Office of Billing Compliance

Mission

Main Functions

Help Line

Management Staff

Policies & Procedures

Office of Billing Compliance Main Functions

• Educational Program: Training in coding, billing and documentation policies is mandatory for physicians and other health care providers, administrators and staff.

These trainings are standard instructor-based or web-based.

• Retrospective compliance reviews of professional coding, billing and documentation is performed at JMH, UMHC/SCCC, ABLEH/BPEI, UMH as well as physician offices and offsite facilities/hospitals associated with the School of Medicine.  Prospective and special compliance reviews are conducted as needed.
• Retrospective compliance reviews of hospital coding, billing and documentation is performed at UMH, UMHC/SCCC and ABLEH/BPEI.
• As the result of our compliance reviews, refunds, credit/adjustments and/or correction of billing errors are requested from clincal departments or hospitals.
• Clinical Departments and Hospitals Compliance Committee meetings are held with the Compliance Physicians, the Clinical or Hospital Administrators and Billing Managers to present the reports, of the findings as a result of the compliance reviews performed.
• The Office of Billing Compliance Newsletter is distributed to physicians, administrators and staff.  The intention of the Newsletter is to disseminate information regarding new procedure codes, new or revised billing and documentation guidelines, or any other information pertaining to billing and/or documentation.

The Office of Billing Compliance Newsletter is complemented by the constant distribution of information to physicians, administrators and staff via e-mail.