Evaluating Compliance Strategies
HCR 220
First let’s take a look at what the billing and coding compliance process is. The billing and coding compliance process is where the doctor prepares a detailed report of the visit, the procedures done, and the diagnosis. Then the coders will properly identify the codes that go with the procedures and diagnosis. Then the billers will be sure to these codes to make sure that the procedure that was performed properly links to the diagnosis and then then submit the billing claim to the insurance company or the patient. This process must be followed to the letter in every office to ensure that the doctor and their staff are properly reimbursed for the services that they provided. This all happened thanks to the Health Insurance Portability and Accountability Act otherwise known as HIPPA. Smiley (2014), “This act was passed by Congress in 1996 and is sometimes called the Privacy Rule. It established the first national standard for use and disclosure of health information and guarantees certain rights to individuals with regard to their healthcare.”
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