Wiki Coding Compliance Plan

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pchamp25

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I code for an ASC that is multiple specialty but I am the only coder and we don't have a coding department. It has been brought to my attention the need for a coding compliance plan and the need for a compliance officer and auditor(s) if audits are performed in house.

We are an independent ASC and I am looking for guidance regarding options and resources in order to put together a coding compliance plan along with how to handle audits. Some suggestions on some audit companies that others have dealt with and would recommend?

This is all new to me so I am, honestly, not even sure where to start so any help would be much appreciated!
 
Don't you have a coding department of one? :)

I would caution about putting a plan or policies in place if you have no way of regulating them or any procedures around that. I am not sure it is the place of a staff coder to create a compliance plan and try to implement it. The staff coder should not be auditing themselves either. It is almost better to have nothing at all if you have no way to follow the plan or procedures in place to implement it. Do you have a manager, director or someone at a higher level. Seems to me the C-level or higher level should be making these policies.
If you are an ASC there are also state requirements.

Resources:

This link was from a RAC but there are other helpful links to check at the bottom of the page:

This is from an attorney site, but has good info:
 
amyjph said:
Don't you have a coding department of one? :)

I would caution about putting a plan or policies in place if you have no way of regulating them or any procedures around that. I am not sure it is the place of a staff coder to create a compliance plan and try to implement it. The staff coder should not be auditing themselves either. It is almost better to have nothing at all if you have no way to follow the plan or procedures in place to implement it. Do you have a manager, director or someone at a higher level. Seems to me the C-level or higher level should be making these policies.
If you are an ASC there are also state requirements.

Resources:

This link was from a RAC but there are other helpful links to check at the bottom of the page:

This is from an attorney site, but has good info:
Click to expand...
Thank you for this info! I am a coding dept of one :)
I also wear many hats as we are a small facility. I am the Revenue Cycle Manager in charge of the billing and insurance verification departments. I will review this info with my practice manager and the president of the management company that over sees our facility as a whole. I know they will be the ones to implement the plan but wanted to get more information re: a coding compliance plan to pass on to them.
 
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