Being a licensed healthcare professional means more than just taking care of patients. It involves adhering to Medicare, Medicaid, TriCare, and third-party payor regulations for reimbursement. Yet, with so many laws, rules, and policies to follow, how can physicians, pain management specialists, chiropractors, and other practitioners make sure they’re doing it right?
What should you, a healthcare provider, do to prevent serious criminal charges, massive civil fines, termination from federally funded programs, medical license revocation — essentially, the loss of your career?
You need to have a compliance program. And with our free eBook, Physician Guide to Basic Compliance Concepts, we’ll explain everything about what goes into one.
Written by our experienced and reputable national healthcare compliance attorneys, our manual walks you through how to set up checks and balances within your business model. Using our unique six-step method, you’ll be able to train your staff on what they should do when they spot trouble, such as false claims, overbilling, and improper coding.
We’ll teach you proper protocols for internal investigations and third-party audits; what you should do if you discover illegal conduct happening at your practice; and whether it’s in your practice’s best interest to disclose particular violations to the CMS, OCR, and OIG.
With the Physician Guide to Basic Compliance Concepts, you’ll have a solid blueprint to keep your practice committed to the highest standards.
In healthcare, compliance means a system of policies, processes, and training, all of which conform to state and federal laws and regulations dictating delivery of healthcare supplies and services.
Every healthcare provider billing Medicaid, Medicare, TriCare and/or commercial insurers must provide comprehensive, compliant claims for each service rendered and for every supply and pharmaceutical used in delivery of patient care.
When you register for our free eBook, Physician Guide to Basic Compliance Concepts, you’ll learn how to put these processes in place for your entire practice.
State and federal investigators are savvy at spotting healthcare providers who file false claims under Medicaid, Medicare, TriCare, or private commercial insurance. They use comprehensive data analytics, auditing, and state-of-the-art observation techniques to catch practices they suspect are committing healthcare fraud.
The penalties imposed for false, non-compliant claims are harsh. They include:
In Physician Guide to Basic Compliance Concepts, we explain how to best prepare for audits and internal investigations, if illegal activity is suspected at your practice.
A healthcare practice that has an effectual compliance program in place shows the government that the practice is taking a proactive measure toward legal and regulatory adherence.
By having a compliance plan in place, healthcare professionals and medical practices are protected from civil, administrative, and criminal penalties imposed by state and federal governments, as well as from network exclusions and payment reviews.
A solid, effective compliance plan assures that a healthcare practice staff knows how to spot and fix improper claims via a custom auditing and monitoring procedure. By following the compliance program, employees will respond to suspicious issues in a timely manner — and the healthcare organization could prevent a formal investigation from even happening.
If, however, a government agency or a private insurer investigates and prosecutes healthcare fraud, that healthcare practice’s culpability score, fines, and penalties can be reduced if the practice shows that a comprehensive compliance program was established prior to the offense.
Our Physician Guide to Basic Compliance Concepts has what you need to know about putting a Correctional Action Plan in place (to prevent future mistakes from occurring), as well as effective disciplinary policies for your practice.
In our Physician Guide to Basic Compliance Concepts, you will gain insight from our health care compliance attorneys on what state and federal government entities look for, and how you can be prepared.
With 35 years of experience exclusively in healthcare law, our reputable compliance lawyers are experts in defending healthcare providers in matters involving:
We represent licensed medical professionals, including:
We practice nationally, with offices in Detroit, Michigan; Miami and Sarasota, Florida; and Los Angeles/Southern California.
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Ronald W. Chapman Sr., M.P.A., LL.M.
Founding Shareholder
President & CEO
Complex Healthcare Fraud, Qui Tam,
Uninsured Physicians
All Offices – Main Office Sarasota
6841 Energy Court
Sarasota, FL 34240
Phone: (941) 893-3449
Miami Office
701 Waterford Way, Suite 340
Miami, FL 33126
Phone: (305) 712-7177
From responding to the Feds to conducting internal investigations, our national healthcare fraud and compliance lawyers explain it all here.
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Troy, MI 48098
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Sarasota, FL 34240
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Suite 340
Miami, FL 33126
T. 305.712.7177
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