Ethics and professional conduct
Compliance programs, documentation, coding, audits, business arrangements and fair charges for U.S. licensees
U.S. licensed health professionals: physicians, PAs, nurse practitioners and other APRNs, RNs, pharmacists, dentists and dental hygienists, therapists, behavioral health clinicians, and practice owners and leaders.
Structured learning and a written reflection to show insight after a complaint, an investigation or a board inquiry.
Focused learning on a core standard of practice, with a certificate and reflection for your portfolio.
This course teaches U.S. licensees how to keep the financial side of their practice accurate, lawful and fair. Building on the basics of fraud and abuse law, it goes into the practical machinery of billing compliance: the 2023 HHS-OIG General Compliance Program Guidance and its seven elements, documentation that supports medical necessity and coding, evaluation and management levels, incident-to, split or shared and teaching physician billing, NCCI edits and modifiers, high-risk services, risk adjustment and AI tools, internal and external audits, appeals, overpayment response, compensation and ownership arrangements, copayment waivers, good faith estimates and patient billing protections.
It is written for physicians, PAs, nurse practitioners and other APRNs, registered nurses, pharmacists, dentists and dental hygienists, physical, occupational and speech therapists, behavioral health clinicians and practice owners and leaders. It is also useful for licensees whose billing has been questioned by a payer, an employer, a government contractor or a state board, and who need to understand what went wrong and how to show change.
Financial integrity matters in the United States because every claim relies on a licensee's documentation and identity, and because enforcement is increasingly data driven. Billing problems can lead to repayment, civil and criminal liability, exclusion from federal programs, Medicare revocation, NPDB reports and board discipline. This course gives you the knowledge and practical tools to prevent problems, use compliance structures well and respond honestly if something goes wrong.
11 sections · 26 lessons · 3 hours · 20-question final assessment
Final assessment
20scenario-based questions
Certificate of completion
Certificate of completion. Not CE or CME credit unless accepted by your board.
The course includes a structured reflective account template: guided prompts to record what you learned, how you will apply it and how the change will show in your practice. It gives you written evidence of insight after a concern, and a ready record for your learning portfolio.
Write it in your own words and leave out anything that could identify a patient, a colleague or a case. If you have an open complaint or case, talk to your adviser before reflecting on it in writing.
The 2023 HHS-OIG General Compliance Program Guidance describes written policies, a compliance officer and committee, training, effective communication lines, enforcement and discipline, auditing and monitoring, and responding to detected problems. The course explains each element and how it looks in a large health system versus a small practice.
Yes. It covers when services by NPs, PAs and other clinicians can be billed incident-to a physician, the rules for split or shared visits in facility settings, teaching physician rules and locum tenens billing. It also covers selecting E/M levels by medical decision making or total time.
Report and return it. Federal law requires identified overpayments to be reported and returned within set timeframes, and keeping them can create False Claims Act liability. The course explains how to quantify an overpayment, involve compliance and counsel, and document what changed so the problem does not recur.
The integrity course introduces fraud and abuse law as one part of honesty in practice. This course goes deeper into the machinery of billing compliance: documentation for medical necessity, coding rules, audits, ADRs and appeals, fair market value in compensation arrangements, copayment waivers and good faith estimates.
$89 buys three self-paced hours, open immediately. Billing scenarios are checked as you go, the 20-question final requires 80%, and your reflective account plus certificate follow. This is education rather than legal advice, and it carries no CE or coding certification credit.
Every legal and regulatory point comes from primary sources: state practice acts and board rules, federal law and national professional codes of ethics. Anything we cannot confirm is left out.
Lessons, scenarios and assessment questions are written by us for each edition separately, then checked for accuracy, teaching quality and fair assessment before publication.
When a code, standard or law changes, the affected courses are reviewed and updated. Reported errors in legal or regulatory facts are corrected first.
Honesty where it is tested: records and late entries, license and DEA attestations, billing under federal fraud and abuse law, and conflicts of interest.
Accurate, timely, defensible records: CMS entry rules, medical necessity, cloned notes and AI scribes, corrections and addenda, access requests and retention.
From board letter to end of probation: root-cause analysis, a testable remediation plan, monitors and audits, and an organized remediation portfolio.
