decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Billing Company Model Compliance Plan / Risk assessment - billing companies
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Article Overview
This article explains how billing companies can structure a model compliance plan around OIG guidance. It focuses on compliance planning, internal risk assessment, policies and procedures, education, audit and investigation planning, and related operational safeguards for billing activities. The article is aimed at billing company compliance staff, legal personnel, and administrators who need to understand the general scope of recommended compliance program elements and the kinds of risks those programs should address.
Why This Topic Matters
Billing companies handle sensitive compliance responsibilities for providers, so their internal controls can affect legal exposure, audit readiness, and program integrity. Understanding the scope of OIG expectations helps organizations evaluate whether their policies, training, and oversight processes are aligned with federal health care program concerns.
What You Will Learn
- How OIG frames compliance planning for billing companies
- Why risk analysis is central to a billing company compliance program
- How policies, procedures, training, and audits fit together in a compliance framework
- What kinds of operational risk areas should be considered at a high level
- How billing companies can coordinate compliance responsibilities across functions
Who Should Read This
- Billing company compliance officers
- Healthcare billing administrators
- Legal staff supporting billing operations
- Internal auditors and risk management teams
- Healthcare consulting professionals
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