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Medicare Compliance for Healthcare Personnel (Online CE Course)

(based on 181 customer ratings)

Author: Christopher Young
Reviewer: Barbara Cebulski, MS, MLS(ASCP)

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Objectives

  • Define "voluntary compliance program" and discuss the elements that should be included.
  • Identify the Medicare laws and regulations.
  • Identify compliance problems and issues.
  • Explain each of these terms or processes that are related to Medicare reimbursements: Medical necessity; International Classification of Diseases(ICD) coding; Current Procedural Terminology (CPT) coding; Advance Beneficiary Notice.
  • State the responsibilities of administration, management, employees, and the billing department that are related to Medicare compliance.

Customer Ratings

(based on 181 customer ratings)

Course Outline

Click on the links below to preview selected pages from this course.
  • Voluntary Compliance Program
    • Introduction
    • 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
      • Your healthcare facility has a compliance officer (CO) and a Compliance Committee. Which of the following statements is true regarding the individuals...
  • Laws and Regulations
  • Compliance Issues
    • Confidentiality
    • Billing
      • Billing
      • Fraud and Abuse
      • Fraud and Abuse, continued
      • Billing for Patient Tests and Services
    • Inducements
      • Kickbacks (Inducements)
    • Documentation
      • Documentation
    • Whistleblowers
  • Processes and issues related to Medicare Reimbursement
  • Responsibilities for Medicare Compliance
  • References
      • References

Additional Information

Intended Audience: All healthcare 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.

31--Documentation
23--Employee's Responsibility
33--Special Role for Managers
25--High Risk Billing
10-Confid
How to Subscribe


31--Documentation


23--Employee's Responsibility


33--Special Role for Managers


25--High Risk Billing


10-Confid