decisionhealth Newsletters, Answer Books - 2008 Issue 5 (May)
Answer_Book / Fraud_and_Abuse / Compliance_tips_to_avoid_fraud_investigations
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Article Overview
This Find-A-Code article discusses broad compliance planning for medical practices in the context of fraud and abuse concerns. It focuses on documentation standards, internal controls, staff education, auditing, communication, and corrective processes, with reference to AMA guidance and the relationship between medical records and claim support. It is aimed at physicians, practice managers, billing staff, compliance officers, and others involved in office compliance programs.
Why This Topic Matters
Strong documentation and compliance processes are central to reducing fraud investigation risk and supporting the accuracy of submitted claims. The article is useful for practices reviewing internal policies, training, and monitoring procedures.
What You Will Learn
- Core documentation elements expected in patient records
- General components of an effective practice compliance plan
- How auditing, communication, and corrective action fit into compliance efforts
- Why medical record support matters in the claims process
Who Should Read This
- Physicians
- Practice managers
- Compliance officers
- Billing staff
- Medical coders
- Office administrators
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