Click on the links below to preview selected pages from this course.
- Voluntary Compliance Program
- Seven Elements of a Compliance Program
- Seven Fundamental Elements of a Voluntary Compliance Program
- Element 1
- Element 2
- Element 3
- Element 4
- Element 5
- Element 6
- Element 7
- Laws and Regulations
- Compliance Issues
- Case Study 2
- Processes and issues related to Medicare Reimbursement
- Medical Necessity
- Advance Beneficiary Notice (ABN)
- ABN Form CMS-R-131
- Case Study 5
- Test Ordering
- Panels and Profiles
- Physician Notices and Acknowledgements
- Responsibilities for Medicare Compliance
- Sales and Marketing
- Equipment, contracts, and pricing
General Course Information: This course is designed to train laboratory staff on the basic concepts of Medicare compliance. It is based on the OIG Compliance Program Guidance for Clinical Laboratories, and covers seven elements of a successful compliance program: risk areas, coding, ABNs, tests and panels, inducements, billing, and whistleblowers. It includes real-life case studies that highlight pertinent issues.
Intended Audience: All clinical laboratory personnel.
Level of Instruction: Basic
Author information: Christopher Young, of Laboratory Management Support Services, Phoenix, AZ, is an independent consultant, and nationally recognized speaker and expert currently specializing in compliance, sales and marketing, and customer service, as they pertain to clinical laboratories. He has extensive first-hand laboratory experience, in positions ranging from phlebotomist, to decision support coordinator, and in his consulting practice.
Reviewer information: Barbara Cebulski, MS, MLS(ASCP) has over 40 years of experience in the medical laboratory profession as a technologist, section supervisor, and laboratory manager. She was an Inspection and Technical Specialist for nine years with the College of American Pathologists in the Laboratory Accreditation Program and, until her retirement in 2015, was Program Director for MediaLab, Inc. Barbara holds a Masters in Instructional Technology from Georgia State University.