ED Coding & Reimbursement Alert - 2010 Issue 10
Compliance: Study These Compliance Basics Before You Run Afoul of the OIG
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Article Overview
This article discusses compliance fundamentals for physician and Part B practices, with emphasis on how compliance risks can affect practices of any size. It covers general oversight responsibilities, internal auditing, documentation, self-disclosure, staff supervision, and awareness of HIPAA-related issues. The piece is aimed at physicians, practice managers, coders, and compliance staff who want a broad understanding of why basic compliance processes matter and what general safeguards are commonly emphasized.
Why This Topic Matters
Compliance failures can occur even in small or solo practices, and the article explains why routine oversight and documentation are important for reducing risk. It is relevant to practices that want to strengthen internal controls, improve billing oversight, and maintain awareness of regulatory obligations.
Article Sections
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Compliance risks in practices of all sizes
Introduces the broad compliance challenges faced by physician practices and explains that size does not eliminate regulatory responsibility.
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Billing oversight and internal control concerns
Reviews general concerns involving staff oversight, billing review, and the importance of monitoring practice activity for irregularities.
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Responding to a discovered compliance problem
Summarizes broad response steps discussed in the article, including review, documentation, and follow-up measures after an issue is identified.
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Avoiding future compliance issues
Covers general preventive measures such as internal audits, physician education, and attention to privacy and regulatory requirements.
What You Will Learn
- Why compliance matters for practices regardless of size
- The role of internal audits and ongoing physician education
- Common areas where oversight problems can arise in practice operations
- General considerations when responding to a compliance concern
- Why HIPAA awareness remains part of practice compliance
Who Should Read This
- Physicians
- Solo practitioners
- Practice managers
- Medical coders
- Compliance consultants
- Billing staff
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