist providers in their response to the pandemic. At the same time, the federal, state and local governments have all issued numerous guidelines, directives and waivers that have directly and indirectly impacted physician compensation. Going forward, key changes to the allocation of wRVUs under the proposed 2021 Medicare Physician Fee Schedule (MPFS) could have a major impact on physician compensation.

Overview This seminar provides Professionals working in this area with: A thorough understanding of the complexities involved Covers all the relevant regulations and guidelines Gives real life examples of how to register and maintain various types of combination products Interfaces: Change Management and LCM Compliant safety reporting for combination products Documentation requirements and interfacing

Overview This 6-hour seminar will be addressing how practice/business managers (or compliance offers) need to get their HIPAA house in order before the imminent audits occur. It will also address major changes under the Omnibus Rule and any other applicable updates for 2018. Areas also covered will be texting, email, encryption, medical messaging, voice data and risk factors as they relate to IT. The primary goal is to ensure everyone is well educated on what is myth and what is reality with this law, there is so much misleading information regarding the do's and don'ts with HIPAA - I want to add clarity for compliance officers and what you guys need to do and how to best implement your HIPAA program based on over 18 years of personal experience working with Federal auditors, state auditors, and corporate auditors.

Overview: Incident-to coding for your non-physician practitioners (NPPs) services in conjunction with a supervising physician continues to generate confusion- and 2019 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.

Overview: The advent of COVID-19, though tragic, will be the backdrop for this webinar, which will cover the specific points of how cloud is a unique vehicle to use for normal on-prem operations while facilitating a smooth transition to telework or telehealth operations, and how this enables almost seamless business continuity when conditions force migration from “inhouse-to-telework-back-to-inhouse” operations. The major take-away will be how a strategic plan for cloud adoption can be integrated with operations continuity during times like this to keep everything running and address patient needs {almost} without missing a step.”

Overview: This lesson will be going into great detail regarding you practice or business information technology and how it relates to the HIPAA/HITECH Security Rule and securing PHI in transmission. I will go through multiple examples and specific scenarios and also offer simple common-sense solutions. Areas covered will be texting, email, encryption, medical messaging, voice data, personal devices, and risk factors. I will uncover myths versus reality as it relates to this very enigmatic law based on over 1000 risk assessments performed as well as years of experience in dealing directly with the Office of Civil Rights HIPAA auditors. I will speak on specific experiences from over 17 years of experience in working as an outsourced compliance auditor, expert witness on multiple HIPAA cases in state law, and thoroughly explain how patients are now able to get cash remedies for wrongful disclosures of private health information.

Overview: This lesson will be going into great detail regarding the practice or business information technology and how it relates to the HIPAA Security Rule, in particular portable devices. Areas covered will be texting, email, encryption, medical messaging, voice data and risk factors as they relate to personal devices. I will uncover myths versus reality as it relates to this very enigmatic law based on over 1000 risk assessments performed as well as years of experience in dealing directly with the Office of Civil Rights HIPAA auditors. I will speak on specific experiences from over 17 years of experience in working as an outsourced compliance auditor, expert witness on multiple 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: Healthcare is often driven by factors extraneous to but impacting on care delivery: regulation, revenue cycle, supplychain and many others. Now, enter IT automation as a companion driving force - no longer in the business office but out on the floors. Old news, but still a problem that needs to be addressed: how to best integrate it smoothly. Why you should Attend: There are many examples of successful EMR, HIE, and other automation implementations within American healthcare. There are also many examples of projects not going according to plan, with the attendant cost-overruns and missed schedule dates. Equally important is that even the dates that are met often don't deliver as promised.