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Certified Medical Compliance Officer

Lead the compliance program in a medical office. From data breaches to audits, business associate agreements, and everything in between, a well-trained compliance officer fills an important role, minimizing risks and costly mistakes.
32 CEUs
18 HRs
2,095
 
The Bureau of Labor Statistics projects this occupation will grow by 8.2 percent through 2026, adding about 23,700 new jobs.

Why get certified?

– The CMCO program includes training in all areas needed for medical offices to stay compliant with federal guidelines.
– The certification validates proficiency in the development, implementation, and management of an ongoing compliance program.
– The advanced knowledge gained from this program helps minimize costly compliance threats in your organization.
– CMCO certification demonstrates to employers, business associates, and auditors that you have specialized compliance expertise.
– A compliance certification lays the foundation for career advancement, and helps you stand out in a competitive job market.

Your Projected Salary*

$52k
Average salary in 2017 for a medical coding professional
$70k
Average salary in 2017 for a CMCO

 

*Source: AAPC. Job salary will vary on years of experience, location, practice, and # of certifications.

Course Summary

Enroll in the CMCO certification program online and get certified on your schedule.
This program includes unrivaled instruction, resources, and support:
  • 12 pre-recorded, 90-minute sessions, led by program author, Robert W. Liles, JD, MBA, MS
  • Physical course manual with real case studies and resources for ongoing reference
  • Access to recorded material online for up to one year after the original recording date
  • Proctored certification exam

Exam

  • The exam is open book with five hours allotted for completion.
  • 85 questions with 4 extra credit questions.
  • The CMCO course manual and all notes may be utilized during the exam.
  • All exams are hand-graded by the instructor and results are provided within 4 to 6 weeks of completion.

PMI’s Exam Coordinator schedules the exam in a testing center near the candidate’s location - usually a nearby community college or testing facility. A score of 70% or better is required to earn the CMCO certification. If the candidate does not achieve a passing grade on the first attempt, he/she may re-test for an additional fee.

Registered students can access the recordings online for up to one year after the original recording date.

Practice Management

  • Compliance structure and enforcements
  • The seven elements of the compliance plan
  • Health care fraud enforcement and sentencing guidelines
  • False Claims Act, Stark, and the Federal Anti-Kickback Statute
  • Calculation of civil monetary penalties
  • Whistleblower complaints
  • Legal provisions of compliance with a review of actual case examples
  • Impact of Health Care Reform on enforcement statutes and practices
  • Performing a gap analysis and other means of identifying practice-specific risks Billing/coding/coverage and reimbursement

Billing/coding/coverage and reimbursement

  • Coding, billing and documentation considerations
  • LCDs/NCDs and their applicability to coverage decisions
  • Drafting and incorporating the office compliance plan
  • Mission statement, codes of conduct, and organizational goals
  • The growing threat of electronic security and identity theft Compliance, risks, actions and issues

Compliance, risks, actions, and issues

  • Role of the Compliance Officer in the organizational hierarchy
  • UPICs, ZPICs, RACs, SMERCs, and other Medicare/Medicaid contractors
  • Correct handling of an audit request
  • Organizational risks, peer review actions, state licensure issues
  • Employee screening, staff, and patient relations
  • Employee notification of obligations and consequences for failure to comply
  • Drafting enforcement and discipline provisions
  • Ongoing monitoring and auditing
  • Overview of law enforcement organizations Medicare exclusion and its impact on an organization

Medicare exclusion and its impact on an organization

  • Permissive vs. mandatory exclusion
  • Co-payments, waivers, deductibles, and write-offs
  • Overpayments, federal Anti-Kickback, False Claims Act, and Stark implications
  • Gratuities, kickbacks, and payments to physicians
  • Types of referrals that may violate one or more federal statutes
  • Business relationships between your practice/clinic and other providers
  • Setting up mechanisms for employees to file anonymous complaints
  • Avoiding allegations of reprisal and responding to identified deficiencies
  • Voluntary repayments - advantages and disadvantages of making repayment Law enforcement investigation tools

Law enforcement investigation tools

  • Subpoenas and search warrants and how to respond to compulsory process
  • Employment of consultants, lawyers, and other third-party advisors
  • Federal and non-federal administrative appeals of denied claims
  • HIPAA/HITECH and the relationship between privacy and compliance
  • Business associate pitfalls to consider
  • Future risks to your organization

Robert W. Liles, JD, MBA, MS

Robert W. Liles was the first National Health Care Fraud Coordinator and subsequently worked as Deputy Director of the U.S. Department of Justice, Executive Office for United States Attorneys. As Managing Member in the Washington D.C. based office of Liles Parker, PLLC, Robert heads one of the nation’s leading law firms focused on health care fraud defense and regulatory matters representing providers in civil, criminal, and administrative proceedings. Robert’s background, education, and experience bring this class to life with a real-world perspective.

 

D.K. Everitt, CMCO, CCO

D.K. Everitt is a certified medical compliance officer with over thirty years experience in practice management, the development and management of medium to large medical facilities, and the development, implementation, and maintenance of corporate compliance programs. He serves as Chief Healthcare Compliance Officer and President of The Compliance Division, L.L.C.

  • The CMCO is geared towards non-hospital healthcare professionals.
  • Experience working in a medical office is recommended for this course.
  • Candidates for CMCO certification must demonstrate competency by proctored examination.
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“Even honest mistakes can trigger an audit. If your office gets on the radar of RACs, ZPICs, UPICs and other contractors commissioned by CMS, they will request the documentation that supports the claims for reimbursement that you have submitted to the Medicare program….if it’s not yours, you’ve got to pay it back!”

Robert W. Liles, JD, MBA, MS, Managing Partner, Liles Parker, PLLC

New to the compliance field?

If you’re new to the field or need CEUs to renew your certification, our online training courses are perfect for you to learn (or refresh) compliance fundamentals.

OSHA Compliance Guidelines for the Medical Practice

3 CEUs
3 HRs
199
 
Register Now

Management & Leadership For the Medical Practice

6 CEUs
6 HRs
299
 
Register Now