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About this program

Back by popular demand – join us for this rebroadcast of a PMI favorite.

2021 is The Year of the Audit? Some experts are already knees-deep with investigations and audit defense work. The upheaval in healthcare last year resulting from the pandemic along with changes to the 2021 EM Documentation Guidelines is ripe territory for audit scrutiny. Regulatory compliance and audit defense expert Sean M. Weiss predicts problems will continue for providers and health system based on the surge in telehealth services and COVID-19 waivers extended during the Public Health Emergency (PHE) to help providers operate more efficiently. But it's not too late to get things straight!

Despite the ongoing PHE, payor audits have and continue to ramp up. TPE, MAC, OIG, RAC, MIC, CERT and SIU as well as other types of audits are in full swing. Steps you take now can build a better case for the future if errors/oversights are flagged in an audit. It all comes down to establishing a "Culture of Compliance"!

All medical office leaders should make time for this important session. Sean will explain how you can perform a self-audit or bring a professional auditor onsite to guide the process before it becomes a red flag. Sean will also help you to understand how to build a solid defense and the difference between disclosure and refund processes.

Participants in this session will learn how to:

• Research, locate specific payer policies, utilization guidelines, participation agreements, contracts or any other published guidance documents when you perform audits
• Secure authoritative guidance from peer-reviewed papers, specialty society publications, and guidance from the AMA, CMS, etc.
• Challenge payers that try to argue your lack of knowledge or obligation thereof
• Request that they produce the binding guidance documents that place the responsibility on you or your providers.