Links to External Training
- Health Care Fraud Prevention and Enforcement Action Team (HEAT) Provider Compliance Training
Videos and audio podcasts on the website of the Office of Inspector General.
Provider Training Modules
These fraud, waste, and abuse courses were developed to assist providers in learning appropriate billing and coding practices. Our goal is to assist you in compliance, resulting in expedient and error-free claims processing. Providers that complete these training courses will gain valuable information regarding proper billing for medical services. Training and development will greatly minimize the chances your medical claims will be flagged for a Department of Program Integrity review.
- Physical Therapy (PDF)
This training will define key elements of physical therapy claims and identify fraudulent billing practices.
- Speech Therapy (PDF)
This training will cover the increase of speech therapy claims and prominent codes used. Recent speech therapy fraud schemes will also be reviewed.
- Ambulance HCPCS Codes and Modifiers (PDF)
This training discusses the proper billing practices regarding ambulance and hospital claims. The use of appropriate modifiers is also reviewed.
- Ambulance Upcoding (PDF)
This training discusses billing for services provided under Advanced Life Support Services (ALS) or Basic Life Support Services (BLS).
- Billing Guidelines for Health Care Provided to Veterans and Beneficiaries (PDF)
Provides detailed instruction on the completion of the CMS 1500 form.
- Code Gaming (PDF)
Provides appropriate billing and coding practices. Providers who complete this training will learn how to appropriately bill for medical services.
- Home Infusion Excessive Charges (PDF)
Discusses the growth of home infusion therapy, including anticipated trends and billing practices.
- Home Infusion Supply Codes (PDF)
Provides an overview of appropriate codes utilized for billing home infusion supplies.
- J Codes Over Billing Schemes (PDF)
Provides an overview of various J Code schemes regarding injectable drugs.
- Modifier Fraud 25, 26, 76, 77, TC (PDF)
Discusses the definition of billing code modifiers and individual schemes associated with each.
- PIT Overview (PDF)
Covers the Program Integrity Tools (PIT) requirements, functionality and impact on providers.
- Sleep Studies (PDF)
Provides a general understanding of a Sleep Study and how to properly bill for this care.