BCO Annual Chart Audits

As mandated by the University’s Billing Compliance Plan, the Billing Compliance Office (BCO) conducts chart reviews of the clinical departments’ Medicare, Medicaid and other billings.  During the course of its reviews, the BCO staff uses, or makes available to the clinical departments, the resources described in this section.

Departmental Compliance Self-Reviews

Clinical departments are required by UT Southwestern to conduct quarterly self-reviews of medical record documentation, as well as the CPT (procedure) and ICD-9 (diagnosis) codes assigned to services provided to Medicare, Medicaid or other patients.  Clinical departments can use the information and resources contained in this section to conduct these quarterly self-reviews.

EthicsLine

The University has contracted with EthicsLine, an independent third-party, to receive employee telephone calls regarding issues of non-compliance with Federal and state laws and regulations, as well as with UT System and University policies and procedures.  Employees who do not believe it is appropriate to internally report instances of non-compliance, or who have concerns about retaliation, are encouraged to contact EthicsLine.  This section provides additional information about EthicsLine.

Health Care Fraud and Abuse

This section provides an overview of the types of activities that can be considered by the federal and/or state governments to be health care fraud or abuse.  The section also describes steps taken by federal, state and private payers to combat health care fraud/abuse.

Policies

The section contains policies, procedures and other information directed at ensuring that the University’s documentation, coding and billing activities comply with all applicable laws, regulations and policies.  This section also contains policies used by the Billing Compliance Office when conducting its annual chart audits.