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National Health Care Anti-Fraud Association (NHCAA) Conference

August 25, 2015 @ 8:00 am - August 27, 2015 @ 5:00 pm

August NETS

Functional Medicine: Fraud in Diagnostic Procedures & Treatments Outpatient Facility Schemes Responding to Provider Defenses

Agenda: 

Functional Medicine: Fraud in Diagnostic Procedures & Treatment

August 25
1 day | 8 CPEs
Level II
Substitution, Cancellation, and Deadline for Participant Roster: Friday, August 7

Agenda

Functional medicine aims to address underlying causes of chronic disease through the impact of lifestyle, genetic, and environmental factors. Many office services and procedures, as well as diagnostic and laboratory tests are used, across specialty areas, to identify causes of these chronic conditions. Faculty will review a variety of procedures, such as lab work on blood metal levels, allergies, hormones, and genetic screenings, as well as treatments like alternative medicine, supplements, detox, and prescription drugs.

Explore this emerging area, learn new schemes to bring back to your unit, and understand how these tests and procedures are being billed and under what circumstances may be considered inappropriate. Faculty will show participants how to recognize red flags in medical records, data, and coding and will highlight fraud issues through case studies.

This program has the prior approval of AAPC for 7.0 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

 

Outpatient Facility Schemes

August 26
1 day | 8 CPEs
Level II
Substitution, Cancellation, and Deadline for Participant Roster: Friday, August 7

Agenda

Explore fraud schemes unique to hospitals, ambulatory surgery centers, dialysis units, and other outpatient clinic settings. Examine common facility billing & coding schemes and understand what investigative strategies are most effective in these settings through case study examples. Learn how to interpret records and documentation associated with various facilities.

This program has the prior approval of AAPC for 6.0 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

 

Responding to Provider Defenses

August 27
1 day | 8 CPEs
Level II
Substitution, Cancellation, and Deadline for Participant Roster: Friday, August 7

Agenda

This program will prepare SIU investigators and law enforcement for common provider health care fraud defenses. Faculty will explain how to hone investigations to counter the most common, as well as the most complex, defenses and those unique to commonly billed specialty areas. Understand concerns with electronic records, sampling methodology/extrapolation, medical record norms, and common legal issues, including ERISA, and how to avoid common investigative pitfalls. Participants will also learn how to present findings to the provider and use findings in negotiations.

 

August 26th 9:45am – 10:55am

Advize Health Auditors Melissa Jewett (CPC, CPMA QA Specialist) and Rebekah Evans (CPC, CMBS Medical Auditor) will be speaking about:

Investigating FWA in the Emergency Room

Determine which codes are most typically used when medically unnecessary upcoding occurs. Find out common pitfalls, ways to guard against fraud, waste, and abuse, and red flags in your data, medical records, and audits.

Details

Start:
August 25, 2015 @ 8:00 am
End:
August 27, 2015 @ 5:00 pm
http://nhcaa.org/education/education-training-opportunities/in-person-nets/august-nets.aspx

Organizer

NHCAA
View Organizer Website

Venue

Westin Riverwalk
San Antonio, TX United States + Google Map