ED Coding & Reimbursement Alert - 2010 Issue 18
Compliance: Study These Compliance Basics Before You Run Afoul of the OIG
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Article Overview
This premium article discusses foundational compliance concerns for physician practices and other Part B providers. It focuses on why compliance obligations apply to practices of any size, common breakdowns in office oversight, and broad best practices such as internal auditing, physician education, documentation, and attention to HIPAA-related compliance. It is aimed at physicians, practice managers, compliance staff, and billing professionals who want a general understanding of practice compliance responsibilities and risk areas.
Why This Topic Matters
Compliance problems can affect practices regardless of size, and weak oversight can expose a practice to repayment, self-disclosure, and other regulatory risk. The article helps readers understand why routine monitoring and documented compliance processes are important.
Article Sections
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Practice compliance applies to all practice sizes
Introduces the general compliance obligations that apply to physician offices and other Part B providers. Emphasizes that smaller practices can face the same oversight responsibilities as larger organizations.
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Oversight, billing review, and self-disclosure considerations
Discusses the importance of monitoring billing activity, responding to concerns raised by advisors, and documenting corrective steps. Covers broad themes related to practice oversight, repayment, and compliance response planning.
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Know how to avoid these issues
Summarizes practical steps for maintaining an active compliance program. Highlights internal audits, ongoing physician education, and staff quality controls.
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Keep an eye on HIPAA
Addresses general HIPAA compliance awareness in medical practices. Notes that basic privacy and compliance lapses may persist over time if they are not actively monitored.
What You Will Learn
- Why compliance applies to practices of all sizes
- How billing oversight and internal review support compliance
- Why corrective action and documentation matter after a problem is discovered
- How internal audits and physician education fit into a compliance program
- Why HIPAA awareness is part of ongoing practice compliance
Who Should Read This
- Physicians
- Practice managers
- Medical office administrators
- Compliance officers
- Billing and coding professionals
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