Reviewing Claims for Compliance: Lessons Learned from OIG Corporate Integrity Agreements
Webinar Date/Time: December 6, 2018 at 2:00 PM EST
Join Strategic Management Services and SAI Global for a free webinar on Thursday, December 6th at 2:00 PM EST. The webinar will focus on lessons learned from Corporate Integrity Agreements (CIAs), specifically related to claims reviews. Such reviews are typically conducted by an Independent Review Organization (IRO), as required by the Office of Inspector General, to verify ongoing compliance with payor guidelines and effective billing and coding of systems and internal controls. During the webinar we will also discuss best practices for implementing compliance audits and documentation initiatives to improve your organization’s overall compliance with federal and state requirements and reduce risks and vulnerabilities.
Strategic Management’s Subject Matter Expert on billing and coding, Cornelia Dorfschmid, PhD, MSIS, PMP, CHC, will provide an overview of topics including:
- Claims volume and frequency of reviews
- Documentation of reviews
- Statistical and judgmental sampling
- Error rates and instances of deficiencies
- Medical necessity and appropriate documentation
- Centers of Medicare & Medicaid Services Overpayment rule and extrapolation
Cornelia Dorfschmid PhD, MSIS, PMP, CHC has over 20 years of private and government sector experience in compliance consulting, the majority of which was in management and executive capacities. She is a recognized expert in the areas of corporate compliance, HIPAA and compliance risk assessments, enterprise risk management (ERM), RAT-STATS sampling and overpayment estimation, and litigation consulting. She has operational experience with organizations under CCA/CIA and settlement agreements with the Department of Health and Human Services OIG, and works with various law firms and their clients to arrive at satisfactory solutions for payment error issues, overpayment settlements, fair market value issues, and self-disclosure. Read her full bio here.