Evaluating Compliance Strategies Essay

817 Words4 Pages
Evaluating Compliance Strategies There are specific steps that must be taken in the medical and billing process. The guidelines established in the compliance process are put in place by Health Insurance Portability and Accountability Act (HIPAA) and healthcare staff members to the protect the patients, the staff and the physicians. The compliance process guarantees that inaccuracies and errors are avoided in the medical office. This paper will cover the linking procedures and diagnoses, the implications of incorrect medical coding and how medical coding, physician and payer fees are related to the compliance process. The entire medical billing process initiates when the patient is seen at a medical facility by a physician. Once the office…show more content…
There are several errors that can occur during the billing and coding process. There are possibilities of claims being coded wrong or even denied due to coding errors, errors associated to billing or medical necessity errors. Claims are denied for medical necessity are due to services reported because they do not meet professional medical care standards. To assist the staff in avoiding these implications it is important to ensure that the medical staff is aware of the most up to date information on medical billing and coding software. To avoid errors and mistakes it is very important to keep up with new and deleted codes. Another implication that can occur in incorrect medical coding is audits; having staff members look over claims and verify the information is correct would help a medical facility avoid audits. To ensure compliance in coding is done correctly it is important to understand the use of codes and be aware of billing and coding practices. It is important that medical staff is well trained and understand all aspects of coding and billing to guarantee that documentation and claims are filed
Open Document