Overview
What is a compliance program?
- A compliance program consists of a series of internal controls and measures to ensure that all federal, state and local statutes and regulations governing federally funded health care programs are being followed.
What are the benefits of a compliance program?
- An effective compliance program provides a mechanism that brings the public and private sectors together to reach mutual goals of reducing fraud and abuse, improving operational quality, improving the quality of health care and reducing the costs of health care. Attaining these goals provides positive results to business, government and individual citizens, alike. In addition to fulfilling a legal duty to ensure that false or inaccurate claims are not submitted to government and private payers, an effective compliance program provides numerous additional benefits.
These benefits may include:Improving compliance with applicable laws and requirements, which is essential to the core mission of an academic medical center;
- Assisting physicians who work within or graduate from medical schools/residency training programs to adhere to billing requirements; and
- Assisting providers in avoiding government enforcement actions pertaining to fraud and abuse.
The University of Texas Southwestern Billing Compliance Program consists of the following elements:
- MSRDP Coding and Charge Capture Policies and Procedures
- Billing Compliance Advisory Committee
- Billing Compliance Office
