Healthcare compliance 2 – discussion

Many compliance problems occur in the process by which a hospital prepares and submits claims to payors for reimbursement of the services it has provided to Medicare and Medicaid beneficiaries. Which of the following procedures do you think would be most effective in preventing problems. In a few sentences, explain why you think so. 

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  • A mechanism for maintaining effective, accurate communication channels between claims/billing staff and clinical staff.
  • Medical records used as the basis for submitted claims are organized and legible to facilitate their audit and review.
  • The compensation given to the claims department, coding clerks, and claims consultants does not function in any way as an incentive to improperly code claims.

-(use the PDF that I attached on the bottom – it will help)

-there is no word limit

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