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第三方计费合规指南强调风险意识。

Third-party biller compliance guidance emphasizes risk awareness.

作者信息

Saner R J

机构信息

Powers, Pyles, Sutter and Verville, P.C., Washington, DC, USA.

出版信息

Healthc Financ Manage. 1999 Mar;53(3):43-5.

Abstract

The voluntary compliance guidance for third-party billing companies released by the HHS Office of Inspector General (OIG) in December 1998, like the OIG's previously released guidance directed at hospitals, home health agencies, and clinical laboratories, identifies seven minimum elements for an effective corporate compliance program: written compliance policies, designation of a compliance officer, ongoing training, open lines of communication, guidelines to ensure the enforcement of compliance standards, internal monitoring and auditing of compliance activity, and procedures to respond to and correct errors. Three areas of concern for third-party billing companies are emphasized in the new guidance document: compliance risk, claims documentation, and disclosure of suspected misconduct or fraud.

摘要

美国卫生与公众服务部监察长办公室(OIG)于1998年12月发布的针对第三方计费公司的自愿合规指南,与OIG此前发布的针对医院、家庭健康机构和临床实验室的指南一样,确定了有效企业合规计划的七个最低要素:书面合规政策、合规官的指定、持续培训、开放的沟通渠道、确保合规标准得到执行的指南、对合规活动的内部监测和审计,以及应对和纠正错误的程序。新指南文件强调了第三方计费公司需要关注的三个领域:合规风险、索赔文件以及对涉嫌不当行为或欺诈的披露。

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