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Red Flags of Fraud (001260-20231030)
(LMS Course)
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Description: This course will explain how to be on the alert for red flag issues to avoid being involved in Medicare fraud committed by outside contractors; what these issues include the penalty for failure to detect fraud; suspicious signs that can indicate fraudulent activity; the proper procedure for reporting fraud and violations; and how to handle external communications. Course run time 13 minutes.
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Published: November 13, 2023
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Espanol
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English Talking Points
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Understanding and Using the Medicare Triple Check Process (001111-20210101)
(LMS Course)
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Description: Ensure accuracy of billing for skilled services. Prevent submission of false claims. Reduce the number of adjusted or denied claims. Determine that residents receive the benefits to which they are entitled. Ensure that clinical documentation correlates with financial data. Course run time 10 minutes.
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Published: August 04, 2023
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Espanol
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Are You Compliant with Conflict of Interest Expectations (001006-20210101)
(LMS Course)
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Description: Identify Company core compliance values; state the purpose of the Company Code of Conduct; list several examples of a conflict of interest; understand how to report a conflict of interest or other concern. Course run time 16 minutes.
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Published: August 03, 2023
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Espanol
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Medical Director Contracts in a Nursing Facility (001075-20210101)
(LMS Course)
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Description: Identify the Anti-Kickback Statute. Identify the Stark Law. Determine what components are required in a physician contract. Course run time 14 minutes.
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Published: August 03, 2023
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Espanol
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Medicare Enrollment / Disenrollment (001076-20210917)
(LMS Course)
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Description: Recognize the four parts of Medicare and what each part covers for the beneficiary. Discuss Medicare Advantage plans and how they differ from original Medicare. Discuss what needs to be included in the facility’s policy and procedure for Medicare Enrollment/Disenrollment in order to be compliant with regulations, resident rights, and to avoid fraud, waste, and abuse of government funds. Run time 35 minutes.
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Published: August 03, 2023
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Espanol
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Protecting Resident Finances (001154-20220101)
(LMS Course)
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Description: Develop an understanding of appropriate professional behavior regarding gift giving from residents or their families, learn about F-tag 602 that prohibits financial exploitation of residents and misappropriation of residents’ property or funds, discuss the consequences of theft and the best practices for issues affecting residents and their belongings. Course run time 13 minutes.
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Published: August 03, 2023
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Espanol
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Creating a Culture of Compliance (001178-20220101)
(LMS Course)
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Description: This course will explain what a Compliance and Ethics program is; discuss Element 4 Communication, Education, and Training; describe culture; and list areas for focus when planning to develop a culture of compliance. Course run time 13 minutes.
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Published: August 03, 2023
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Espanol
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Liability of Fraudulent Documentation (001179-20220101)
(LMS Course)
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Description: This program will discuss that fraudulent documentation is a widespread issue; the penalties for falsifying information; the purpose of the OIG; that falsifying bills and medical records are common schemes; situations which may suggest fraudulent activities; and the importance of complete and accurate documentation of services. Course run time 12 minutes.
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Published: August 03, 2023
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Espanol
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Business Ethics (001225-20221223)
(LMS Course)
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Description: This course will discuss the definition of ethics and its key values, potential conflicts of interest, ethical business practices, the importance of honest communication, the duty to report, and practices to avoid. Course run time 23 minutes.
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Published: August 03, 2023
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Espanol
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Origin of Fraud (001202-20220811)
(LMS Course)
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Description: This program will discuss the role of the Office of Inspector General (OIG) and Department of Justice (DOJ); Medicaid fraud control units and Medicare and DOJ fraud strike forces; Federal monitoring of nursing homes; CMS nursing home enforcement, enforcement remedies; deficiency severity and scope levels; the origin of fraud; the importance of a compliance and ethics program and required components; Federal compliance-related laws; and what to do if contacted by government agent/investigators. Prime subscribers will earn CE's. Course run time 51 minutes.
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Published: August 03, 2023
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Espanol
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