ED Coding & Reimbursement Alert - 2016 Issue 7
Compliance: Stick to 4 Tips for Compliance Bliss
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Article Overview
This article discusses common compliance questions faced by Part B practices and how they intersect with broader regulatory and operational responsibilities. It is aimed at practice administrators, compliance officers, billing staff, and physicians who manage audits, internal reporting, and recordkeeping processes. The content centers on general compliance planning, CMS-related guidance, whistleblower issues, and documentation practices, including attestation-related policy considerations.
Why This Topic Matters
Compliance problems can lead to audits, disputes, and potential legal exposure, so practices need practical awareness of how internal controls, reporting channels, and recordkeeping expectations are handled. The article helps readers assess whether their compliance approach is current and appropriately tailored to their organization.
Article Sections
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Don’t Think You’re Immune to Whistleblowers
Discusses whistleblower concerns in practice settings and the importance of responding appropriately to employee complaints about suspected wrongdoing.
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Compliance Plan Alone Won’t Protect You
Reviews the limitations of generic compliance plans and the need for practice-specific oversight of regulatory, payment, operational, and legal risk areas.
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Identify Conflicts of Interest
Covers late medical record signatures, chart documentation concerns, and the use of attestation-related guidance referenced from CMS materials.
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Show Employees Where to Report Compliance Issues
Addresses internal reporting pathways, anonymity protections, retaliation concerns, and how compliance plans may handle ethics-related issues.
What You Will Learn
- Common compliance concerns that arise in physician practices
- How compliance plans should be tailored to practice risk areas
- General issues surrounding medical record signatures and attestations
- Ways compliance plans can support internal reporting and ethics concerns
Who Should Read This
- Part B practices
- Physicians
- Compliance officers
- Practice administrators
- Billing and coding staff
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