Corporate Compliance

Ensure coders submit compliant claims

Strategies for Health Care Compliance, November 1, 2008

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Physician documentation plays a big part of the billing process in medical facilities. But no matter how clear and concise the documentation, a payer could still deny a claim due to mistakes made by coders and data entry staff members. Don’t rely solely on an interview or a reference check to prove that a coder performs high-quality work or that he or she knows how to code for a particular specialty. “Without any monitors over the quality of the work, you really don’t know,” says Joe Rivet, CPC, CCS-P, CICA, a regulatory specialist at HCPro, Inc., in Marblehead, MA.

Although human error remains inevitable, auditors and compliance officers should employ the following practices to decrease mistakes as much as possible.

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Strategies for Health Care Compliance.

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