Compliance Programs can INCREASE Profitability.

OIG compliance is primarily about ensuring your practice does not do something wrong and that you are billing, coding, and collecting in an ethical and true manner.  It primarily benefits insurance companies by ensuring no waste, fraud, or abuse.  However, in writing the compliance program, I noticed that the checks and balances procedures I was doing in my practice to monitor my billing department fulfilled most of the OIG requirements.

Having OIG compliance activities answers a few business-minded questions.

1-      Am I billing for all services I provide?

2-      Do I have doctor’s notes for each patient encounter?

3-      Are all claims leaving the EHR system and accepted by the clearing house?

4-      What are my top denials, and how to avoid them?

5-      Am I collecting what you should?

6-      Is my biller posting, writing off, and appealing correctly?

Need help? Breakthrough Coaching has resources to help with OIG compliance. Procedures to ensure office procedures are practical and efficient from day 1 when the patient walks in the door through payment.  Ensuring through monitoring and auditing that is part of your daily, weekly, and monthly routine that all the is are dotted, and t’s are crossed.  You don’t have to wonder, “Am I collecting what I should?” “Are appeals going out?” you will know.

BTC Resources: Forms 211, 1109, 1110, 1111