Compliance and the FQHC Revenue Cycle

May 2, 2023

In this day-long training, Susannah Vance Gopalan of Feldesman Tucker and Rebekah Wallace Pardeck of Achieve Revenue Management will discuss key areas of regulation that federally qualified health centers (FQHC) encounter at each stage of the revenue cycle, from enrolling the FQHC with federal programs, to “onboarding” clinicians, to self-auditing filed claims.

After defining the concept of revenue cycle compliance and the activities it encompasses, the presenters will first identify key sources of law, regulation, and program guidance relevant to revenue cycle processes. The presenters will discuss revenue cycle compliance risk areas they have observed in their work with health centers, ranging from managed care credentialing of clinicians, to key FQHC claim documentation requirements, to the handling of non-covered and bundled services in the claims process. The presenters will identify the various types of Medicare and Medicaid audits and auditing entities, providing an overview of typical audit processes. Finally, they will identify best practices for revenue cycle compliance, including policies and procedures and internal audit schedules and protocols.

Target Audience

  • Health Center CEOs
  • CFOs
  • COOs
  • Revenue cycle managers and billing managers

Learning Objectives

After this training, you will be able to:

  1. Identify key sources of law, regulation, and program guidance relevant to revenue cycle processes
  2. Learn strategies for proactively addressing the key risk areas in the FQHC revenue cycle
  3. Describe the Medicare and Medicaid audit types and auditing entities
Course summary
Available credit: 
  • 4.25 Certificate of Attendance
  • 5.00 CPE
    FTLF is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors.
Course opens: 
12/20/2022
Course expires: 
08/03/2023
Event starts: 
05/02/2023 - 11:00am EDT
Event ends: 
05/02/2023 - 4:30pm EDT
Cost:
$650.00

Agenda

FTLF Virtual Classroom
Tuesday, May 2, 2023
*Agenda times are all ET and subject to change*
 
Tuesday, May 2, 2023
11:00 a.m. - 4:30 p.m. ET
11:00 - 11:15 a.m. Introductions
11:15 - 11:30 a.m. Defining Revenue Cycle Compliance
11:30 a.m. - 12:15 p.m.

Regulatory Framework

  • Fraud and abuse laws
  • Payor rules and requirements
  • Section 330 program requirements
12:15 - 12:30 p.m.Break
12:30 - 1:45 p.m.

Key Risk Areas

  • Provider onboarding (enrollment, managed care credentialing, NPI enumeration)
  • Claim documentation requirements
  • Documenting FQHC wraparound claims
  • Medical necessity
  • Non-covered and bundled services
1:45 - 2:15 p.m. Break
2:15 - 3:00 p.m.

Investigations Process

  • Internal
  • Outside agencies
3:00 - 3:15 p.m. Steps for Correction
3:15 - 3:30 p.m. Break
3:30 - 4:15 p.m. 

Ongoing Monitoring

  • Suggested compliance plan elements
  • Policies and procedures
  • Internal audit schedule
4:15 - 4:30 p.m. Q&A

FTLF'S VIRTUAL CLASSROOM

This live, interactive training will take place in FTLF's Virtual Classroom, hosted by Zoom.  Should you have any technical questions or would like more information, please contact us at learning@ftlf.com or 1-855-200-3822.

SUSANNAH VANCE GOPALAN

Susannah is a Partner in the firm’s health law practice group where she focuses on health care litigation and regulatory counseling, with a focus on Medicaid and Medicare payment, financing, and compliance issues. Susannah brings regulatory expertise to bear when advising clients and pursuing litigation on their behalf. She has experience negotiating Medicaid waivers and managed care arrangements on behalf of providers, provider associations, and governmental entities. She represented a group of providers in reaching a settlement in major Medicaid litigation. [Full Bio]

REBEKAH WALLACE PARDECK (Achieve Revenue Management, LLC)

President and Owner of Achieve Revenue Management, LLC, Rebekah has more than 20 years of coding, revenue cycle management, operations, and training experience. She provides training and revenue cycle management services to federally qualified health centers, rural health clinics, and medical practices and community health centers.

Previously, Rebekah worked for over a decade as a consultant with a national accounting firm and as the director of operations for management service organizations and hospital-owned multispecialty physician practices. She is experienced in consulting on professional revenue cycle analysis and enhancement, medical practice operations, patient flow redesign, business process improvement and development, staffing analysis and redesign, practice efficiency and productivity and educational sessions and training. [Full Bio]

Participants can earn up to 5.00 CPE credits in Specialized Knowledge and Applications upon completion of all course requirements.

ADDITIONAL INFORMATION

  • Prerequisites: None 
  • Target Audience: Health Center CEOs, CFOs, COOs, Revenue cycle managers and billing managers
  • Advanced Preparation: None  
  • Program Level: All
  • Delivery Method: Group Internet Based

Feldesman Tucker Leifer Fidell LLP is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website www.nasbaregistry.org (formerly www.learningmarket.org).

Available Credit

  • 4.25 Certificate of Attendance
  • 5.00 CPE
    FTLF is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors.

Price

Cost:
$650.00
Please login or register to take this course.

TRAINING IS NOT RECORDED

This training will not be recorded for later viewing, as we would like attendees to be comfortable and candid, sharing their experiences and asking scenario-based questions. The discourse between the attorneys and participants is a valued part of each training.


Registration Fees

Early Registration
(Through February 28)
Regular Registration
(March 1 and Later)
$650$795

 


Group Discounts

Bring your team! Discounts are available for groups of three (3) or more individuals from the same organization. Please contact us to process your registration.

Groups of 3 - 6
Groups of 7 - 10
Groups of 11 - 15
Over 15 attendees
10% off 15% off20% offCall us!

Registration Instructions

Each registration must be in the name of the individual(s) who will attend. This allows FTLF to communicate important course information to the actual attendee(s), add training materials and handouts to the right account, and properly assign certificates of attendance or CPE credits. 

To register for this training:

  • For yourself: login to your account and register with your personal information
  • For someone else: login with the ATTENDEE’S login information or create an account for the ATTENDEE and register from the ATTENDEE's account
  • For a group: email Learning@ftlf.com to complete group registration

If you encounter problems or have questions Contact us.


Payment

We accept payment by PayPal, credit card, and check. Payment for any live training is due upon registration. If payment is not received in full prior to the start of the event, FTLF reserves the right to cancel your order and deny you entrance to the training.


Cancellation/Transfer Policy

All cancellation or transfer requests must be received in writing at learning@ftlf.com. Requests for refunds or transfers for in-person events will be granted according to the following schedule:

  • 30 or more days prior to the event, requests for a full refund or a transfer, minus a $75 administrative fee, will be granted.
  • Between 11 to 29 days prior to the event, requests for cancellations will be granted a 50% refund and requests for transfers will be granted, space permitting and subject to a transfer fee.
  • Within 10 days of the event start date, no requests for refunds or credits will be granted. At FTLF's discretion, late transfers may be granted, space permitting and subject to a transfer fee.

If there are extenuating circumstances regarding your cancellation, please reach out to the FTLF Training Team directly at learning@ftlf.com.

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