Compliance Guidelines and Policies

If you have any questions or need assistance with the compliance forms, please contact the Compliance Office. If you would like to report a compliance incident or concern, please click here.

To access the Compliance Policy library, please click here

COMPLIANCE PROGRAM GUIDANCE

• 1.01 Annual Compliance Program Plan
• 1.03 Compliance Investigation and Resolution Process
• 1.04 Compliance Risk Assessment
• 1.05 Compliance with Self-Identified Overpayments
• 1.06 Compliance with False Claims Act
• 1.07 Department Compliance Report Requirements
• 1.08 Non-Intimidation and Non-Retaliation Policy
• 1.09 Department Compliance Report Requirements

AUDITING & MONITORING

• 2.01 Clinical Compliance Auditing and Monitoring
• 2.02 Clinical Compliance Audit Findings: Error Type Definitions and Scoring Methodology
• 2.03 Exclusion Screening of Federal and State Exclusion Lists
• 2.04 Government Inquiries: External Reviews & Second Level Appeals

BILLING, CODING & DOCUMENTATION

• 3.01 Annual Code Updates
• 3.02 Billing Limitations for Services with Advanced Physician Practitioners
• 3.03 Clinical Documentation: Co-Surgery Cases
• 3.04 Clinical Documentation: Assistant Surgery Cases
• 3.05 Clinical Documentation: Overlapping Surgery Cases
• 3.06 Clinical Documentation: Surgery/Procedure Note Core Documentation Requirements
• 3.07 Clinical Documentation: Timely Completion of Medical Record Entries
• 3.08 Clinical Fellows Billing Policy
• 3.09 Electronic Medical Record Guidance
• 3.10 Telehealth Documentation Requirement
• 3.11 Medicare Opt Out Regulations and Billing Requirements
• 3.12 Use of Chaperone Policy
  
• 3.13 Medicare Opt Out Request Form

RESERCH BILLING COMPLIANCE

• 4.02 Research Billing Compliance Handbook
• Coverage Analysis Guidelines for Sign-off