Evaluating Compliance Strategies

Topics: Insurance, Medical classification, Procedure codes Pages: 3 (808 words) Published: January 29, 2012

Evaluating Compliance Strategies|
[Type the document subtitle]|
This is about the evaluating compliance strategies on billing and coding and how if following the guidelines of the insurance companies. Also that the payer will paid the bill if it is correct. | |

By: Bonnie S. Jarosiewicz|

It is a very long process for billing to prepare the bill that is required to submit for payment. There also have been a lot of mistakes when billing because some did not know the guidelines of medical coding when sending the bill to the insurance company. This assignment will show how to making medical billing and compliance strategies so mistakes will not be made. Even through that not any means is any one perfect and mistakes will be made.

All medical practice relies on the medical claims to be correctly coded and billed. If it is not done right there could some delay in payment, and the medical practice revenue could be a loss, fraud investigation, financial sanction, disciplinary action, and exclusion from any government programs. They are not only using the correct codes, known as CPT or Current Procedural Terminology and explain the procedures were done and why they were done. There are times that the claims are not complete and are return to the medical office for further information. Because a lot of claims have been sent back to the medical office they have to come back with a decision that is evaluating compliance strategies in medical coding to keep the billing consisting and efficient.

There are so many methods of evaluation compliance strategies in medical coding then meeting with the doctor and billing staff to make sure the necessary handbooks are understand and how to use the coding systems. The insurance companies sends out there rules and guidelines to make sure the billing staff has a better understanding in billing codes and form completion procedures. One of the biggest complaints that the insurance...
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