Payor Disputes & Audits: Observations & Strategies

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Payor Disputes & Audits: Observations & Strategies

Online Healthcare Compliance Training

Release Date: 12-9-2020
Expiration Date: 12-8-2021

Target Audience: This activity is designed for Physicians, Healthcare Providers, Practice Managers, Human Resources, Employees

Learning Objectives: At the end of this activity, physicians should be able to:

  • Describe the government audit process – from initial correspondence through the various stages of appeal and share speakers’ experience with respect to commercial payor audits – what is similar and what is different from government audits.
  • Discuss the provider’s responsibilities with respect to the medical necessity of testing for which it is submitting claims.
  • Identify steps providers can take to prepare for audits prior to an audit being initiated.

Faculty: Courtney Tito, Esq., Member of McDonald Hopkins, LLC. Courtney Tito counsels and represents clients in the health law industry, including, federal and private payor audits and disputes, reimbursement, contract, corporate, enrollment revocations, payment suspensions, internal investigations, compliance and regulatory, and in responding to federal subpoenas and civil investigative demands. She advises clients in both federal and state matters. She has counseled clients on regulatory, licensing, compliance, reimbursement, corporate, CLIA standards, state and federal fraud and abuse rules and regulations and telehealth matters. She has also advised clients regarding direct to consumer issues.

Accreditation Statement and Financial Disclosure: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint-providership of the Medical Society of Delaware and First Healthcare Compliance. The Medical Society of Delaware is accredited by the ACCME to provide CME activities for physicians.

The following faculty and members of the CME Planning Committee have no financial relationships with commercial interests: Courtney Tito, Esq., Sheba E. Vine Esq., William Sheppard, MD.

Credit Designation Statement: The Medical Society of Delaware designates this internet enduring material activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Joint providership of CME by MSD in no way implies endorsement of any product or service. This activity is not supported by commercial funding.

Receiving CME Credit: In order to claim AMA PRA Category 1 Credit™, a post-test must be completed at the conclusion of this activity with a minimum grade of 67%.

Hardware/Software Requirements: Mac or Windows

For technical questions/difficulties, please contact or call 888.543.4778

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