The complexities of billing can turn into a very real legal nightmare for you and your practice (i.e., balance billing and write-offs for out-of-network, financial hardship, insurance only, professional courtesy, etc.). Even a simple, honest mistake can lead to massive financial penalties, require you to repay reimbursements you’ve previously received, or worse, result in criminal prosecution.

Billing laws and regulations continue to become more complicated each year. Many states now require providers to obtain out-of-network payment from the health plan and not the patient — or risk violating the law. CMS and private payer auditors are actively monitoring compliance and waiting for errors.

With the right guidance, you can take proactive steps to stay off auditors’ radars and avoid stressful audits and devastating penalties.

During this 60-minute online training session, attorney Amanda Waesch, Esq., will provide practical, actionable advice to help you avoid dangerous billing missteps and protect your practice.

What You'll Learn

• How to legally write off certain balances when billing out of network
• How to meet billing requirements and avoid criminal prosecution
• How to prevent OIG fraud charges related to routine waivers and write-offs
• The difference between professional courtesy and insurance-only billing
• How to implement policies to monitor write-offs and bad debt
• When and if you can offer professional courtesy
• Possible punishments and penalties for improper balance billing
• How to train staff on discount compliance do’s and don’ts
• How to avoid violating Stark and Anti-Kickback statutes due to balance billing practices
• Proven tips to keep your billing compliant and legally sound
• When it is appropriate to write off co-pays or deductibles
• And more practical compliance strategies

Real-World Consequences of Non-Compliance

Ignoring complex billing regulations is not an option. There are documented cases where physician practices attempted to comply but still faced severe penalties.

•  A California physician received five days in jail and a $562,500 fine.
• A medical practice was required to repay $4.3 million after being sued for improper balance billing.
• A pulmonology practice paid $10,000 in fines and repaid $2.5 million in collected funds.

It is essential to understand how to properly navigate the legal pitfalls of billing for your services. Without proper compliance safeguards, your practice could face similar consequences.

Don’t take unnecessary risks — secure your spot in this must-attend online training session today.