Certified Medical Compliance Officer (CMCO)

Compliance certification is a strategic move. Medical office professionals who expand their compliance knowledge now will have the edge in today’s ever-changing health care climate.

Why You Need It

Each day that passes without an effective compliance plan increases your risk of staggering fines, penalties or even criminal liability if an auditor uncovers overpayments or alleged fraud. It is no longer a question of whether or not a practice will be audited by a third party, but when.

The evolution of health care is changing the way we handle patient records, write prescriptions, bill for services, work with physicians, hospitals and DMEs, etc. As if all of this weren’t stressful enough, the Office of the Inspector General (OIG) is watching and commanding total compliance with applicable rules and regulations.

Lack of knowledge won’t hold up in a federal audit.

Medicare and Medicaid have expanded audit contractor programs to squash fraud and waste. RAC/ZPIC or other contractors have been authorized by Medicare to come in to your office and request dozens, even hundreds of claims, with little notice and you must comply. Remember, even honest mistakes can trigger an audit.

Don’t be intimidated.

This is scary stuff, but for us, it’s a natural fit. We know this subject inside and out. PMI has spent 30 years teaching medical office professionals how to do it the right way. This program was carefully developed by leading compliance experts, Robert W. Liles and D.K. Everitt. They teach this course in a way that you will understand, sharing real-world compliance examples relevant to your office. You’ll learn to handle tough situations with ease.

Is your organization prepared for greater accountability?

The OIG expects all health care organizations to be compliant with health care laws. This goes well beyond a paper document stuck in a file. It represents a functional, ongoing program with factors such as measuring effectiveness, proper training, review and update of policies and procedures. Your practice will be held accountable for new fraud and abuse risk areas that may arise as your organization becomes involved with new payment and delivery systems (such as medical homes, accountable care organizations, bundled payments, and value-based purchasing).

The severity of fines for false and fraudulent claims and kickbacks is staggering. As an example, the OIG has set the minimum settlement amount for violations of Self-Disclosure Protocol (SDP), under both the anti-kickback statute and the physician self-referral (“Stark”) law at $50,000 and up to three times the total remuneration.

Call The Center at 504-621-1670 or email us for details