Running head: Evaluating Compliance Strategies

Assignment: Evaluating Compliance Strategies
Name
Axia College of University of Phoenix
HCR 220
Date

“Guidelines established by the healthcare staff and laws established by HIPAA are what make up the compliance process. These laws and guidelines were established to protect the patients, physicians, and staff members” (U.S. Dept. of Health and Human Services, n.d.). Errors in the office can be avoided by having a compliance process in effect. Using updated billing and coding software will help reduce errors made in the billing process. I agree with having a guide consisting of codes to aid in the billing process. I do regard this as cheating rather, to be used as a guide. Many offices currently have sheets that are located on the front of the patients’ file with the diagnosis and the code next to the diagnosis which the physician fills out. This eliminates an unnecessary step in the billing process and is a quicker, easier, and more accurate way to avoid errors. “In order to avoid rejection of the claim, it is important that the diagnoses and procedures are correctly linked” (AAFP, 1999). This also ensures that the claim is paid for the correct procedure performed by the physician. If an incorrect procedure was billed this could result in a loss of money by the physician for the type of procedure that was performed. The claim will have to be adjusted and resubmitted to the insurance company if the claim is rejected. These mistakes can cause the physicians’ accounts receivable to be out of balance, and result in claims left outstanding for payment. “The repercussions of incorrect medical coding can result in lost revenue, which could add up to a sum of thousands of dollars. These ramifications can be avoided by ensuring the office staff has the