Restrain upcoding mistakes or risk OIG scrutiny

In dealing with compliance, practice size does matter – even solo practitioners have to stay on the straight and narrow.

Even small dermatology coding practices have to stay compliant with government regulations – and even though this sounds like a simple fact, it is one that many Part B providers may fail to take notice of.

Ensuring physician practice compliance can be a difficult path, and many practices think of it as something that large hospitals should train eyes on – after all, those are the entities that get all of the media exposure when they break compliance rules. However every practice is responsible for the compliance, irrespective of how big or small.

Physicians take note

In some cases, small practices think compliance rules do not affect them – however they also do not realize that they are at risk of being noncompliant.

Here's an instance: "I met with a solo practitioner some years back who took me in as a consultant,">

"It was my sad duty to let him know that his office manager, who submitted all of his claims, was upcoding all of his office visits as she entered them into the computer so that she could pay his quarterly malpractices-insurance premiums," says Hills. "She had been working for ten years and was a trustworthy employee."

The fault was the physician's as he never took the time to review the monthly reports that the officer gave to him, says Hill. He also never looked closely at his deposits into his corporate checking account, where there was a clear trend toward increased deposits every third month.

Give attention to your advisors: In the above instance, the physician's accountant had pointed out the problem to him, "however he accepted his office manager's explanation that insurance companies often held payments till the end of the quarter so that they made more money on interest gathered during the 3 months they delayed on claims," says Hill. "He was really sad when I advised him he would have to self-disclose to all of the insurance companies for the ten years she had been doing his billing and that he'd have to send a check for overpayments along with the letters."

Here's why: It was the doctor's job to handle the overpayments as he owned the practice and claims were submitted using his provider number. "He's charged with the oversight of the coding and billing procedures," Mark C. Rogers, Esq., with The Rogers Law Firm in Braintree, Mass says.

In a scenario such as this, the following four considerations should come into play:

Dermatology coding practices have to stay compliant with government regulations – and even though this sounds like a simple fact, it is one that many Part B providers may fail to take notice of. Ensuring physician practice compliance can be a difficult path, and many practices think of it as something that large hospitals should train eyes on – after all, those are the entities that get all of the media exposure when they break compliance rules. However every practice is responsible for the compliance, irrespective of how big or small. Physicians take note In some cases, small practices think compliance rules do not affect them – however they also do not realize that they are at risk of being noncompliant.

Here's an instance: "I met with a solo practitioner some years back who took me in as a consultant,">The doctor should end the office manager's employment immediately. dermatology coding practices have to stay compliant with government regulations – and even though this sounds like a simple fact, it is one that many Part B providers may fail to take notice of.

Ensuring physician practice compliance can be a difficult path, and many practices think of it as something that large hospitals should train eyes on – after all, those are the entities that get all of the media exposure when they break compliance rules. However every practice is responsible for the compliance, irrespective of how big or small.

Physicians take note In some cases, small practices think compliance rules do not affect them – however they also do not realize that they are at risk of being noncompliant. Here's an instance: "I met with a solo practitioner some years back who took me in as a consultant,">

A full audit of the practice's billing should occur since the office manager started her employment (if there is a problem with upcoding in one area; there are probable problems elsewhere, says Rogers). dermatology coding practices have to stay compliant with government regulations – and even though this sounds like a simple fact, it is one that many Part B providers may fail to take notice of.

Ensuring physician practice compliance can be a difficult path, and many practices think of it as something that large hospitals should train eyes on – after all, those are the entities that get all of the media exposure when they break compliance rules. However every practice is responsible for the compliance, irrespective of how big or small. Physicians take note In some cases, small practices think compliance rules do not affect them – however they also do not realize that they are at risk of being noncompliant. Here's an instance: "I met with a solo practitioner some years back who took me in as a consultant,">

As part of his self-disclosure, the doctor should show what he's done to ensure that such a scenario will not happen again. Particularly, the termination of the employee and the accomplishment of an effective corporate compliance program. dermatology coding practices have to stay compliant with government regulations – and even though this sounds like a simple fact, it is one that many Part B providers may fail to take notice of. Ensuring physician practice compliance can be a difficult path, and many practices think of it as something that large hospitals should train eyes on – after all, those are the entities that get all of the media exposure when they break compliance rules. However every practice is responsible for the compliance, irrespective of how big or small.

Physicians take note In some cases, small practices think compliance rules do not affect them – however they also do not realize that they are at risk of being noncompliant. Here's an instance: "I met with a solo practitioner some years back who took me in as a consultant,">Document the above steps completely. Way to avoid these issues: The scenario described above can have an impact on practices of all sizes. According to Hill, "Few practices have a set compliance plan that they work and they keep alive," says Hill. Here are two tips that she's gleaned through her auditing work, which you can utilize to ensure your practice stays on the straight and narrow.

dermatology coding practices have to stay compliant with government regulations – and even though this sounds like a simple fact, it is one that many Part B providers may fail to take notice of. Ensuring physician practice compliance can be a difficult path, and many practices think of it as something that large hospitals should train eyes on – after all, those are the entities that get all of the media exposure when they break compliance rules. However every practice is responsible for the compliance, irrespective of how big or small. Physicians take note In some cases, small practices think compliance rules do not affect them – however they also do not realize that they are at risk of being noncompliant. Here's an instance: "I met with a solo practitioner some years back who took me in as a consultant,">

Internal audits are a necessity, with a minimum of quarterly physician education covered. According to Hill, "Most doctors see ten times as many patients than they did ten years ago just to earn the same amount of money. All too often, the corners that are cut are linked to the quality and integrity of their staff." dermatology coding practices have to stay compliant with government regulations – and even though this sounds like a simple fact, it is one that many Part B providers may fail to take notice of.

Ensuring physician practice compliance can be a difficult path, and many practices think of it as something that large hospitals should train eyes on – after all, those are the entities that get all of the media exposure when they break compliance rules. However every practice is responsible for the compliance, irrespective of how big or small. Physicians take note In some cases, small practices think compliance rules do not affect them – however they also do not realize that they are at risk of being noncompliant. Here's an instance: "I met with a solo practitioner some years back who took me in as a consultant,">Train eyes on HIPAA: According to Hill, complete disregard for even the basic HIPAA laws is common as well. "The longer the practitioner has been in practice, the poorer the infractions are."