{[ promptMessage ]}

Bookmark it

{[ promptMessage ]}

hcr220wk7assignEvaluating Complianc

hcr220wk7assignEvaluating Complianc - Running head...

Info iconThis preview shows pages 1–3. Sign up to view the full content.

View Full Document Right Arrow Icon
Running head: EVALUATING COMPLIANCE STRATEGIES 1 Evaluating Compliance Strategies HCR/220 June 12, 2011
Background image of page 1

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
EVALUATING COMPLIANCE STRATEGIES 2 Evaluating Compliance Strategies Billing and coding compliance strategies are physician’s protection against revenue loss and any kind of financial risk. The strategies for compliance are: Carefully defining bundled codes and know the global periods Benchmark the practice’s E/M codes with the national average Use modifiers appropriately Be clear on professional courtesy and discounts to uninsured/low income patients Maintain compliant job reference aids and documentation templates Carefully defining what procedures are within a bundled code is important so they do not have to be unbundled. The most used bundling set of rules is the Medicare’s CCI list of codes. Some payers have their own set of codes that are unique. If there is a different set of codes used than the payer must make them available for the medical biller. Many sets of codes are used it all depends on the payer. A problem that can rise from using different sets of codes is linking the right diagnoses with the right procedure. Linking diagnoses and procedures is important for the payers to determine if the appropriate charges have been billed and if they are necessary. “Remember: the ICD-9 code must support the medical necessity for performance of the
Background image of page 2
Image of page 3
This is the end of the preview. Sign up to access the rest of the document.

{[ snackBarMessage ]}

Page1 / 5

hcr220wk7assignEvaluating Complianc - Running head...

This preview shows document pages 1 - 3. Sign up to view the full document.

View Full Document Right Arrow Icon bookmark
Ask a homework question - tutors are online