Apr 16, 2024 (PART 1: Balanced Billing Laws: Prevent Avoidable Violations and Penalties)

Writing off patient out-of-network co-payments or deductibles without meeting individual financial hardship exceptions will land you in hot water with the OIG – unless you know exactly how to comply with complicated, ever-changing Balanced Billing Laws.

Many states require you to get out-of-network payments directly from health plans rather than your patients. What makes it worse is that CMS and private payer auditors actively watch and wait for you to slip up. The only way to avoid being targeted is to master the complexities of balanced billing laws. Even a simple mistake can result in massive violation penalties and even jail time.

But, with some help, you can comply with complicated government-balanced billing laws, avoid stressful audits, and steer clear of the massive penalties that violations can bring.

This is where attorney Rachel V. Rose, JD, MBA, can help. During her 60-minute online training, Rachel will walk you through EXACTLY when and how to use waivers, comply with CMS, OIG, and federal and state Balanced Billing laws, correctly manage write-offs and the right and wrong way to write off patient amounts due, so you hold onto your reimbursements and stay out of legal trouble.

Here are just a few of the step-by-step balanced billing law compliance tactics you’ll receive by attending this online session:

• Uncover how to write off some balances when billing out-of-network legally
• Meet billing requirements to avoid criminal prosecution
• Mitigate routine waiver use and write-offs that raise auditor red flags
• Pin down the difference between professional courtesy and insurance only
• Implement policies to monitor your write-offs and bad debt
• Determine when and if you can offer professional courtesy
• Identify the possible punishment and penalties for improper balance billing
• Train staff to avoid discount compliance dos and don’ts
• Avoid violating Stark and Kickback statutes due to balance billing
• Proven tips to keep your billing compliant and legal
• And so much more…

Apr 17, 2024 (PART 2: Copays: What to Charge, When to Waive & How to Collect More)

Improperly collecting copays for private and government payers can lead to severe violations (although for different reasons). Several court cases have found healthcare practices guilty of fraud for failing to collect copays and deductibles. The punishment for these violations includes civil damages and forfeiture, civil monetary penalties, imprisonment, criminal fines, and payer exclusions.

This is where healthcare attorney Amanda Waesch, Esq., can help you protect your practice. Amanda has assembled a 60-minute online training to walk you through how your practice can avoid copay collection violations and still receive your due payments.

Here are just a few of the tactics you’ll receive during this training that will help you better protect your practice from errors when collecting copays:

• Avoid costly violations due to discount, waiver, and write-off policies
• Offer prompt-payment discounts without breaching copay rules
• Pin down when NEVER to balance bill uncollected funds
• Effectively communicate collection policy to patients to slash risk
• Master financial hardship waiver requirements to head off costly errors
• Uncover how professional discounts can violate Anti-Kickback laws
• Utilize an Advanced Beneficiary Notice (ABN) to avoid penalties
• Bulletproof your copay/deductible collections policy to reduce compliance risk
• Prevent the No Surprises Act from reducing your rightful collections
• Determine what constitutes “routine” when issuing a copay waiver
• Identify copay/deductible collection policy mistakes and correct them
• Stop fraud allegations related to write-offs and bad debt
• Tap into payer contract “lowest rate” clauses to minimize liability
• Implement collection policy training dos and don’ts to protect against fraud
• And so much more…

Apr 18, 2024(PART 3: Stop Violating Professional Courtesy & Patient Discount Laws)

Writing off patient copays and offering colleagues professional courtesy discounts can quickly make you an OIG target. The problem is that federal and state professional courtesy and patient hardship discounting laws are complex and confusing, and there are about a million ways to violate them.

Sure, there are legitimate reasons to waive patient copays or write off some or all of what they owe, but this can also look like an inducement, which is illegal. Although it’s common to offer professional discounts, if not implemented correctly, it can be considered an enticement for future referrals, violating the Anti-Kickback statute.

Even innocent discounting mistakes can land you in hot water with the OIG, and the ensuing penalties and fines can bury even the most financially healthy practice. Fortunately, with some help, you can avoid scrutiny when dealing with professional courtesy discounts and avoid the headaches and stress that come with it.

Healthcare attorneys Ashley Watson, Esq. and Daphne Kackloudis, Esq., are here to help. During their 60-minute online training, you will learn the right and wrong ways to write off amounts due correctly and offer discounts to patients, business associates, fellow physicians, vendors, and others. Ashley and Daphne help you overcome the complexities of professional courtesy and patient hardship by discounting laws and providing the tools you need to comply.

Here are just a few of the step-by-step strategies you’ll learn to comply with patient and professional courtesy discount rules by attending this info-packed online session:

• Identify which providers and family members never to offer discounts to
• Pin down the exact language you must include in your professional courtesy policy
• Differentiate the legal requirements of free services from discounted ones
• Secure the legal definition of “routine” waivers so you can avoid them
• Translate the False Claims Act legalese into actionable steps to avoid scrutiny
• Determine what “professional courtesy” actually entails in the OIG’s eyes
• Train staff to prevent discount compliance do’s and don’ts
• Define what the AMA means when advising physicians to “use their judgment.”
• See how private payers define discounts and if their rules line up with Medicare’s
• Identify when you can write off copays vs. the entire patient bill
• And much, much more…

Our Healthcare Expert entirely presents these webinars. Rachel V. Rose, Amanda Waesch, Ashley Watson & Daphne Kackloudis