Compliance Policies and Procedures:
POLICY GUIDELINES
The policy of the University has always been to ensure that all claims for third-party reimbursement use the proper code(s) for the service(s) provided, that the documentation in the medical record supports the code(s) billed, and that each claim is submitted in the name of the appropriate provider. To guide physicians and billing personnel in meeting this objective, the Compliance Officer shall review existing policies, revise them as necessary, and develop any additional policies. Relevant policies will be incorporated into this Plan as they are approved by the Compliance Committee. Such policies may include but are not limited to:
- Policy on Billing Responsibility
- Policy on Medical Record Documentation
- Policy on Teaching Physician Rules
- Policy on Routine Waiver of Coinsurance and Deductibles
- Policy on Refunding Overpayments
- Policy on Annual Reviews of Providers’ Compliance
- Policy on Reporting Compliance and Ethics Concerns
- Policy on Sanctions for Plan Violations
- Policy on Review of Disciplinary Action Related to Non-Compliance
- Policy on Properly Billing Services for Patients on Clinical Trials