Body Of Knowledge Course Catalog

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The Body of Knowledge Course Catalog will give you an overview of the content in each section. The Virtual Learning Library is continuously being updated with content.  We make every effort to update the catalog as new content is added. If a section of the Virtual Learning Library is not listed, it does not currently contain conent. 
 
  1. 1A.  Business Aspects of Care Settings: Core Care Setting

    1. 1.  Physician Practices (Professional Fee Services) 
      • Auditing Physician Clinic Operations 
      1. 2.  Acute Care Hospitals (Including Emergency Department, Ancillary Departments, and Other Clinical Care Activities) 
        • The Ins and Outs of Endoscopy 
        • Auditing the Laboratory 
        • Controlled Substance and Drugs of Abuse: Important Focus Points for the Internal Auditor 
        • Radiation Oncology: A Look at High-Risk Codes 
      2. 3.  Post-Acute Care (Rehab, Behavioral, Skilled Nursing Facilities, Home Care, Assisted Living, Durable Medical Equipment, Hospice, Retail Pharmacy) 
        • 21st Century Cures Act and Electronic Visit Verification 
    2. 1B.  Business Aspects of Care Settings: Other Care Settings

      6.  Other Care Settings: Medical Office Buildings 
      • Outpatient Diversion Risk 
  2. 2A.  Revenue Cycle: Health Insurance Provider Revenue Cycle Elements

    1. 2.  Benefits Administration 
      • Tackling a Pharmacy Benefits Manager (PBM) Contract Audit 
      • How to Audit a Pharmacy Benefits Contract 
    2. 2B.  Revenue Cycle: Health Care Provider Reimbursement

      1.  Medicare 
      • Navigating OIG Audits for Device Overpayments: Best Practices  
      • Billing for Non-Physician Practitioners: 'Incident To' and Split Shared Services Office, Hospital and Beyond 
      • Auditing Tips from Entry Door to Exit Conference 
      • Data Analytics in Healthcare Internal Audit A New Level of Value 
      • The Front-Line ACO Audit: The Next Generation of Risk Coverage 
      1. 2.  Medicaid 
        • Auditing Tips from Entry Door to Exit Conference 
      2. 3.  Advantage Programs  
        • Auditing Tips from Entry Door to Exit Conference 
        • The CMS Independent Auditor - A Case Study 
        • What is Going on with the Payers? Attacking Managed Care Denials - The New Battleground 
      3. 4.  Commercial Payors 
        • Auditing Tips from Entry Door to Exit Conference 
  3. 2C.  Revenue Cycle: Health Care Provider Revenue Cycle

    3.  Registration/Patient Access 
    • High-Value Revenue Cycle Assessments 
  4. 4.  Provision of Services and Documentation
    • Evaluation and Management Auditing
    • Radiation Oncology: A Look at High-Risk Codes by Kristen Taylor and Lashelle Bolton
    • Audit the Middle of the Revenue Cycle: Ensure Effective Charge Capture Performance by Amy Lee Smith
    • High Value Charge Capture and Revenue Integrity Assessments
    • Documentation - Inpt vs. Obs - It is all about the patient's story Plus Total Knee Anguish
  5. 5.  Charge Capturing 
    • High Value Charge Capture and Revenue Integrity Assessments
    • Charge Capture - Using Data Analytics to Stop the Bleeding
    • Charge Capture Continuous Auditing by Kristin Freitas
    • High-Value Revenue Cycle Assessments by Don Billingsley and Richard Williams
    • Audit the Middle of the Revenue Cycle: Ensure Effective Charge Capture Performance by Amy Lee Smith
    • Medical Device Credit Audits: These Aren’t Your Ordinary Devices!
  6. 7.  Coding 
    • Evaluation and Management Auditing
    • Wound Care Center Audits: Consider Treatment Complexity and Billing Compliance Risks by Beth Schindler and Julie Griffin
    • Hospital Chart Audits - What You Are Missing
    • Medical Device Credit Audits: These Aren’t Your Ordinary Devices!
    • The Chargemaster in a Multipayer Environment by William Malm
  7. 8.  Billing 
    • Wound Care Center Audits: Consider Treatment Complexity and Billing Compliance Risks by Beth Schindler and Julie Griffin
    • Billing for NonPhysician Practitioners: 'Incident To' and Split Shared Services Office, Hospital and Beyond
    • Hospital Chart Audits - What You Are Missing
    • Auditing Tips from Entry Door to Exit Conference
    • The Chargemaster in a Multipayer Environment by William Malm
    • Billing for NonPhysician Practitioners: ‘Incident To’ and Split Shared Services Office, Hospital and Beyond….

2C.  Revenue Cycle: Revenue Deductions

6.  Collections 
  • Credit Balance Resolution and Overpayment Refunds: Auditing, Monitoring and Documenting Best Practices
  1. 7.  Management Monitoring/Key Performance Indicators 
    • Revenue Analytics
    • Defining the Meaning of 'Auditing' and 'Monitoring' & Clarifying the Appropriate Use of the Terms
  2. 3A.  Regulatory Environment: Regulatory Bodies

    1. 1.  CMS
      • CMS Program Audit? Let's Get Ready Now!
      • Medical Necessity and the Two-Midnight Rule Overview
      • The CMS Independent Auditor - A Case Study
      • Top Enforcement Targets
      • Clinical Compliance: Care Management Auditing
      • C9: Auditing and Monitoring Emerging Compliance Risk Areas
      1. 2.  OIG 
        • A Guide for Auditing Physician Payments by Jim Passey and Anne Brummell
        • OIG Audits in the Outpatient World
        • Documentation - Inpt vs. Obs - It is all about the patient's story Plus Total Knee Anguish
        • Navigating OIG Audits for Device Overpayments: Best Practices
        • Top Enforcement Targets
      2. 4.  DEA 
        • Controlled Substance Security - Audits of Opioid Prescribing Practices
        • Controlled Substance Security: Controlled Substance Infusion Audits by Kim New
        • Controlled Substance Security: Effective Diversion Program in Ten Steps by Kim New
        • Controlled Substance and Drugs of Abuse: Important Focus Points for the Internal Auditor
        • Outpatient Diversion Risk by Kim New
        • Patient-Specific Controlled Substance Drips by Kim New
      3. 5.  FDA 
        • 21st Century Cures Act and Electronic Visit Verification (Conference Session Power Point)
      4. 6.  The Joint Commission 
        • High Level Disinfection Auditing
    2. 3B.  Regulatory Environment: Regulations

      1. 1.  HIPAA 
        • Medical Devices & HIPAA: What Could Go Wrong?
        • Why Won't HIPAA Just Go Away? by Matthew Jackson and Kevin Dunnahoo
        • HIPAA Security: Don’t Live in Fear by Matthew Jackson and Kevin Dunnahoo
        • Don't Let Third Parties Bring Down Your Business: Effective Vendor Management
        • Cybersecurity IT Transformation and Analytics
        • Computer Security Incident Response: What an Auditor should know
      2. 2.  Stark and Anti-Kickback
        • A Guide for Auditing Physician Payments
      3. 3.  False Claims Act
        • Credit Balance Resolution and Overpayment Refunds: Auditing, Monitoring and Documenting Best Practices
      4. 5.  CMS Conditions of Payment
        • Data Analytics in Healthcare Internal Audit A New Level of Value
      5. 6.  Affordable Care Act
        • The Front-Line ACO Audit: The Next Generation of Risk
  3. 4A.  Core Business Functions: Operational/Financial

    1. 2.  Procurement
      • Navigating OIG Audits for Device Overpayments: Best Practices
      • Contract Reviews Maximize Savings While Minimizing Risk
    2. 3.  Materials Management
      • Capital Project Cost Management - Implementing a Pre-Construction Contract Review & an Ongoing Monitoring Program to Establish Cost Controls
    3. 5.  Cash Management
      • PCI Compliance: Tips to Getting It Right
      • Registration and Point of Sale Needs
      • Contingent Fee Audits by Jason McKinney
    4. 8.  Finance/Accounting
      • Construction Auditing:  How to Differentiate Job Site and Indirect Costs - Part 2
      • Registration and Point of Sale Needs
      • Contingent Fee Audits by Jason McKinney
    5. 9.  Contract/Vendor Management
      • Capital Project Cost Management - Implementing a Pre-Construction Contract Review & an Ongoing Monitoring Program to Establish Cost Controls
      • Construction Auditing:  How to Differentiate Job Site and Indirect Costs - Part 2
      • Construction Auditing: How to Differentiate Job Site and Indirect Costs - Part 1 by Ron Risner
      • Construction Auditing: Ten Important Construction Agreement Clauses by Ron Risner
      • Contract Reviews Maximize Savings While Minimizing Risk
      • Don't Let Third Parties Bring Down Your Business: Effective Vendor Management
      • How to Audit a Pharmacy Benefits Contract by Lisa Coggins and John Byrd
      • Tackling a Pharmacy Benefits Manager (PBM) Contract Audit
    6. 11.  Research
      • Do You Have It Right? Clinical Research Billing Rules, Risks and Audits
    7. 4B.  Core Business Functions: Information Technology

    8. 1.  Electronic Medical Record Systems
      • Beyond HIPAA Compliance
      1. 3.  Information Governance
        • AHIA IT Audit and Information Security Survey
        • Enterprise Risk Assessments by Debra Harrington
        • Information Technology: Technology Trends to Watch by David E. Sems
        • PCI Compliance: Tips to Getting It Right
        • Spreadsheet Data Integrity by Greg Burris
        • Top IT Risks and Opportunities from an Audit Perspective
        • Track D4:Shifting to the Cloud: Understanding IT Investment Management Beyond Your Data Center Walls
      2. 4.  Cybersecurity
        • Biomedical Devices: Network Threats Walking Your Halls
        • Cybersecurity IT Transformation and Analytics
        • Cybersecurity Trends: How Audit can think like the bad guys
        • Engage Your Board in Cybersecurity Discussions
        • How to Prevent and Prepare for Digital Hostage Situations by David E. Sems
        • Internal Audit’s Critical Role in Cybersecurity by Raj Chaudhary and Jared Hamilton
        • IT Risks - What You Should, But May Not Know or Have Not Audited?
        • NIST Cybersecurity Framework - A Practical Approach to Risk Assessments and Assessing Security Posture
        • Strategies for Mitigating Cybersecurity Risks
        • Computer Security Incident Response: What an Auditor should know
      3. 5.  Biomedical Devices
        • Track B3: One Hospitals Journey Through a Medical Device Reprocessing Compliance Audit
        • Biomedical Devices: Network Threats Walking Your Halls
        • Medical Devices & HIPAA: What Could Go Wrong?
        • Navigating OIG Audits for Device Overpayments: Best Practices
        • Patient and Staff Safety: Biomedical Function Audits by Linda Sartore McClain and Gary Burnett
    9. 4C.  Core Business Functions: Compliance

    10. 1.  Corporate Compliance/Legal
      • Controlled Substance Security - Audits of Opioid Prescribing Practices
      • OIG Audits in the Outpatient World
      • CMS Program Audit? Let's Get Ready Now!
      • What is Going on with the Payers? Attacking Managed Care Denials - The New Battleground
      • Track B3: One Hospitals Journey Through a Medical Device Reprocessing Compliance Audit
      • The Yates Memo: A Compliance Game-Changer by Venson Wallin
      • The Yates Memo by Joseph R. LaMagna
      • Roles and Responsibilities - Corporate Compliance and Internal Audit
      • Ethics at Work: The No-Good-Choice Corner: Because You Waited Too Long by Marianne M. Jennings
      • DOJ Compliance Program Assessments Are Coming by Carrie Cavanaugh
      • Contrasting Roles and Responsibilities - Corporate Compliance and Internal Audits
      • Article #5: Documented Comprehensive Approach
      1. 2.  Privacy
        • Personal Mobile Device Use in Healthcare by Justin Moret
        • Beyond HIPAA Compliance
        • Why Won't HIPAA Just Go Away? by Matthew Jackson and Kevin Dunnahoo
      2. 3.  Credentialing and Privileging
        • Controlled Substance Security: Propofol: Don’t Overlook This Drug by Kim New
        • Controlled Substance Security: Considerations When Tampering Occurs by Kim New
      3. 5.  Conflict of Interest
    • Ethics at Work: The No-Good-Choice Corner: Because You Waited Too Long by Marianne M. Jennings
    1. 4C.  Core Business Functions: Administrative Functions

    2. 1.  Risk Management
      • Construction Auditing: How to Differentiate Job Site and Indirect Costs - Part 1 by Ron Risner
      • Construction Auditing: Ten Important Construction Agreement Clauses by Ron Risner
      • Top IT Risks and Opportunities from an Audit Perspective
      • Internal Audit’s Critical Role in Cybersecurity by Raj Chaudhary and Jared Hamilton
      • Seven Component Framework
      • Track D7: The "New" Critical Audit Area - Health IT
      • Defining the Meaning of 'Auditing' and 'Monitoring' & Clarifying the Appropriate Use of the Terms
      1. 2.  Enterprise Risk Management
        • Track B6: Linking the Audit Plan to Strategic Risks
        • A Relevant Materiality Concept by Michael P. Fabrizius and Sridhar Ramamoorti
        • Seven Component Framework
        • Engage Your Board in Cybersecurity Discussions
        • Roles and Responsibilities - Corporate Compliance and Internal Audit
      2. 4.  Patient Safety
        • Track D7: The "New" Critical Audit Area - Health IT
        • High Level Disinfection Auditing
        • Controlled Substance Security: Propofol: Don’t Overlook This Drug by Kim New
        • Controlled Substance Security: Considerations When Tampering Occurs by Kim New
      3. 5.  Organizational Governance
        • The Yates Memo: A Compliance Game-Changer by Venson Wallin
        • A Case for COSO: How the COSO 2013 Integrated Framework's Guiding Principles Can Improve Healthcare Organizational Governance
        • The Yates Memo by Joseph R. LaMagna
      4. 6.  Strategic Planning
        • Track B6: Linking the Audit Plan to Strategic Risks