Main Functions

Main Functions

The Office of Billing Compliance main functions are to review inquiries concerning billing issues related to compliance or reports of non-compliance by determining whether a compliance issue exists and, if so, investigate and develop an appropriate response; develop an annual audit plan of the goals and objectives for the Billing Compliance Program. Review and update billing compliance plan policies and procedures, as well as the annual audit plan. The audits performed by the OBC appraise the potential risks associated with various billing, coding and documentation activities and the effectiveness and application of appropriate controls to limit those risks; incorporation of standards and policies that guide UHealth personnel with regard to Professional and Hospital fee billing.

Coordinate training of clinical, hospital staff and billing personnel concerning applicable billing, coding and documentation requirements and UHealth policies in collaboration with both Professional and Hospital Physician Compliance Officers to develop and approve educational materials and programs; provide corrective action plans to address any instances of non-compliance with UHealth and/or regulatory policies or billing requirements and recommendations of disciplinary actions for any violations committed.