Purpose
This assignment has two parts. The first part will focus on the importance of a coding compliance plan and the second part will get you to consider the importance of monitoring coding compliance. At the end of this assignment, the student should be able to evaluate compliance with external forces and analyze components of risk management as it relates to a healthcare organization which meets the following CAHIIM competencies.
V.2. Evaluate compliance with external forces. (5)
V.3. Analyze components of risk management as related to a health organization. (4)
Compliance Policy
You are the new coding manager at PeeDee Pirate Health, you learn quickly that there is no coding compliance plan in place. Propose at least 6 policies and procedures that would be appropriate in a coding compliance plan and determine (5) the importance of including these proposals in the coding compliance plan.
Fraud and Abuse Focus
New to your role as revenue cycle manager, you are nonetheless surprised to learn that there is no formal process in place for isolating potential areas of compliance concern. You recognize that this would generate a focused approach for internal or external auditing, leading to identification of coding compliance concerns and opportunities for coder education. Recommend to the coding supervisor a minimum of four best practices for determining focus areas for auditing and monitoring of coding compliance.
Analyze components of risk management as it relates to a healthcare organization which meets the CAHIIM competencies.
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