Excellence in Dermatology™
Excellence in Dermatologic Surgery™
Excellence in Medical Dermatology™
Excellence in Dermatopathology™

Maintaining Compliance in Dermatology: Safeguarding Against Legal and Financial Risk Manual

Protect your practice to avoid and reduce potential billing fraud with this intuitive resource. Plus, get access to a ton of handy checklists, videos, tip sheets and much more!
Item # PME16
Member
$135.00
Retail
$260.00
  • Overview

    From preventing erroneous claim submissions to avoiding unlawful business conduct when dealing with federal and private-sector payers, this resource will help you understand and apply the legal and regulatory requirements needed to improve your claims payment processes, mininmize billing errors and reduce the risks of audits.

    Get access to a TON of templates, including handy checklists, videos, tips sheets and more! Templates on CD-ROM included with manual.

    Looking for a digital format? eBook also available here!

  • Specifications
    # of pages: 327
    Publisher: American Academy of Dermatology 
    Templates and sample forms included on CD  
    Format: Perfect Bound
    Item#: PME16
  • Table of Contents
    1. Introduction
    2. Compliance Manual A Guide for Dermatology Practices
      • An OIG Compliance Glossary: Abbreviations and Definitions
      • OIG Compliance vs. HIPAA Compliance
      • Office of the Inspector General (OIG) Compliance — Voluntary
      • HIPAA Privacy and Security Compliance — Mandatory
    3. Exhibit 1 Some Questions Compliance Professionals Should Ask as They Prepare for Health Care Reform
    4. Exhibit 2 Understanding Program Exclusions
    5. Exhibit 3 Commonly Used Anti-Kickback Statute Safe Harbors
    6. Exhibit 4 Physician Self-Referral Law (42 U.S.C. § 1395NN): Commonly Used Physician Self-Referral Law Exceptions
    7. Exhibit 5 Physician Self-Referral Law (42 U.S.C. § 1395NN): 
    8. Three Questions to Ask When Analyzing the Physician Self-Referral Law 
    9. Stark Law Compliance Tips
    10. Exhibit 6 Comparison Of The Anti-Kickback Statute And Stark Law
    11. Chapter 1 Why Your Practice Should Consider Implementing an OIG Compliance Program
    12. Chapter 2 Medicare Basics for Dermatology Practices — A Refresher Course
    13. Medicare Part A 
    14. Medicare Part B
    15. Medicare Part C
    16. Medicare Part D – Prescription Drug Program 
    17. Physician Participation in the Medicare Program
    18. Additional Medicare Billing Considerations
    19. Exhibit 7 Out-of-Network Waiver Form
    20. Exhibit 8 Patient Information
    21. Exhibit 9 Sample Beneficiary Letter — Nonparticipation — Elective Surgery
    22. Exhibit 10 Notice to Medicare Patients
    23. Exhibit 11 and Exhibit 12 Advance Beneficiary Notice (ABN)
    24. Exhibit 13 Notice of Noncovered Service to Managed Care Patients
    25. Exhibit 14 Medicare Patient Registration
    26. Chapter 3 Designating a Compliance Officer or Contact
    27. Exhibit 15 Compliance Leader Job Description
    28. Chapter 4 Outlining and Implementing Your OIG Compliance Plan 
      •  The Let’s Do It Schedule – Setting the Compliance Program in Motion 
      •  Effective Audits Protect Your Practice 
      •  Deciding Which Type of Audit to Do First 
      •  The Function of Monitoring and Auditing
    29. Exhibit 16 Simple Audits with Sample Surveys
    30. Exhibit 17 Operating an Effective Compliance Program
    31. Exhibit 18 Confidentiality Policy and Confidentiality Statement
    32. Exhibit 19 Sample Job Description
    33. Chapter 5 Implementing Compliance Practice Standards 
      • What’s the Difference Between a Policy and a Procedure? 
      •  Writing Procedures 
      •  Who is Going to Write the Procedure for Each Job? 
      •  Options to Procedure Writing In-House
    34. Exhibit 20 Sample Office Policy
    35. Exhibit 21 Sample Office Procedure
    36. Exhibit 22 Initials Log
    37. Exhibit 23 Refund Notice
    38. Exhibit 24 Minor Patient Registration Form
    39. Exhibit 25 Patient Demographics
    40. Exhibit 26 Fee Ticket/Encounter Form Completion
    41. Exhibit 27 Charge Entry/Claims Submission
    42. Exhibit 28 Payment Posting
    43. Exhibit 29 Appeals and Reviews
    44. Exhibit 30 Sample Appeal Letter
    45. Exhibit 31 Audit Requests
    46. Exhibit 32 Collection of Copayments, Deductibles and Balance Billing
    47. Exhibit 33 Medical Necessity
    48. Exhibit 34 Coding Documentation
    49. Chapter 6 Conducting Appropriate Compliance Training and Education 
      •  Education and Training to Achieve Compliance 
      •  Documenting Your Education and Training Efforts
    50. Exhibit 35 MEDICARE MedLearn (MLN)
    51. Exhibit 36 Record of Baseline Testing, Education, and Training
    52. Exhibit 37 Record of Review of Educational Materials
    53. Exhibit 38 In-Service Training Documentation
    54. Exhibit 39 Evaluation of Presentation
    55. Exhibit 40 Medicare Baseline Test
    56. Exhibit 41 Training Policy
    57. Chapter 7 Responding to Detected Offenses and Developing Corrective Action
      • Taking Corrective Action – The Fix It Plan 
      • Developing a Set of Monitors and Warning Indicators
    58. Exhibit 42 A Sample OIG Compliance Policy
    59. Exhibit 43 Employee Certification
    60. Exhibit 44 Compliance With HHS OIG Fraud Alerts
    61. Exhibit 45 Investigations and Corrective Actions
    62. Exhibit 46 Annual Compliance Audit
    63. Exhibit 47 Compliance Documentation
    64. Exhibit 48 Tips for Success in the OIG Self-Disclosure Protocol
    65. Chapter 8 Developing Open Lines of Communication
    66. Exhibit 49 Suspected Violation(s) Report
    67. Exhibit 50 Training Tool: Compliance is Always a Two-Way Communication
    68. Chapter 9 Enforcing Disciplinary Policy through Well-Publicized Guidelines 
      • The Enforcement Plan
    69. Exhibit 51 Counseling Conference Sheet
    70. Exhibit 52 Non-Employment of Sanctioned Individuals
    71. Exhibit 53 Employee Standards of Conduct and Disciplinary Policy and Action
    72. Chapter 10 Maintaining Your OIG Compliance Program