Healthcare Compliance Guidelines for Physicians and their Practices.
Healthcare compliance is absolutely mandatory and slack billing practices may cost you thousands of dollars in fines.
1. Compliance Package is the Immediate Need of the Hour for any Provider…
A compliance package is required as soon as possible by any provider that bills Medicare, Medicaid, and/or programs supported by federal or state governments. It relates the HHS Office of the Inspector Generals (OIG) compliance regulation on billing, coding, contracts, and interactions which is now required under the Affordable Care Act.
2. HIPAA Security.
HIPAA is more than a confidentiality stamp provided to patients. All benefactors no substance the insurance must meet the terms with HIPAA 5010 compliance is the order of the day. HIPAA cover information, to audit the security of all protected health information both paper and electronic, so you must have policies audit at least annually.
3.Cash Flow Management.
Providers are anxious about getting reimbursed, but rarely inspect Medical billing and collections until it is a crisis.
4.Be Active in your Mails.
Medicare has comeback requests and if you miss those, you can have your number withdrawn and might not get it back for two years.
5.Choose the Best Medical Billing Team.
- Hire the best Medical Billing Company .
- Check references. Do not hire someone without physician billing experience.
- Ask them to code situations for you or question them on their knowledge.Also many medical practices end up in a cash crisis or in trouble because the billing person does not bill correctly.If the person bills incorrectly, because he is told to do so by the provider, take a advisory note this will eventually come back to disturb the practice.
6.Ensure an Audit Happens !
Make sure that your billing team keeps up with the billing rules/changes.Ensure your staff known when it is suitable to bill the physician and when to bill under the mid-level. This has been a massive audit entry for Medicare and commercial plans.
7. Documentation.
The documentation must permit the billable services submitted.
8.Take A Look !
Meet at least monthly with your billing practice management company to analyse summary reports of
2. Accounts Receivable aging by payer.
3. Denials Claims.
