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Elements of an HIM Compliance Program
HCFAs Payment Error Prevention Program
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accurate coding AHIMA American Hospital Association and/or appropriate assessment auditing and monitoring chargemaster claims code assignment coding accuracy coding policies coding practices coding professionals coding staff complete compliance program compliance specialist conducted consultant corporate compliance officer corrective action CPT codes determine developed diagnoses and procedures diagnosis codes diagnosis-related group diagnostic information discharges in DRG disciplinary action documentation practices educational programs employees example federal fraud and abuse HCFA health information management health record documentation healthcare data healthcare organization home health identified implemented improve individual inpatient issues Management code MDS data medical necessity medical staff Medicare mix index necessary nursing facilities official coding guidelines outpatient overpayments patient patterns payer payment policies performed personnel physician documentation physician practice policies and procedures problems procedure codes Prospective Payment System regulations regulatory requirements reimbursement reports responsible sample standards Subdomain submitted supervisor tion Total Days upcoding violations