Healthcare is a multi-trillion-dollar industry that remains highly regulated. When organizations bill for services, they are reimbursed on a good-faith basis with the expectation that clinical documentation supports the services reported and regulatory compliance has been met. Every year the OIG releases their respective work plan which highlights areas and services that represent high priority audit targets during the upcoming year. It is important to stay aware of the 2023 OIG audit targets and use the work plan as a guide to mitigate compliance risk. Healthcare compliance audits and investigations are occurring at unprecedented rates. Gone are the days when the large hospitals and pricey DRGs (diagnosis related groups) were the only targets on the radar for compliance enforcement. It is imperative for organizations to stay diligent and apprised of these compliance initiatives and be especially proactive in their compliance efforts, conduct regular audits of processes and clinical documentation, and comply with the mandatory self-reporting requirements set forth by the Affordable Care Act.
This webinar will cover the key governing authorities involved in healthcare compliance, dissect various pathways involved in audits and investigations, review the OIG 2023 work plan, spotlight 2023 audit trends and audit targets, identify relevant action protocols, discuss recent OIG advisory opinions, identify elements of an effective compliance plan, and discuss actionable best practice tips for success in 2023.
Toni Elhoms, CCS, CRC, CPC, AHIMA-Approved ICD10-CM/PCS Trainer is a nationally known speaker and recognized subject matter expert on medical coding, reimbursement, and revenue cycle management. She is the Founder and CEO of Alpha Coding Experts, LLC. She holds multiple credentials with the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). With over a decade of industry experience, she has led and supported hospital systems, universities, physician practices, payers, government agencies, and other entities on coding, billing, and compliance initiatives. She is a frequent contributor to various media outlets, speaker, and regular guest on industry podcasts. She created the Alpha Coding Podcast series to share her industry Pro-Tips. She also leads and mentors a network of revenue cycle management professionals across the country and serves as the President of the Orlando, FL AAPC Chapter.
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