LAST CHANCE REGISTER NOW...healthcare industry with the promise of a paperless office and...
Transcript of LAST CHANCE REGISTER NOW...healthcare industry with the promise of a paperless office and...
Learn more at hcca-info.org/clinicalQuestions: [email protected]
Clinical PracticeCompliance ConferenceOCTOBER 11–13, 2015 | PHILADELPHIA, PA
Why should you attend?• Get updated on government
initiatives specific to physicians and their practices
• Network with your peers
• Hear the latest enforcement trends
• Learn about correct documentation, billing and coding practices, and operating on a limited budget
LAST CHANCE
REGISTER NOW
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PROGRAM AT A GLANCESUNDAY, OCTOBER 117:00 am–6:30 pm Registration8:00–9:30 am P1 Coding Reviews and Education for Physicians: Turn Their Dread into Delight! – Jeannie Cagle, RN, CPC, Senior Manager, Coker Group
9:30–9:45 am Networking Break9:45–11:15 am P2 Provider Risk In ICD-10: Justification through Appropriate Documentation – Betty B. Bibbins, Founder, CEO & Executive Physician
Educator, DocuComp LLC; George Breen, Member of the Firm, Epstein Becker & Green PC
11:15 am–12:30 pm Lunch (on your own)12:30–2:00 pm P3 Risky Business: Compliance Risks Associated with Electronic Medical Records (EMRs) – Lamon Willis, Director, Enterprise Business
Development, AAPC
2:00–2:15 pm Networking Break2:15–3:45 pm P4 Sampling 101: A Primer for Internal and External Audits – Frank D. Cohen, Director of Analytics, Doctors Management LLC
3:45–4:00 pm Networking Break4:00–5:30 pm P5 Security Risk Assessment for Small Practices: Tools and Case Studies – Joette Derricks, Vice President, Derricks Consulting
5:30–6:30 pm Welcome Reception
MONDAY, OCTOBER 127:00 am–6:00 pm Registration
7:00–8:15 am Continental Breakfast (provided)
8:15–8:30 am Opening Remarks
8:30–9:30 am General Session: GS1 Practical Guidance for Health Care Governing Boards – Katherine Matos, Senior Counsel, US Dept. of Health & Human Services, Office of Inspector General; Laura Ellis, Senior Counsel, US Dept. of Health & Human Services, Office of Inspector General
9:30–10:30 am General Session: GS2 Prescription for Change: Congressional Actions Impacting Healthcare Providers – Kim Brandt, Chief Oversight Counsel, Senate Finance Committee Minority Staff; Troy Barsky, Partner, Crowell and Moring (formerly of CMS)
10:30–11:00 am Networking Break
11:00 am–12:00 pm 101 HIPAA Risk Management Programs: Doable, Practical, Financially Feasible – Eric Hummel, Founder and CTO, QIP Solutions; Katherine L. Foy, MSW, Director of Compliance and Consumer Risk for Public Health Management Corporation
102 Is Your Practice a Government Target? Pre-Audit Risk Assessment – Frank D. Cohen, Director of Analytics, Doctors Management LLC
12:00–1:00 pm Networking Lunch (provided)
1:00–2:00 pm 201 Using CERT Data to Fine Tune Your Audits – Joette Derricks, Vice President, Derricks Consulting
202 Drug Diversion by Healthcare Personnel: Essential Compliance Considerations – Kimberly New, Diversion Specialists
2:00–2:30 pm Networking Break
2:30–3:30 pm 301 “Incident To” and “Shared/Split Billing” Are Your Providers Billing These Services Correctly? – Vicki L. Dwyer, Chief Compliance Officer, Valley View Hospital; Nancy C. Kennedy, Chief Compliance & Privacy Officer and Chief Operations Officer, Galichia Medical Group
302 Is Your EMR System Protecting the Rights of Your Adolescent Patients? – Moses Vargas, General Counsel, CT Children’s Medical Ctr; Trisha A. Farmer, Director: Risk Mgmt, CT Children’s Medical Ctr
3:30–4:00 pm Networking Break
4:00–5:00 pm 401 Fundamentals of Physician Coding for Non-Coders – Robert A. Pelaia, Senior University Counsel for Health Affairs, Univ of FL
402 Physician Arrangements: Strategies to Reduce Compliance Risk – Bret S. Bissey, MBA, FACHE, CHC, CMPE, Senior Vice President, Compliance Services, MediTract; Michael P. McKeever, Director, Internal Audit, Saint Peter Healthcare System
5:00–6:00 pm Networking Reception
TUESDAY, OCTOBER 137:30 am–3:30 pm Registration
7:30–8:30 am Continental Breakfast (provided)
8:30–9:30 am General Session: GS3 Dealing with Difficult Physicians – Lynn Myers, MD, CPC, CHC, Chief EMR & Coding, Texas Health Organization for Physicians; Robert Ossoff, MD, CHC, Maness Professor of Laryngology and Voice, Department of Otolaryngology, Vanderbilt University Medical Center
9:30–10:30 am General Session: GS4 Reporting and Reimbursement Challenges for Clinical Practices under PPACA – D. Scott Jones, CHC, Sr. VP Risk Mgmt & Corporate Compliance, HPIX; Richard E. Moses, DO, JD, Physician/Attorney
10:30–11:00 am Networking Break
11:00 am–12:00 pm 501 The Compliance Officer’s Role in Physician Contracting – Joseph A. Piccolo, VP Compliance, St Mary Medical Center
502 The OIG Self-Disclosure Protocol and Statistical Sampling for Non-Statisticians – Gretchen L. Segado, Mgr Fraud Investigation & Dispute Services, Ernst & Young; Karen Makara, Executive Director, Ernst & Young LLP
12:00–1:00 pm Networking Lunch (provided)
1:00–2:00 pm 601 Temperature Monitoring of Pharmaceuticals and Vaccines: A Primer for Clinicians – David Silva, PwC; Doug O’Brien, Pharm.D., Kaiser Permanente
602 Medical Necessity: Avoid Costly Audits – Becky Rodrian, Director, Professional Consulting Services, Panacea Healthcare Solutions
2:00–2:15 pm Networking Break
2:15–3:15 pm 701 Credit Balance Resolution and Over-payment Refunds: Auditing, Monitoring, and Documenting Best Practices – Andrew W. Smith, Senior Manager, Protiviti, Inc.; Richard Williams, Managing Director, Protiviti
702 The Art of Internal Investigations and Self-Disclosures – Leia C. Olsen, Attorney, Hall Render Killian Heath & Lyman P.C.
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AGENDA
SUNDAY, OCTOBER 11
7:00 am–6:30 pm
Registration
8:00–9:30 am
P1 Coding Reviews and Education for Physicians: Turn Their Dread into Delight!
Jeannie Cagle, RN, CPC, Senior Manager, Coker Group
• Proven methods to communicate coding guidelines clearly so learning takes place
• The #1 reason coding education is ineffective and often a waste of time
• The benefits of one on one education as well as group sessions
9:30–9:45 am
Networking Break
9:45–11:15 am
P2 Provider Risk In ICD-10: Justification through Appropriate Documentation
Betty B. Bibbins, Founder, CEO & Executive Physician Educator, DocuComp LLC
George Breen, Member of the Firm, Epstein Becker & Green PC
• Review the impact of physician documentation on the justification of resource utilization in today’s changing regulatory healthcare environment.
• ICD-10 brings more enforcement risk to providers: reviewing the areas providers ought to be concerned about
• Recognize appropriate documentation within the medical record in ICD-10
11:15 am–12:30 pm
Lunch (on your own)
12:30–2:00 pm
P3 Risky Business: Compliance Risks Associated with Electronic Medical Records (EMRs)
Lamon Willis, Director, Enterprise Business Development, AAPC
• The advent of the EMR is viewed as the Holy Grail of the healthcare industry with the promise of a paperless office and connectivity which would advance patient care and increase reimbursement. Where there is a reward there is also risk!
• Learn about the Pros and Cons of the EMR and the special challenge areas which all providers and users should be aware of to and avoid problems by learning lessons from others
• Review of case studies enhances the need to be proactive in monitoring the use of the EMR in all settings of the provider organization to help prevent fraud and abuse
2:00–2:15 pm
Networking Break
2:15–3:45 pm
P4 Sampling 101: A Primer for Internal and External Audits
Frank D. Cohen, Director of Analytics, Doctors Management LLC
• Learn the basics of sampling, including sample size selection and proper sampling methods
• Know how to determine which sampling method is the best for your specific situation
• Learn how to create your own internal samples and how to defend against extrapolation by exposing poor sampling techniques
3:45–4:00 pm
Networking Break
4:00–5:30 pm
P5 Security Risk Assessment for Small Practices: Tools and Case Studies
Joette Derricks, Vice President, Derricks Consulting
• Review the current HIPAA Security Rule and Meaningful Use requirements for covered entities
• Examine what is required to conduct a Security Risk Assessment and identify the key steps to ensure compliance
• Review available tools to assist small practices in their compliance efforts
5:30–6:30 pm
Welcome Reception
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AGENDA
MONDAY, OCTOBER 12
7:00 am–6:00 pm
Registration
7:00–8:15 am
Continental Breakfast (provided)
8:15–8:30 am
Opening Remarks
8:30–9:30 am
GENERAL SESSION
GS1 Practical Guidance for Health Care Governing Boards
Katherine Matos, Senior Counsel, US Dept. of Health & Human Services, Office of Inspector General
Laura Ellis, Senior Counsel, US Dept. of Health & Human Services, Office of Inspector General
9:30–10:30 am
GENERAL SESSION
GS2 Prescription for Change: Congressional Actions Impacting Healthcare Providers
Kim Brandt, Chief Oversight Counsel, Senate Finance Committee Minority Staff
Troy Barsky, Partner, Crowell and Moring (formerly of CMS)
• Overview of legislative changes in the healthcare delivery system impacting healthcare providers
• Update on physician payment issues (Sustainable Growth Rate final legislation) and physician transparency requirements (Sunshine Act implementation)
• Congressional actions to address provider concerns with fraud and abuse audits from CMS and the ever growing appeals backlog that is the result
• Latest congressional developments on audit and appeals issues
10:30–11:00 am
Networking Break
11:00 am–12:00 pm
101 HIPAA Risk Management Programs: Doable, Practical, Financially Feasible
Eric Hummel, Founder and CTO, QIP Solutions
Katherine L. Foy, MSW, Director of Compliance and Consumer Risk for Public Health Management Corporation
• Compliance with HIPAA privacy and security safeguards that must be implemented by all CEs and BAs is just one leg of the journey toward the ultimate goal of ongoing risk management. This session will underscore the difference
• We’ll demonstrate a Web-based step-by-step process-focused solution that can jump start any sized practice toward both compliance with required controls, and a viable ongoing risk management solution
• Valuable insights from a Security Officer in the trenches at a mid-sized specialty practice will provide a sense of how an IT software application plus virtual consulting support can accomplish a transfer of HIPAA knowledge and expertise to your team
102 Is Your Practice a Government Target? Pre-Audit Risk Assessment
Frank D. Cohen, Director of Analytics, Doctors Management LLC
• Gain a comprehensive understanding of the audit process from the auditor’s perspective
• Create a risk-assessment strategy for your practice
• Learn how to build an audit plan that prepares you for any external audit event
12:00–1:00 pm
Networking Lunch (provided)
1:00–2:00 pm
201 Using CERT Data to Fine Tune Your AuditsJoette Derricks, Vice President, Derricks Consulting
• Understand how the CERT Program produces national, contractor-specific, service-specific paid claim error rates, as well as provider compliance error rates that compliance auditors can use to fine tune their audit selections
• Explore sample NCDs/LCDs coding requirements to understand how insufficient documentation errors may be reduced or eliminated
• Identify key process deficiencies that can result in a CERT error or a claim denial and how to fix them
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AGENDA
1:00–2:00 pm
202 Drug Diversion by Healthcare Personnel: Essential Compliance Considerations
Kimberly New, Diversion Specialists
• Drug diversion by healthcare personnel is a major patient safety, public health, and regulatory issue
• You will learn how to build an effective program to prevent, detect and respond to diversion and to protect patients, staff and the community
• You will learn the regulatory issues relating to institutional drug diversion
2:00–2:30 pm
Networking Break
2:30–3:30 pm
301 “Incident To” and “Shared/Split Billing”: Are Your Providers Billing These Services Correctly?
Vicki L. Dwyer, Chief Compliance Officer, Valley View Hospital
Nancy C. Kennedy, Chief Compliance & Privacy Officer and Chief Operations Officer, Galichia Medical Group
• Medicare’s billing of “Incident To” and “Shared/Split” services can be very confusing for providers. This session will help you understand Medicare’s requirements for correctly billing for these services
• What do outside auditors look for when reviewing documentation for “Incident To” and “Shared/Split” services? Learn how to ensure these services meeet published and unpublished documentation criteria
• Design and implement audits to ensure that the Medicare “Incident To” and “Shared/Split” service requirements are being used correctly by your providers both in the office and hospital setting
302 Is Your EMR System Protecting the Rights of Your Adolescent Patients?
Moses Vargas, General Counsel, CT Children’s Medical Ctr
Trisha A. Farmer, Director: Risk Mgmt, CT Children’s Medical Ctr
• Discussion of which visits should be treated as confidential (e.g., HIV, pregnancy, mental health, substance abuse). How to segregate the documentation of these services in the medical record. Implications of allowing staff to view their child’s record
• Use of Personal Health Records and On-line Patient Portals. How to allow the patient’s parent access to the portal without violating the adolescent’s rights. Which health information can be shared via the portal? What other data can be shared via portal?
• Which Laws Govern Adolescents’ Rights? A review of certain state statutes that set forth adolescent rights. What are the potential ramifications of violating an adolescent’s rights?
3:30–4:00 pm
Networking Break
4:00–5:00 pm
401 Fundamentals of Physician Coding for Non-Coders
Robert A. Pelaia, Senior University Counsel for Health Affairs, Univ of FL
• The basics of procedural (CPT) coding, including Evaluation & Management (E&M) coding
• General overview of diagnosis (ICD-10) coding
• This is a hands-on classroom style session: Attendees should have session materials and handouts with them in order to participate in the learning process
402 Physician Arrangements: Strategies to Reduce Compliance Risk
Bret S. Bissey, MBA, FACHE, CHC, CMPE, Senior Vice President, Compliance Services, MediTract
Michael P. McKeever, Director, Internal Audit, Saint Peter Healthcare System
• Hospital-physician arrangements continue to present risk related to anti-kickback and STARK issues.
• Discussion will focus on action providers can take to develop proactive processes to deal with the risks.
• This includes tips to avoid liability for noncompliant relationships
5:00–6:00 pm
Networking Reception
TUESDAY, OCTOBER 13
7:30 am–3:30 pm
Registration
7:30–8:30 am
Continental Breakfast (provided)
8:30–9:30 am
GENERAL SESSION
GS3 Dealing with Difficult PhysiciansLynn Myers, MD, CPC, CHC, Chief EMR & Coding, Texas Health Organization for Physicians
Robert Ossoff, MD, CHC, Maness Professor of Laryngology and Voice, Department of Otolaryngology, Vanderbilt University Medical Center
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AGENDA
9:30–10:30 am
GENERAL SESSION
GS4 Reporting and Reimbursement Challenges for Clinical Practices under PPACA
D. Scott Jones, CHC, Sr. VP Risk Mgmt & Corporate Compliance, HPIX
Richard E. Moses, DO, JD, Physician/Attorney
• Review PPACA quality reporting requirements for clinical practices
• Examine impacts on reimbursement and revenue for both inpatient and outpatient settings
• Discuss methods of using PPACA requirements to enhance the quality of care process in clinical practices
10:30–11:00 am
Networking Break
11:00 am–12:00 pm
501 The Compliance Officer’s Role in Physician Contracting
Joseph A. Piccolo, VP Compliance, St Mary Medical Center
• Guding the contract process to insure compliance
• The compliance officer as a resource to the operational team
• Auditing and monitoring physician transactions from a compliance perspective
502 The OIG Self-Disclosure Protocol and Statistical Sampling for Non-Statisticians
Gretchen L. Segado, Mgr Fraud Investigation & Dispute Services, Ernst & Young
Karen Makara, Executive Director, Ernst & Young LLP
• Discuss the current enforcement climate and changes in recent CIAs
• Introduce sampling terms and methodologies and provide a demonstration of RAT-STATS statistical sampling software
• Discuss the revised OIG Provider Self-Disclosure Protocol and consider OIG sampling methodologies and tips for ensuring a fair sample
12:00–1:00 pm
Networking Lunch (provided)
1:00–2:00 pm
601 Temperature Monitoring of Pharmaceuticals and Vaccines: A Primer for Clinicians
David Silva, PwC
Doug O’Brien, Pharm.D., Kaiser Permanente
• Learn about the nexus between temperature monitoring and compliance, and patient safety and quality
• Review clinicians’ obligations vis-a-vis temperature monitoring
• This session will assist attendees in creating a checklist of steps to follow in crafting a culture of compliance in temperature monitoring
602 Medical Necessity: Avoid Costly AuditsBecky Rodrian, Director, Professional Consulting Services, Panacea Healthcare Solutions
• Learn your risk if medical necessity is not clearly documented
• Define the meaning of medical necessity and it’s role in provider documented
• Learn the important differences between medical decision making and medical necessity, but also how they relate to each other, and discuss why medical necessity is being questioned by payers
2:00–2:15 pm
Networking Break
2:15–3:15 pm
701 Credit Balance Resolution and Over-payment Refunds: Auditing, Monitoring, and Documenting Best Practices
Andrew W. Smith, Senior Manager, Protiviti, Inc.
Richard Williams, Managing Director, Protiviti
• The importance of resolving credit balances timely and accurately
• Status and implications of CMS’s repayment rule
• Effective auditing, monitoring, and documenting for physician groups of varying resources
702 The Art of Internal Investigations and Self-Disclosures
Leia C. Olsen, Attorney, Hall Render Killian Heath & Lyman P.C.
• Learn processes for conducting internal investigations as part of an effective compliance program
• Summarize the legal background and reasons why physician practices might consider self-disclosure and describe the different self-disclosure options available
• Identify operational challenges that occur during the investigation and self-disclosure process and understand the role of Compliance Counsel in the process
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DEMOGRAPHIC INFORMATION
REGISTRATION Clinical Practice Compliance Conference | October 12–14, 2014 | Philadelphia, PA
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REGISTRATION CLINICAL PRACTICE COMPLIANCE CONFERENCE | OCTOBER 11–13, 2015 | PHILADELPHIA, PA
SESSION SELECTION Please indicate below which sessions you would like to attend. This information will be used to assist us in planning. You are not obligated to attend selected sessions.
SUNDAY (additional fees apply after 8/18/15)
PRE-CONFERENCE AM
8:00 – 9:30 AM
P1
9:45 – 11:15 AM
P2
PRE-CONFERENCE PM
12:30 – 2:00 PM
P3
2:15 – 3:45 PM
P4
4:00 – 5:30 PM
P5
TUESDAY
11:00 AM – 12:00 PM
501 502
1:00 – 2:00 PM
601 602
2:15 – 3:15 PM
701 702
MONDAY
11:00 AM – 12:00 PM
101 102
1:00 – 2:00 PM
201 202
2:30 – 3:30 PM
301 302
4:00 – 5:00 PM
401 402
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DETAILS CLINICAL PRACTICE COMPLIANCE CONFERENCE | OCTOBER 11–13, 2015 | PHILADELPHIA, PA
Hotel & Conference Location:
DoubleTree by Hilton Philadelphia Center City 237 S. Broad Street Philadelphia, PA 19107 215-893-1600 https://resweb.passkey.com/go/HCCAClinicalPractice
The group rate is $189 single/double occupancy plus tax. This rate is good through Friday, September 18, or when the group block is full, whichever comes first. Guest room internet is included in the group rate. HCCA recommends booking early to ensure you receive the group rate.
Registration Terms & Conditions: Please make your check payable to HCCA, enclose payment with your registration, and return it to the HCCA office, or fax your credit card payment to 952-988-0146. If your total is miscalculated, HCCA will charge your card the correct amount. All expenses incurred to maintain or improve skills in your profession may be tax deductible, including tuition, travel, lodging, and meals. Please consult your tax advisor.
Cancellations/Substitutions: You may send a substitute in your place or request a conference credit. Conference credits are issued in the full amount of the registration fees paid and are good for 12 months from the date of the cancelled event. Conference credits may be used towards any HCCA service. If you need to cancel your participation, notify us prior to the start date of the event by email at helpteam @ hcca-info.org or by fax at 952-988-0146. Please note that if you are sending a substitute, an additional fee may apply.
Group Discounts: Discounts take effect the day a group reaches the discount number of registrants. Please send registration forms together to ensure that the discount is applied. A separate registration form is required for each registrant. Note that discounts will NOT be applied retroactively if more registrants are added at a later date, but new registrants will receive the group discount.
5 or more: $50 discount for each registrant10 or more: $100 discount for each registrant
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Special Needs/Concerns: Prior to your arrival, please call HCCA at 888-580-8373 if you have a special need and require accommodation.
Dress Code: Business casual dress is appropriate.
Recording: No unathorized audio or video recording of HCCA conferences is allowed.
Continuing Education Units: HCCA is in the process of applying for additional credits. If you do not see information on your specific accreditation and would like to make a request, please contact us at 952-988-0141 or 888-580-8373 or email [email protected]. Visit HCCA’s website, hcca-info.org for up-to-date information.
ACHE: The Health Care Compliance Association is authorized to award 18 hours of pre-approved Category II (non-ACHE) continuing education credit for this program toward advancement, or recertification in the America College of Healthcare Executives. Participants in this program wishing to have the continuing education hours applied toward Category II credit should indicate on their attendance when submitting application to the American College of Healthcare Executives for advancement or recertification.
Compliance Certification Board (CCB): Compliance Certification Board (CCB): CCB has awarded a maximum of 22.2 CEUs for these certifications: Certified in Healthcare Compliance (CHC)®, Certified in Healthcare Compliance–Fellow (CHC-F)™, Certified in Healthcare Privacy Compliance (CHPC)®, Certified in Healthcare Research Compliance (CHRC)®, Certified Compliance & Ethics Professional (CCEP)®, Certified Compliance & Ethics Professional–Fellow (CCEP-F)®, Certified Compliance & Ethics Professional–International (CCEP-I)™.
Nursing Credit: The Health Care Compliance Association is preapproved by the California Board of Registered Nursing, Provider Number CEP 12990, for a maximum of 22.2 contact hour(s). The following states will not accept CA Board of Nursing contact hours: Delaware, Florida, New Jersey and Utah. Massachusetts and Mississippi nurses may submit CA Board of Nursing contact hours to their state board, but approval will depend on review by the board. Please contact the Accreditation Department at [email protected] with any questions you may have. Oncology Nurses who are certified by ONCC may request CA Nursing Credit (check box or indicate “Nursing” on the CEU form).
CLE: The Health Care Compliance Association is a State Bar of California Approved MCLE provider, a Pennsylvania Accredited Provider, and is an accredited sponsor, approved by the State Bar of Texas, Committee on MCLE. An approximate maximum of 18.5 clock hours of CLE credit will be available to attendees of this conference. All CLE credits will be awarded based on individual attendance.
NASBA/CPE: The Health Care Compliance Association 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, Sponsor Identification No: 105638. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit and may not accept one-half credits. Complaints regarding registered sponsors may be addressed to the National Registry of CPE Sponsors, 150 Fourth Avenue North, Suite 700, Nashville, TN 37219-2417. Website: www.nasba.org. A recommended maximum of 22.0 credits based on a 50-minute hour will be granted for the entire learning activity. This program addresses topics that are of a current concern in the compliance environment. This is an update, group-live activity. For more information regarding administrative policies such as complaints or refunds, call 888-580-8373 or 952-988-0141.
HEALTH CARE COMPLIANCE ASSOCIATION6500 Barrie Road, Suite 250, Minneapolis, MN 55435P 888-580-8373 or 952-988-0141 | f 952-988-0146hcca-info.org | helpteam @ hcca-info.org
HCCA-INFO.ORG/CLINICAL
6500 Barrie Road, Suite 250Minneapolis, MN 55435www.hcca-info.org
Clinical PracticeCompliance ConferenceOCTOBER 11–13, 2015 | PHILADELPHIA, PA
ClinicalCompliance Conference
HCCA’s
PracticeOCTOBER 11–13, 2015PHILADELPHIA, PA
LAST CHANCE
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