Billing/Contractual Compliance Practice Analysis

As defined in the OIG's Model Compliance Plan for Individual and Small Group physician Practices and the OIG's Compliance Plan for Third-Party Billing Companies, a comprehensive risk analysis should identify and rank the various compliance and business risks experienced in daily operations, as well as serve as the basis for written policies.

A BHS risk assessment provides a baseline/benchmark compliance analysis of your practice. Our compliance review includes at a minimum:

Billing/Contractual examination of leases and supplier contracts
Contracts with physicians, hospitals and other facilities
Corporate marketing practices
Assignment of benefits
Marketing and referral practices
Operational manuals
Record keeping
Medical Record Review which encompasses an analysis of the integrity and accuracy of the practice's documentation, coding and billing methods.

The BHS Compliance Review deliverable includes a comprehensive on-site report, a comprehensive record review report, with exhibits, including spreadsheets sorted by patient, CPT code, group physicians and sites (when multiple). Other exhibits include educational reference material as appropriate, such as Carrier Bulletins, CMS(previously HCFA) Policy, and Code of Federal Regulations and/or Federal Register articles, etc. Click here to see an example of one of our Risk Assessment Reports.

If desired, a compliance review may be performed as a confidential service under Attorney-Client Privilege. And, for an even more in-depth practice analysis, that only BHS can provide, you may wish to consider a Focused Medical Review and/or an on-site Educational Session with the entire staff or with selective staff members, such as coding/billing staff or physicians.