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How to create an office Medicare compliance program

Office of Inspector General document details voluntary procedures

Figure 1

Developing compliance guidelines for high-risk areas

The OIG has identified four major high-risk areas for physician practices to concentrate their efforts in developing compliance guidelines. Ophthalmologists should assess their practices for these types of problems.

1. Coding and billing

For most ophthalmologists, Medicare is their largest payer. If your practice falls into that category, billing and coding issues should be a major part of your compliance program.

When creating written policies and procedures for billing and coding, stress the importance of basing billings on the documentation in the medical ...

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