MentorHealth Webinar Calendar of Upcoming Courses

Webinar Calendar of Upcoming Courses - May to June – 2017

MentorHealth webinars are designed to offer professionals in the healthcare industry the knowledge they need in all the areas of the healthcare industry that enables them to excel in their professions. MentorHealth’s trainings bring experts from all the core areas of healthcare and impart learning to help professionals understand and implement all the important issues that matter to their professions. To keep updating your knowledge of regulatory compliance in the healthcare industry, all that is needed is a basic Internet connection.

MentorHealth’s experts offer their insightful analysis into the issues that are of consequence to healthcare professionals in their daily work. Their thoughts help you implement the best practices of the industry into your work. They also offer updates on the latest regulatory requirements arising out of a host of the laws and issues related to healthcare, such as among Affordable Care Act, Anti-kickback statute, HIPAA, HITECH, 21 CFR, FMEA, Electronic Health Records many others.

MentorHealth Webinar Calendar of Upcoming Courses

Take a look at our upcoming webinars from MentorHealth, which will put you on the road to learning about any area that is of importance to your profession. You can plan your learning from MentorHealth by looking at our events in the next few weeks. You can choose from a whole range of topics, right from dealing with substance abuse at the workplace to new techniques for making onboarding effective. There is just no area of healthcare related trainings that are not included in MentorHealth’s training schedule for the next few weeks! Get trained on HIPAA for the Compliance Officer, what to expect for HIPAA 2017 under the new administration, OSHA compliance and safety management, and what Business Associates need to do to implement HIPAA, and many more.

Read More :  http://www.mentorhealth.com/control/webinars_home

Understanding CARC and RARC

A Claim Adjustment Reason Code (CARC) is a code used in medical billing to communicate a change or an adjustment in payment. CARCs have to be used to communicate why there was a difference between the amount paid in a claim or service line and the amount that was billed against it. CARCS are to be mentioned only if there is an adjustment of this kind. If there is no adjustment to a claim or service line, then there is no need to use a CARC.

Further to the CARC is the RARC, or the Remittance Advice Remark Code, which is used for providing extra explanation and information about CARCs when they have already been used. This additional information usually relates to information regarding remittance processing.

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Understanding RARCs further

To explain RARCs further, RARCs are of two types: Supplemental and informational. Most RARCs are supplemental, since they are merely needed to explain an adjustment already done by CARCs. Informational RARCs, on the other hand, are in the form of alerts, because of which they come with the red lettered, bolded word “Alert”. These alerts are of a general nature and are used to convey important information about the processing of the remittance, and are not related to a specific RARC adjustment.

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Because of the nature of these two codes, it is necessary for healthcare providers to get a thorough understanding of the way they work. If there is a claim denial because of lack of proper understanding and application of the codes; it results in nonpayment, which affects the cash flow. Stifling of this cash flow can in turn affect the players in the healthcare industry, especially the smaller ones. Additional resources will be required to set the claim denials right. When there is a delay in setting the claim denials right; precious time may be lost to the extent that the healthcare provider may lose the chance to go on appeal. This will result in permanent denial of the claim.

Getting RARCs and CARCs right is essential to avoid problems in billing

The solution to avoiding such situations is to arm oneself with full and clear knowledge of the way RARCs and CARCs work and to learn how to identify denials and get a grasp of the impact of RARCs and CARCs on denials.

This is the content of a webinar that is being organized by MentorHealth, a leading provider of professional trainings for the healthcare industry. At this session, Gail Madison Brown, a registered nurse and an attorney with over 25 years of experience in healthcare, will be the speaker. To get proper insights into how CARCs and RARCs work, and to understand the ways of avoiding the costly impacts of their improper use; Read More

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The core aim of this webinar is to help participants learn how to identify denials, understand the codes which affect their denials, and to ultimately help them to establish effective and efficient processes for managing, monitoring and preventing denials.  Compliance, Audit, Billing, Coding and Operations professionals will find this course highly useful and valuable.

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Gail will cover the following areas at this webinar on RARCs and CARCs:

  • Identify and understand denials
  • Effectively manage denials
  • Monitoring of denials
  • Methods to prevent future denials
  • Addressing and appealing denials.

Best Practices For Structuring Physician Employment Agreements

One of the major fallouts of the passage of the Affordable Care Act (ACA) or Obamacare is the phenomenal rise in the number of physician practice acquisitions. These are some of the reasons for this rise:

  • Because of physician practice acquisitions, healthcare providers can consolidate and integrate their business better, since acquisition brings about alignment between the business prospects of the referral networks with the hospital’s strategic goals
  • The amendments brought about to the Medicare and Medicaid reimbursement systems of late have been pushing providers towards bundled and integrated payments, a practice that finds favor with hospitals with more physician practice acquisitions
  • With a noticeable decrease in the reimbursement rates of a few specialties, such specialists can feel secure by tying up with a bigger hospital brand. They not only get a little flexibility and bandwidth in negotiating contract rates; they are also assured of building a regular income stream, something for which they have to strive, sometimes indefinitely, in a private practice
  • Physician practices that are acquired by hospitals help experienced and new physicians alike. While experienced physicians see it as a means for supplementing their incomes; such hospitals usually allow younger physicians the freedom of working at times of their convenience, helping them to experience higher work life balance, something physicians of this age group look forward to earning.

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Enter, the Stark Law

The major federal law that deals with this aspect of healthcare practice is the Stark Law. Formally called The Physician Anti-Referral Law, or Stark II, the Stark Law is a very important law regarding physician referrals, whose provisions any healthcare provider which files claims has to comply with.

Noncompliance results in enforcement actions

The Stark Law is primarily aimed at ridding the healthcare sector of malpractices and is implemented in stages known as Stark II and Stark III. The highlight of the Stark Laws is that they deem certain physician actions as unlawful. When negotiating physician practice acquisition agreements, all the minute aspects of this law, including the few changes that were introduced into it in 2016, need to be taken into consideration.

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Given the significant awards and settlements arising out of Stark Law enforcement actions; there is a heightened need for complying fully with the Stark Laws. As medical groups, hospitals, and health systems move towards integration and work out innovative hospital-physician arrangements; the need for putting in place compensation arrangements that are defensible under the Stark Law is undeniable.

Understand all the elements of the Stark Law

All the diligence and knowledge needed for drafting physician practice acquisitions in line with the provisions of the Stark Law, both from the hospitals’ and the physicians’ side, will be explained at a highly valuable webinar on this topic that is being organized by MentorHealth, a leading provider of professional trainings for the healthcare industry.

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The speaker at this webinar, Joseph Wolfe, who is an attorney with Hall, Render, Killian, Heath & Lyman, P.C., the largest health care focused law firm in the country, offers advice and counsel to some of the nation’s largest health systems, hospitals and medical groups on a variety of health care issues.

An understanding of the legally compliant physician practice acquisition agreements

At this webinar, he will explain the ways in which the contents of the Stark Law need to be understood and interpreted for drafting meaningful and legally compliant physician practice acquisition agreements. He will describe what factors need to be closely and carefully analyzed and scrutinized when working out physician practice acquisitions.

To gain the vital insights needed for understanding the nuances of the Stark Law and the other major legal considerations that need to go into physician practice acquisitions, please enroll for this webinar by visiting Stark Law and key considerations

In this session that is going to be of immense use to everyone connected with Stark Law and its implementation, namely professionals such as In-House Counsel, Healthcare Compliance Officers, Healthcare Human Resources, Healthcare CFO’s, and other levels of healthcare executives, Joseph will cover the following areas:

  • Provide a general Stark Law overview
  • Examine critical components of Stark and Anti-Kickback compliant employment arrangements
  • Discuss best practices for drafting physician employment agreements, related compensation plans and facilitating effective onboarding
  • Discuss best practices for auditing existing employment arrangements
  • Describe alternative structures for organizations intending to qualify as Stark group practices.

What is MACRA and HIPAA

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a federal Act that determines the way in which physicians need to be paid when they treat patients who come to them under Medicare. It substantially alters and replaces the earlier Act in this regard, namely the Balanced Budget Act, which was in force from 1997. Signed into law by then president Barack Obama; MACRA is hailed as his biggest step at reforming the healthcare system in the US since the Affordable Care Act or Obamacare of five years earlier.

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What MACRA does is that it does away with the provisions for physician payments that existed earlier, which was considered flawed as it linked physician payments to budget cuts and economic growth, as a result of which physicians were receiving a 21 percent decrease in their payments. MACRA replaces it with “pay-for-performance” programs called Merit based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APM’s).

Brings about reforms in CHIP

Apart from fixing the way doctors are reimbursed under Medicare; MACRA also extends the State Children’s Health Insurance Program, later christened as just CHIP, short for Children’s Health Insurance Program. Under the CHIP reauthorization provision of this law, around eight million children from low-income groups will receive coverage for two years from the date of this legislation. It also brings into its fold children whose families earn a little more than needed to qualify for Medicaid benefits by providing them low cost health insurance coverage.

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Seeks to reform healthcare funding, as well

MACRA also seeks to fill lacunae in the healthcare funding system by requiring higher income beneficiaries to pay higher premiums for their healthcare from 2018. It fixes slabs of premiums that people in different higher income categories have to pay, based on their income.

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Also, starting in 2020, MACRA will prohibit insurers from selling supplementary insurance to new beneficiaries with the intention of covering the costs that accrue on doctor services in Medicare deductible.

The practical ways of implementing MACRA have to be learnt

While all these changes are being sought into MACRA; understanding how to implement it is complex. The law requires strict compliance with its provisions. This is something that only proper and professional trainings can impart.

This is exactly what a webinar that is being organized by MentorHealth, a leading provider of professional trainings for the healthcare industry, will be offering. At this webinar, Brian Tuttle, a healthcare professional with over 15 years’ experience in Health IT and Compliance Consulting, will be the speaker. To understand the deeper aspects of how to implement MACRA; please enroll for this webinar by visiting MACRA and HIPAA

The link between MACRA and HIPAA compliance

In particular, Brian will focus on the core importance of HIPAA to MACRA and how the two relate to each other. He will explain how to actually “prove” compliance with HIPAA.

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Since the government is very stringent on all aspects of HIPAA implementation including in relation to MACRA; Brian will delve into how practice managers or compliance offers need to understand and implement HIPAA. He will pepper the presentation with specific examples of litigated cases that he has been involved with in which HIPAA violations led to prosecution under state laws of negligence. Also offered in the presentation are specifics relating to HIPAA, which has been gleaned from his experience of having worked both with and against the Federal government in multiple HIPAA audits from 2016.

In the course of this discussion, which will be of tremendous value to practice managers and medical professionals of various specializations; Brian will cover the following areas:

  • MACRA
  • MIPS
  • APM’s
  • HIPAA Security Risk Assessment
  • Risk Factors
  • HIPAA and Litigation.

For More Information :

https://www.mentorhealth.com/control/health-care-quality-improvement-act

https://www.mentorhealth.com/control/health-informatics

https://www.mentorhealth.com/control/hipaa-survival-guide

Overcoming the pain of HIPAA enforcement

In many years that it has been in existence, one of the noticeable changes that HIPAA has undergone is in its attitude. The earlier phase of advice and counseling has now given way to hardboiled and unforgiving enforcement. The Office of Civil Rights (OCR) no longer uses the cajoling and persuasive method. It wants to impose super harsh penalties on healthcare organizations which violate its rules.

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For starters, healthcare organizations have to reckon with new, ominously higher fines, which include mandatory minimum fines of the order of $10,000 for those who are willfully neglectful in their compliance. This is in tune with its decision to raise the importance of HIPAA enforcement through audits. Simply no entity that comes under the scanner of the OCR and is required to carry out a HIPAA audit can afford to relax. Their turn for audit or compliance review can come up anytime.

If with all these changes into HIPAA; an entity that is subject to HIPAA compliance, such as a Covered Entity or its Business Associate and related entities do not take the necessary steps to protect their patients’ rights and health information in accordance with what is required under the HIPAA Privacy, Security, and Breach Notification Rules; they have to face the prospect of being slapped with heavy penalties, which, as mentioned above, start at $10,000 in cases of willful neglect. Covered Entities and Business Associates have to implement the privacy requirements, have to provide good information security, and be in overall compliance.

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Learn from the guru of HIPAA compliance

How do Covered Entities and Business Associates and all those that are connected with HIPAA enforcement activity attain compliance? The text in HIPAA is confounding to many professionals. Many words are complex and ambiguous, making its comprehension and interpretation difficult.

It is to help those associated closely with HIPAA enforcement, such as Compliance Directors, CEO, CFO, Privacy Officers, Security Officers, HIPAA Officers, Chief Information Officers, Health Information Managers, Healthcare Counsel/lawyers and Office Managers that MentorHealth, a highly regarded provider of professional trainings for the healthcare industry, will be organizing a learning session.

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At this webinar, senior HIPAA compliance professional, Jim Sheldon Dean, who is the founder and director of compliance services at Lewis Creek Systems, LLC, a Vermont-based consulting firm, which he founded in 1982, will give a complete roundup of HIPAA enforcement and the ways in which the provisions of this legislation need to be complied with. The aim of this webinar is to help participants overcome the difficulties and complexities associated with HIPAA compliance. To enroll for this highly valuable learning session, please visit

http://www.mentorhealth.com/control/w_product/~product_id=801012?/Wordpress-SEO

A complete learning session on all the aspects of HIPAA enforcement

Jim will explain the HIPAA enforcement actions that have taken place, which will help participants to understand why the enforcement took place. It will also help them analyze what could have been done to prevent the incident that led to the enforcement. He will help them assess the unmet requirements and make them understand what they need to do to ensure that the proper policies, procedures, training, and documentation of their application are in place, so that they can prevent problems and limit the organization’s exposure in incidents.

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This kind of learning is vital when one takes a look at the kind of violations that HIPAA has zeroed in on. Which Covered Entity or Business Associate, would have thought that seemingly mundane and harmless actions as returning copiers to the leasing company without removing the PHI on the hard drive, moving offices without accounting for hard drives stored in a closet, or improperly disposing of printed materials could invite penal actions from HIPAA?

With proper guidance, actions such as these or others that invite penalties from the OCR can be undertaken. Jim will seek to provide learning on these aspects to the participants of this webinar. He will cover the following areas at this session:

  • The HIPAA Privacy, Security, and Breach Notification regulations (and the recent changes to them) and how their compliance will be evaluated in enforcement circumstances
  • Recent changes to the HIPAA enforcement regulations that increase fines and create new penalty levels, including new penalties for willful neglect of compliance that begin at $10,000
  • The information and documentation that needs to be prepared in advance so that you can be ready for an enforcement review or an audit without notice
  • The results of prior HHS enforcement actions and audits (and their penalties), including recent actions involving multi-million dollar fines and settlements
  • Questions asked in prior audits and enforcement reviews
  • Identification of weaknesses in organizational compliance
  • Future threats to the security of patient information
  • The importance of a good compliance process to help you stay compliant more easily.

Thorough understanding of the CERT program is necessary to fix error rates

The Comprehensive Error Rate Testing (CERT) is a program used by the Centers for Medicare & Medicaid Services (CMS) for calculating the rate or extent of improper payments of Medicare Fee-for-Service (FFS). The method used by the CMS under CERT is to pick up a stratified random sample of some 40,000 claims that are statistically valid and calculate and audit it to determine if the payments were made in accordance with the rules relevant to items such as coding, Medicare coverage, and billing rules.

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These claims are selected from the submissions made to Part A or Part B Medicare Administrative Contractors (MACs) and Durable Medical Equipment MACs (DMACs) during each reporting period. This sample is deemed as being adequately representative of the universe and is considered a good enough indicator of the method by which improper payments can be calculated for the whole system.

For the 2016 fiscal year, the CMS arrived at Medicare FFS program improper payment rate of 11.00 percent. This means that as much as $41.08 billion was made in improper payments. This represented a slight dip over the previous fiscal year, in which the improper payment rate was 12.09 percent, meaning that a high volume of $43.33 billion was made in improper payments.

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Knowing CERT is important

Having knowledge of the CERT is necessary for players in the healthcare industry, as anyone of them can be picked up from the statistically valid random sample that the CMS chooses from to audit for checking improper payments. How do these entities make sure they are properly equipped to deal with the CERT program?

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A webinar from MentorHealth, a leading provider of professional trainings for the healthcare industry, will seek to answer this. At this session, Gail Madison Brown, a Registered Nurse and an attorney who has focused on health care compliance and revenue cycle management operations for the last 15 years, will be the speaker. To gain full knowledge of how to comply with CERT, please register for this webinar by logging on to

http://www.mentorhealth.com/control/w_product/~product_id=800965LIVE/?Wordpress-SEO

Full exploration of CERT and its functioning

To understand the nitty-gritty of the way the CERT is designed and works. This comprehensive learning about the CERT program will equip participants with the knowledge needed for ensuring compliance with billing and healthcare operations, so that their organization does not get hauled up by the CMS for improper payments. The way in which this program affects the organization and its reimbursement will be taken up for discussion. She will arm the participants with prevention strategies with which they can improve compliance.

Gail will take up these topics at this webinar:

  1. Summary of the CERT program and how it affects healthcare providers
  2. Improper payment measurement history
  3. CERT process and how to respond
  4. Prevention Strategies

Those in compliance, audit, billing and coding, and other professionals engaged in operational strategies will find this course highly useful. Gail will cover the following areas at this session:

  • CERT program -what it does and who if affects
  • History and trends of improper payments
  • How the CERT process works and how you need to respond, including what documentation to provide
  • Understand types of improper payment categories and implement strategies to prevent further CERT requests and demands -No documentation, insufficient documentation, medical necessity, incorrect coding and other issues.

HIPAA implementation should be grasped from an insider’s perspective

Carrying out HIPAA implementation is something a Covered Entity or a Business Associate has no choice about. To carry out this mandatory activity, the most important requirement is getting a proper grasp of how to carry out HIPAA audits. As is known in the industry circles, carrying out HIPAA audits is a big task for even the most seasoned professional in the healthcare industry.

The main reason for which Covered Entities and Business Associates consider HIPAA implementation difficult is because of the nature of HIPAA audits. HIPAA contains words that are subjective and confusing. So, getting a grasp of the nuances and subtexts and their intended meanings is very essential for a Covered Entity and a Business Associate in order to get their HIPAA implementation right.

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Varied kinds of penalties

When one takes a look at the kind of penalties imposed already in 2017; the need for understanding how to get HIPAA implementation right becomes all the more acute. As recently as in the last week of April 2017, the OCR announced a HIPAA settlement of the order of $ 2.5 million on CardioNet, a Pennsylvania-based provider of remote mobile monitoring and rapid response to patients with cardiac issues.

Its fault: it did not take sufficient care to prevent an employee’s laptop, which contained the health records of nearly 1400 patients, from getting stolen. The investigation by OCR concluded that CardioNet had not carried out Risk Analysis properly and had not put the right risk management processes in place at the time the theft took place. This is just one instance of an entity not taking the required steps for HIPAA implementation. There are many others that have attracted similar and even higher penalties for a variety of reasons.

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OCR has been tightening HIPAA implementation audits

All these apart, the allocation in the federal budget for the office of civil rights has gone up by 10 percent for 2017 over the previous year. What does this mean? It makes the OCR’s scrutiny and vigilance of Covered Entities and Business Associates even tighter than it was before, since the OCR has announced that it will be using these extra resources to improve and streamline the tools they use for vigilance and to also adapt newer, more advanced technologies into healthcare IT infrastructure.

All these actions are the result of the reinvigorated Phase 2 HIPAA audits, which the OCR started in March 2016.

Get trained on how to get HIPAA implementation right

A look at all these cases makes it clear that it is absolutely necessary for Covered Entities and Business Associates, as well as all those involved in one or another way with HIPAA audits, such as Practice Managers, Business Associates who work with medical practices or hospitals (namely billing companies, transcription companies, IT companies, answering services, home health, coders, attorneys, etc.), and MD’s, and other medical professionals, to get all the aspects of their HIPAA implementation completely right.

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The in-depth knowledge needed for understanding and getting HIPAA audits right is the learning outcome of a webinar from MentorHealth, a leading provider of professional trainings for the healthcare industry. Brian L Tuttle, a senior Compliance Consultant & IT Manager at InGauge Healthcare Solutions, will be the speaker at this webinar, to enroll for which, all that is needed is to visit

https://www.mentorhealth.com/control/w_product/~product_id=801002?/Wordpress_SEO

As someone who has been on both sides of the audits, Brian will explain the way real life audits are conducted by the federal government for phase 2 and beyond. He will explain just what the highest risk factors for non-implementation are, some of which may even cause people to chuckle. He will explain what practice or business managers or compliance officers need to do if they have to get their HIPAA audits right. Also taken up will be the major changes under the Omnibus Rule and any other applicable updates for 2017.

Brian will mainly seek to clear the misconceptions and myths about this often misunderstood law. He will teach participants the way to put a HIPAA compliance program in place. He will also explain the dos and don’ts of HIPAA Omnibus, among many other issues related to this topic.

The following areas will be covered at this session:

  • Updates for 2017
  • Requirements of Compliance Officers
  • Audit Process
  • What can cause an audit
  • How to avoid audit
  • What to do in the event of an audit
  • How to speak and deal with Federal auditors
  • Risk Assessment
  • Best resources