Corporate Compliance

Tip: Claims submitted at teaching hospitals

Compliance Monitor, September 10, 2008

Hospitals should ensure the following with respect to all claims submitted on behalf of teaching physicians:
  • Only services that are actually provided and documented in accordance with the applicable regulations are billed
  • The physician who provides or supervises the provision of services to a patient should be responsible for the correct documentation of the rendered services
  • The appropriate documentation must be placed in the patient record and authenticated by the physician who provided or supervised the provision of services to the patient
  • Physicians are responsible for ensuring that, in cases where evaluation and management (E&M) services are provided, the patient’s medical records includes appropriate documentation of the applicable key components of the E&M service (e.g., patient history, physician examination, and medical descision-making), as well as documentation to reflect adequately the procedure performed
  • Every physician should document his or her presence during the key portion of any service or procedure for which payment is sought
This tip was adapted from The Compliance Officer’s Handbook. For more information about the book or to order your copy, click here.


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