Approximately 10 years ago, the Office of Inspector General (OIG) issued its first guidance on compliance as it relates to federal mandates for physician practices. Although taking the necessary steps can be a daunting task in an era of complex rules and heightened regulations, there are key areas of government-mandated compliance requirements that practices should…
Maintain compliance with updated federal rules governing privacy protection for patient health information
Tips for creating, maintaining and enforcing an effective plan
Tools, resources help physicians, staff tackle billing and coding rules, navigate healthcare compliance issues
The ACR/ARHP three-day program at 2014 Annual Meeting in Boston to focus on medical coding updates, compliance rules, federal regulations
Program features practical training to keep rheumatology practices current with coding, compliance rules, regulations
A guide to ensure proper coding, billing and accurately diagnose patients.
Compliance programs are an effort by the government to maintain integrity in the healthcare system. These programs target activities causing improper payment to determine their root cause: Was it a mistake or error, was it inefficiency or waste of resources, is the provider bending the rules or abusing the system, or was it intentional deception or fraud? There are also laws dictating the compliance culture within practices and institutions; for example, red-flag rules, antikickback statute, and stark law, to name a few.
Outsourcing your billing to a third party will not alleviate your compliance duties or reduce your risk of a government investigation. Conversely, a relationship with a third-party biller can increase your compliance obligations and raise audit risks.