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Session Descriptions Released for 2016 Compliance Conference

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11/17/2015


Session Descriptions

 


Compliance Officer and Committee                                                                                                            John Outlaw, CHC, CHBME
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Compliance Officer, McKesson Business Performance Solutions

Governance of your company's compliance program is critical to its success. Effective program oversight requires a leader who understands the business and related risks and is empowered to develop and implement the controls necessary to safeguard your company against illegal, unethical or improper conduct. This session will provide a history of the evolution of healthcare compliance programs for context, and discuss the various roles and responsibilities as well as knowledge, experience, skills and other qualities that make for an effective Compliance Officer.  This session will also provide a broader overview of the governance function including board/director/owner responsibilities, the compliance committee and program structure, with practical tips for implementing a new program or improving on an existing one for any size billing company.

 

Policies and Procedures                                                                                                                                    Holly Louie, RN, CHBME
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Compliance Officer, Practice Management Inc.

When is the last time you took a look at your company’s policies and procedures? Do you have the ones you really need, or are they outdated or redundant? Are all your employees complying with your policies and following your procedures?  This interactive session focuses on real life in our companies: what works and what does not and more importantly, why. Come prepared for a session full of tips, tools and examples for ensuring that your policies are working as you intend and successfully reducing your risk.

 

Compliance 101: How to Respond to the Government’s Current Bag of Tricks                                Mark Cunningham, Esq.
                                                                                                                                                              
Chambliss, Bahner & Stophel, PC

Updated! If your organization or client is ever subjected to a government investigation, audit or similar examination, you need to be prepared to mount an appropriate defense.  The government has a number of tools at its disposal when it seeks to recover money.  RACs and similar government agents have become a noteworthy thorn in the side of healthcare providers and billing companies alike.  This session will discuss the current climate, techniques you can implement and areas of tension that can arise between the billing company and the client. Attendees will also gain an understanding of problems that can flow from inadequately preparing for or responding to the government’s investigation.  Both civil and criminal investigations will be reviewed and discussed.

 

Compliance Education and Training                                                                                                                       Carrie Aiken, CHC
                                                                                                                                           Chief Compliance Officer, GetixHealth, LLP

Updated! Compliance programs can only be successful when your employees understand the mission and desired outcome. An effective compliance program starts with clear messaging and understandable objectives. Creating training activities that are meaningful to employees translates into a successful program and fosters a culture of compliance that carries through to operations and client service. This session will target regulatory, operational and compliance areas for education and provide guidance on documenting your efforts. This session will also deliver engaging strategies and options for sharing your message. This will bring compliance to the forefront and enable your organization to achieve and maintain compliance.

 

Effective Auditing and Monitoring                                                                                                            John Outlaw, CHC, CHBME
​                                                                                                    
Compliance Officer, McKesson Business Performance Solutions

Monitoring and auditing may sound intimidating; from understanding the difference between the two, knowing what to monitor, what to audit, how often and how much, along with what to do with the results!  This session will address these questions and provide a comprehensive review to help you understand the various risk areas for third party billing companies that should be incorporated as part of an effective auditing and monitoring program – including some you’ve probably never considered before. Learn practical tips to help prioritize these risks so that you can target your limited resources and develop your own auditing and monitoring plan.   

 

More Money, More Problems: Refunds, Overpayments and Credit Balances                                  Mark Cunningham, Esq.
                                                                                                                                                              
Chambliss, Bahner & Stophel, PC

If you think it's easy to return money, you would be wrong. Refund, overpayment and credit balance issues prove to be some of the hottest and most challenging issues for compliance officers in today’s healthcare environment. Recent regulatory changes and developments present true challenges for a billing company and its clients. This interactive panel discussion will focus on the most recent developments and strategies in these areas.  Our goal will be to share leading approaches from legal, operational and compliance perspectives.  Coming out of this session, you will have a better understanding of the key problem areas and be provided answers on how to respond to them.

 

Risk Assessments and the Oops Factor                                                                                                     Holly Louie, RN, CHBME
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Compliance Officer, Practice Management Inc.

The risks in our industry and businesses have changed, and our risk assessments also have to change to manage the new targets. Do you know how to quantify and accurately prioritize your risks? In a worst case scenario, how would you prove effective risk management? Bad things do happen, even in companies with really good risk assessment plans. This session will help you prepare for the oops, from determining how they could have been prevented to reviewing the critical steps for managing serious events. Learn from real-life situations and lessons learned to successfully manage your company’s specific risks every day.  

 

HIPAA/HITECH and Beyond                                                                                                                                      Carrie Aiken, CHC
                                                                                                                                            Chief Compliance Officer, GetixHealth, LLP

The impact of the Health Insurance Portability and Accountability Act (HIPAA) on our organizations continues to grow with technology, scope of business and risks. Because we serve as business associates, we must all understand the safeguards and best practices associated with protected health information (PHI) for ourselves and our clients. A focused compliance-oriented review of HIPAA privacy and security along with the HITECH regulations is a “must do” on an annual basis. With increased efforts by authorities to enforce HIPAA, you need to stay current to protect the reputation of your organization and steer clear of fines, penalties and corrective action plans. This session will refresh you on HIPAA/HITECH laws and regulations using real situations and enforcement examples to illustrate challenges and solutions. You will leave this session with easy to understand information that can be shared with your staff to put everyone on a path to protecting privacy and security.

 

Does Your Contract Have a Clue?                                                                                                                Mark Cunningham, Esq.
                                                                                                                                                              
Chambliss, Bahner & Stophel, PC

This session will focus on significant compliance “mistakes” in billing agreements and provide alternatives to resolving them. We will provide real world examples of key compliance issues that exist in the three phases of contracting: (1) the negotiation period, (2) the period you are under contract; and (3) the post-termination period. In addition, we will address recent laws, cases and enforcement actions and discuss how these developments might warrant changes to certain provisions within your billing contract. Following this session, you will return to your office equipped with knowledge of leading approaches and options on how to deal with issues that commonly arise.

 

Coding Compliance                                                                                                                                       Holly Louie, RN, CHBME
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                                                                                                                  Compliance Officer, Practice Management Inc.

As those in our industry know, coding is our biggest risk area. From getting the authoritative resources that you really need to managing client, in house, and outsourced coding, there are many opportunities for risk. Can you identify aberrant patterns and have you clearly defined errors? Will your coding survive government auditing of your claims? Perhaps your coding policies and procedures are preposterous or maybe you are not taking the right advantage of coding opportunities. This session will be filled with examples, ideas and tools to assist you and your company when it comes to coding. Along with analyzing the current state of coding, we’ll take a look into the future and see what’s ahead in the coding world. Leave this session being able to use your enhanced coding knowledge to help your clients and better sell your services.