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Education and Training for New Hires CUIMC Office for

Details: Education and Training for New Hires Objective To ensure that CUIMC clinicians, billing personnel, consultants, or contractors (collectively, “billing personnel”), and administrative personnel receive timely billing compliance training.

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Ongoing Training for CUIMC Clinicians and Billing

Details: The OFBC ongoing education and training program for CUIMC clinicians and billing personnel requires them to attend one hour of education per year, which can be met by OFBC on line training via Columbia University training platform on specific coding and compliance issues, attending seminars hosted by the OFBC, or attending New hire training.

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Education and Training Policy for Employees and

Details: Education and Training Policy for Employees and Contractors Involved in Billing. Education and Training for New Hires; Ongoing Training for CUIMC Clinicians and Billing Personnel; Clearing Claim Scrubber Coding Edits in the IDX Billing System; Qualification Standards for Charge Review Personnel; Policy Regarding Ineligible Persons

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Qualification Standards for Charge Review Personnel

Details: All charge review personnel must be provided with regular training and education opportunities both internal and external. All charge review personnel should attend a compliance training session as a new hire employee and every year thereafter.

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Retention of Compliance Training Records Policy CUIMC

Details: Retention of Compliance Training Records Policy. Columbia University Irving Medical Center’s Office for Billing Compliance will retain Compliance and Fraud Waste and Abuse training records for all providers and staff for a period of ten years in compliance with 42CFR 422.504 (d). Training records are housed in our training databases and hard

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Departmental Compliance Responsibilities CUIMC Office

Details: The Departmental Compliance Leaders’ responsibilities include: (1)monitoring compliance with the department compliance plan through routine reviews and departmental billing; (2)maintaining logs of billing or compliance issues that have been raised within the department, as well as the resolution of those issues, maintaining refund logs, and compiling annual compliance statistics for the OFBC

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Billing Compliance CUIMC Office for Billing Compliance

Details: Columbia University Medical Center is dedicated to providing the highest level of medical education, research and patient care. An integral part of this mission is the obligation of each physician, non-physician practitioner, and staff member to act ethically and legally and to document and bill for professional services in accordance with applicable laws and regulations.

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Compliance Operations CUIMC Office for Billing Compliance

Details: Compliance Operations. Billing Compliance Risk Areas. Risk Assessment Policy. Governing Laws and Guidelines. Audit Policy. Corrective Action Policy. Refunds/Credit Balances and Self Disclosures. Education and Training Policy for Employees and Contractors Involved in …

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Evaluation and Management (E&M) Guidelines CUIMC Office

Details: Evaluation and Management coding is a medical coding process in support of medical billing. Practicing health care providers in the United States must use E/M coding to be reimbursed by Medicare, Medicaid programs, or private insurance for patient encounters. E/M standards and guidelines were established by Congress in 1995 and revised in 1997.

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Billing Compliance Manual CUIMC Office for Billing

Details: Billing Compliance Manual. CUIMC's Billing Compliance Plan applies to all CUIMC physicians, faculty, entities, corporations, administrative personnel, clinical research staff, and other health professionals involved in the provision of professional services. The Billing Compliance Manual is intended to summarize, for ease of use and reference

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Policy Regarding Ineligible Persons CUIMC Office for

Details: Individuals and entities can be excluded from program participation for many reasons, including, among others, conviction of a program related offense, license revocation or suspension, and default on health education loans. Several government agencies have exclusion lists available to the public.

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Corrective Action Policy CUIMC Office for Billing Compliance

Details: A Corrective Action Plan may include any or all of the following: (1) a period of pre-billing review of the relevant practitioner or department’s charges; (2) repayment of any associated overpayments; (3) retraining or re-education of practitioners and staff; (4 a written letter of warning or reprimand; (5) imposition of terms of probation

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Billing Consultants or Contractors CUIMC Office for

Details: Objective. To ensure that any outside billing consultants or contractors are retained in accordance with University policy. Policy. The Chief Billing Compliance Officer must review and approve in advance any department’s engagement of outside billing consultants or contractors (including any individuals or entities involved in billing, coding, collections or related activities).

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Prohibitions Against Kickbacks, Self-Referrals and Fee

Details: CUIMC personnel must comply with Federal and State law regarding kickbacks and self-referrals, and University rules regarding conflicts of interest.

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Billing Compliance Risk Areas CUIMC Office for Billing

Details: Billing Compliance Risk Areas assist members of the CUIMC community in preventing the submission of erroneous claims or engaging in unlawful conduct involving Federal and State health care programs.

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Objective CUIMC Office for Billing Compliance

Details: CUIMC is dedicated to providing high quality medical education, research, patient care and service to the community. An integral part of this mission is the obligation of every member of the CUIMC community, including each physician, non-physician practitioner (“NPP”) and staff member (and any affiliate or contractor corporation

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Detection and Prevention of Fraud CUIMC Office for

Details: Objective. To comply with Section 6032 of the Deficit Reduction Act of 2005 (“DRA”), which requires that State Medicaid Plans be amended to require certain types of health care providers to establish written policies that address the following: (1) the Federal False Claims Act, 31 U.S.C. 3729-3733 (“FCA”); (2) the administrative remedies for false claims and statements found in the

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Governing Laws and Guidelines CUIMC Office for Billing

Details: Governing Laws and Guidelines. Prohibitions Against Kickbacks, Self-Referrals and Fee Splitting. Detection and Prevention of Fraud. Physicians at Teaching Hospitals. Speaking with Government Agents. Audit Policy. Corrective Action Policy. Refunds/Credit Balances and Self Disclosures. Education and Training Policy for Employees and Contractors

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Refunds/Credit Balances and Self Disclosures CUIMC

Details: Education and Training Policy for Employees and Contractors Involved in Billing; Medical Billing Guidelines; Documentation & EMR Guidelines; Compliance Policies; Other Practice Policies; Research Billing Compliance; HIPAA/HITECH Compliance; Federal & New York Laws Relating to False Claims; Helpful Phone Numbers, Acronyms & Websites; Frequently

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Physicians at Teaching Hospitals CUIMC Office for

Details: Objective. To ensure that all services in which residents are involved are correctly billed in accordance with applicable rules and regulations regarding physician services in teaching settings. For purposes of this policy, a ‘resident’ includes a resident, intern, or fellow participating in an approved graduate medical education (“GME

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Billing Compliance Plan CUIMC Office for Billing Compliance

Details: The Columbia University Billing Compliance Plan (link is external and opens in a new window) is intended to demonstrate our commitment to the highest standards of ethics and legal and regulatory compliance. The elements of the Plan generally include establishing compliance and practice standards to prevent erroneous or fraudulent conduct, communicating the standards to employees, responding to

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Speaking with Government Agents CUIMC Office for Billing

Details: Request identification and ask for a business card. Contact both the Office of the General Counsel and the OFBC before providing the agent any documents. In the event you are contacted by a government agent, the Office of the General Counsel, 212-854-0287, and the OFBC, 212-305-3842, are available to provide assistance.

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Physicians at Teaching Hospitals (PATH) Regulations

Details: Physicians at Teaching Hospitals (PATH) Regulations. Teaching hospitals receive federal money to train residents. When teaching physicians are involved in a patient’s care and meet certain criteria, their documentation (combined with the resident’s) may be used to bill a professional fee to Medicare Part B, Medicaid, and insurance companies.

› Verified 8 days ago

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Audit Policy CUIMC Office for Billing Compliance

Details: Policy. CUIMC, through the OFBC and individual departments, will conduct the following types of audits. Annual Audits – Conducted by each department as a matter of routine compliance activity and in accordance with each department’s risk assessment. These reviews are the subject matter of the quality assurance audits by the OFBC.

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Principles of Charge Analysis CUIMC Office for Billing

Details: Principles of Charge Analysis. In 1992, as part of Physician Payment Reform, the new Evaluation & Management (E&M) coding for cognitive services was introduced in the AMA CPT Manual. These guidelines were fully implemented in 1995 (1995 Documentation Guidelines). By 1997, Specialty specific Exams were introduced, but not mandated for use.

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