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Proof for HIPAA

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jcbilling:
When compiling a Compliance Plan, do you outline every step of your billing process?

Sometimes it is different for each client... I have DME, Family Practice, Chiro, and PT offices and each one has a different method for sending me their work, we use different systems, etc.

What process do I need to outline in my compliance plan? just the general stuff?

Michele:
It can't be too general or else that will defeat the purpose, however, we too get info different from each client.  We outline what we do once we receive the info more than how we get the info. 

Michele

PMRNC:
You might be confusing policies and procedures with compliance. Your compliance plan will be a general overall road map of what you do to ensure compliance within YOUR business. The steps you will take to protect your clients, yourself, etc.. It is basically your compliance bible.. If you have a question come up about something a client is doing or not doing they should be doing, you refer to your compliance plan to see what appropriate actions should be taken and you implement that protocol.

A policies and procedures is just that.. a full and comprehensive plan of all your policies and procedures I have mine in the same binder with my compliance plan. Each medical practice should have one as well. I require each client to give me a copy of their P&P when they sign with me as well as office policies, financial policies, etc.

oneround:
I strongly agree with both Linda and Michele.  My only disagrement is in Linda's statment, do not confuse compliance and P&P's.  I say that becuse as a compliance office, I implement alot of P&P's, for my BA's, for my company, for my PMG's and my at home billers, simply from my observations.  So, it goes hand in hand.  I stand firm in the advice this fourm has given you, but again, implementing a P&P is easy, but do you follow it?  Case example, we have at home billers, if that is your occupation, but while I was there reviewing her case load she had a friend knock on her door and she let her in.  Now mind you, her comp., was up with and patint information on the screen and needless to say, she had all the pt bills laying around her table.  I do not care if you a at home biller our you a PMB, laws apply and adhere all the same

Annacate:
I am here for the first time, and hope you guys can help me. If a medical assistant refuses to chart when a patient comes in to get an injection (only), and says the superbill is document enough, can I be liable if I send that claim to an insurance company? (The MG is not even listed on the superbill). I told the doctor if there was no documentation it was like it was not done. To make a long story short, the doctor said the superbill was sufficient. I disagree but wanted your opinion. I may have to find other employment. Help! Ann

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