BC Advantage - 2011 Issue 10
Validation of a Providers Right to Bill
Subscribe or sign in to view the full article.
Article Overview
This article explains a compliance-focused aspect of medical practice audits: confirming that individuals involved in billing or care delivery are not excluded from federal health care programs. It discusses why this matters to auditors, practice leaders, and consultants, outlines the general verification workflow using the OIG exclusions database, and describes the kinds of reporting and documentation that support compliance efforts.
Why This Topic Matters
Exclusion screening is a basic compliance safeguard that can affect billing integrity, audit scope, and organizational risk. The article helps readers understand why provider eligibility checks should be part of routine oversight, not an afterthought.
What You Will Learn
- Why provider exclusion screening is relevant in compliance audits
- Who in a practice may need to be checked for federal program exclusion
- How the OIG exclusions database fits into the verification process
- When exclusion checks may be incorporated into audit workflows
- How auditors may document and escalate findings in a practice setting
Who Should Read This
- Medical auditors
- Compliance consultants
- Practice administrators
- Billing managers
- Healthcare compliance professionals
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com