Master 2025 Medicare & Medicaid Rules to Avoid Penalties
Format: On-Demand Webinar | Presenter: Gabrielle Juliano-Villani, LCSW | Duration: 60 minutes | Location: Online Webinar
Course Description:
This comprehensive overview demystifies Medicare and Medicaid compliance for healthcare providers across all disciplines. Drawing from real-world experience and current regulations, this training breaks down complex compliance requirements into practical, actionable guidance that any healthcare professional can implement.
The webinar focuses on essential compliance areas that impact all providers, including documentation requirements, billing integrity, and safe harbor regulations. Participants will gain a clear understanding of how to maintain compliant practices while avoiding common pitfalls that can trigger audits or investigations. Through practical examples and case studies, providers will learn how to integrate compliance best practices into their daily operations.
Special emphasis is placed on fraud prevention strategies, proper documentation techniques, and understanding the key differences between Medicare and Medicaid requirements. The presentation provides clear guidelines for maintaining compliance while delivering quality patient care.
Learning Objectives:
- Understand fundamental Medicare/ Medicaid compliance requirements
- Master key documentation standards
- Learn basic billing compliance requirements
- Identify potential risk areas in daily practice
- Develop effective compliance protocols
- Understand audit triggers and prevention
- Implement proper record-keeping practices
- Understand the key Medicare/ Medicaid Differences
- Know about the essential documentation requirements
- Know how to comply with billing compliance fundamentals
- Master the risk prevention strategies
- Learn how to be prepared for Audit and mastering preparation techniques
Areas Covered in the Session:
- Medicare: Federal Health Insurance Program
- Part A: Hospital Insurance
- Part B: Medical Insurance
- Part C: Medicare Advantage Plans
- Part D: Prescription Drug Coverage
- Medicaid: Joint Federal-State Program
- Income-based eligibility
- State-specific requirements
- Mandatory benefits
- Optional benefits (varies by state)
- Medicare vs. Medicaid Comparison
- Documentation Requirements
- Common Reasons for Audits:
- Compliance Risk Areas
- Time-Based Service Documentation
- Time-Based Service Documentation Required Elements
- Billing Compliance
- Documentation Retention: Record Keeping Requirements
- HIPAA Records
- Medicare/ Medicaid Records
- High-Risk Areas
- Compliance Best Practices
- Audit Prevention
- Red Flags That Trigger Audits
- Practical Compliance Tips
- Required HIPAA Forms
- Notice of Privacy Practices (NPP)
- Authorization for Release of Information
- Business Associate Agreements
- Security Risk Assessment Documentation
- Medicare/ Medicaid Required Forms
- Initial Patient Documentation
- Ongoing Service Documentation
- Financial Documents
- Required Compliance Program Forms
- Staff Documentation
- Policy and Procedure Documentation
- Audit Documentation
- Essential HIPAA Policies
- Implementation Checklist
- Best Practices for Form Management
- Electronic Health Records
- Paper Records
- Hybrid Systems
- Resources
Suggested Attendees:
- Mental Health Providers
- Healthcare Providers of all Disciplines
- Practice Administrators
- Medical Office Managers
- Billing Specialists
- Healthcare Compliance Officers
- Clinical Support Staff
- New Healthcare Providers
- Group Practice Owners
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1Course Joining Link And Materials
About the Presenter:
Gabrielle is a Medicare/ Medicaid billing expert with over a decade of hands-on experience in health practice management and compliance. As the founder of GJV Consulting and Training, she brings extensive expertise from building, managing, and successfully selling a group practice of 15 therapists, primarily serving Medicare and Medicaid clients. During the practice transition, she developed and implemented comprehensive Medicare and Medicaid training programs to ensure continuity of care and compliance. Most recently, Gabrielle has demonstrated her expertise at scale by helping a major mental health technology company expand their Medicaid services across multiple states. Under her guidance, the company successfully launched in three additional states, increasing their Medicaid coverage to over 12 million lives. Her strategic implementation led to remarkable growth, including a 92% quarter over-quarter increase in Medicaid bookings and exceeding client acquisition goals by serving over 16,000 Medicaid clients. Her documentation trainings have been featured on Person Centered Tech, Spruce Health, Be Your Own Biller, continued, and Bill Like A Boss. Known for her approachable and compassionate teaching style, Gabrielle transforms complex Medicare and Medicaid requirements into clear, actionable steps. She is passionate about helping health professionals implement effective compliance strategies while avoiding costly billing mistakes, enabling them to build sustainable, compliant practices with confidence.
Snippet From Our Previous Session
Testimonials
"This program on HIPAA did a great job providing actionable concepts in a way that updated our team and me, I now know how I will implement the concepts because I already did it in their online seminar, it was easy to ask questions from the speaker at the end of my 60 minutes course."
— Melissa Preston, Health Information Management Staff
"David Vaughn covered the material completely and I have a new understanding of when, where and why we need to use an ABN"
— Sandie Fowler, Out of Network Billing Staff
"Great presentation. Able to do during the day. Timing was great."