decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Billing Company Model Compliance Plan / Essentials of OIG's third-party medical billing company model compliance plan
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Article Overview
This article outlines the Office of Inspector General’s model compliance plan framework for third-party medical billing companies. It is relevant to compliance leaders, billing managers, auditors, and healthcare organizations that rely on outside billing services, because it discusses the main program elements, reporting expectations, internal controls, and oversight practices emphasized by OIG guidance. The article also points readers to related OIG fraud alert and risk-area resources.
Why This Topic Matters
Third-party billing operations can create compliance exposure for both billing companies and providers. Understanding the OIG’s model plan helps organizations build internal controls, reporting pathways, training, and audit processes that support compliant billing operations.
What You Will Learn
- The major components of an OIG model compliance plan for third-party billing companies
- How compliance responsibilities are framed for billing-company-originated and provider-originated issues
- What types of internal controls, reporting mechanisms, training, and auditing are emphasized
- How the article connects the model plan to other OIG fraud and risk-area resources
Who Should Read This
- Billing company compliance staff
- Medical billing managers
- Healthcare compliance officers
- Revenue cycle leaders
- Healthcare auditors
- Providers using third-party billing services
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