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Essay / Research Paper Abstract
A 4 page paper suggesting additions to a hospital compliance plan to more closely align it with regulatory requirements. The paper suggests that an identified compliance plan be edited to specifically address issues of billing errors and physician referrals, as well as changes in electronic data security required by HIPAA. Bibliography lists 4 sources.
Page Count:
4 pages (~225 words per page)
File: CC6_KShlthCrComPlan.rtf
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Unformatted sample text from the term paper:
central difficulty in devising a corporate compliance plan is the complexity of overseeing one highly complex and detailed activity (health care) so that it complies with extensive government regulations.
Errors can occur quite innocently, resulting in inaccurate billing that has no fraudulent intent behind it. Privacy requirements are difficult to meet in terms of preventing anyone but the
user from seeing computer screens. Ownership positions are changing among physicians, and hospitals need to ensure that they have a means of notifying individual patients that specific physicians are
in practice with those who extend referrals to patients. The University Medical Associates Compliance Plan addresses many points on a high level, but the level for several items may
be too high. The plan likely needs more detail in areas such as coding, privacy and physician referral. Billing Errors There are
myriad ways that coding errors can arise. The most obvious is that simple clerical errors, but patient needs can change rapidly. A physician can order equipment or services
but subsequently determine that the equipment or service is unnecessary or that there is an alternate choice available. If the change is made but then lost in the "paper
trail," the discrepancy can result in a billing error that no one intended. Government regulations contain specific requirements regarding who performs what duties.
Billing for physician services must be for services that were indeed delivered by a physician, and not by a staff member. Privacy
Electronic data security rules of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 went into effect in April 2005, the last of three broad areas addressed by HIPAA
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