| Compliance Plan Guidance for Physician Practices |
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Crystal S. Reeves, CPC Since the Office of Inspector General (OIG) released its Compliance Plan Guidance for Physicians Practices in October 2000, many physician practices have put “Compliance Plan” on the top of their “To Be Done” lists.How successful the practice is in accomplishing this undertaking will no doubt depend on what else is going on in the practice, e.g., employee turnover, new activities, physician support, etc.). Realizing that practices may not be able to implement a full-blown plan, the plan guidance states that the OIG recommends developing a plan in stages. Four risk areas identified by the OIG are: 1. Coding and billing 2. Reasonable and necessary services 3. Documentation 4. Improper inducements (referrals, anti-kickback violations) At least three of these risk areas can be addressed by performing a chart audit. Whether performed by an existing employee or outside firm, a chart audit is a good first step in identifying inadequate documentation and lack of documented medical necessity. During the process, other compliance and billing issues may also be identified. So, if you do not know where to start on your path to compliance, why not begin with Step 1? That is, perform a chart audit. For information on performing chart audits, or for outside assistance with the process, contact contact Department B at (714)665-6920 or email |
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