Global Certificate in Medical Claim Regulatory Compliance
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⢠Medical Claims Process: Understanding the basics of medical claims process, including claim submission, documentation, and payment processing.
⢠Regulatory Compliance: Overview of regulatory compliance in healthcare, including laws and regulations related to medical claims and billing.
⢠Coding and Classification Systems: In-depth analysis of coding and classification systems, including ICD-10, CPT, and HCPCS.
⢠Fraud, Waste, and Abuse Prevention: Strategies for preventing fraud, waste, and abuse in medical claims, including detection and reporting requirements.
⢠Compliance Audits: Understanding the compliance audit process, including internal and external audits, and how to prepare for them.
⢠Risk Management: Techniques for managing risk in medical claims, including compliance risk assessments and corrective action plans.
⢠Data Analysis and Reporting: Analyzing and reporting data related to medical claims, including data integrity and accuracy.
⢠Compliance Training: Best practices for compliance training, including development, implementation, and maintenance of training programs.
⢠HIPAA Compliance: Overview of HIPAA regulations and their impact on medical claims and billing, including privacy and security requirements.
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