Hcr 220 Week 2

Ruenda Kee

University of Phoenix

Medical Records Documentation and Billing

HCR/220

June 7, 2013

Kathleen Collier

Compliance plans are put into place to find, correct, and prevent illegal medical office practices.  The compliance plan is enforce to follow all areas of the government regulation of medical practices such as Equal employment opportunity regulation and occupational safety and health administration. There are several parts of the compliance plan that should be followed policies and procedure written out, appointment of compliance officer and committee, training, compliance, disciplinary systems, auditing and monitoring and responding to and correcting errors are compliance guidelines that help defense against a false claims and accusation. In correlation with medical records documentation standards, includes keeping patients records organize and in chronological order it shows. They are legally responsible for providing care to patients to prevent fraud and abuse through these plans eliminate the possibility of errors by training staff members who work with medical records including front office staff along with billers and coders. In the compliance it states who performed what services and describes why, where, when, and how it was done.

Steps five and six of the medical billing process are related to compliance plans.   In coding and billing, it is necessary to use correct diagnosis and procedure coding when assigning them to an encounter.   Complying with official coding guidelines is a must to determine medical necessity of the charges. Steps one through four are related with medical records.   The front desk clerk and the staff are required to follow all guidelines procedures in obtaining demographic and insurance information from the patient.   Based on HIPAA guidelines, this information is not allowed to be given to anyone without written consent of the patient.   Also, when checking out patients, the physician or medical supervisor are...