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LCHD/CHC Corporate Compliance Report Jan-Jun2008 - Schanding
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Corporate compliance-first half 2008
In 2007 you approved the Health Department’s Corporate Compliance Plan. The Corporate Compliance Plan, focusing particularly on billing practices, is a requirement for organizations that receive $5 million in Medicaid funds annually. The plan’s adoption included providing feedback to the Board of Health twice annually on the results of internal audits completed to monitor billing practices.
Listed below are the findings of the most recent reviews of the three service areas that generate Medicaid billings:
Community Health Services
Four programs bill Medicare or Medicaid for services provided. Three of the programs (Immunizations, Tuberculosis Clinic, and Hearing and Vision) generate bills for services directly from the encounter forms that are completed at the time of service. Billing is generated from the encounter forms and totals are double checked for accuracy prior to submission. In effect, audits are conducted concurrently.
Family Case Management generates bills based on services documented in the client’s record. An audit of one bill for each Case Manager is conducted monthly to assure that the service being billed is adequately documented. The number of correctly documented bills for service is presented below.
CHN Billing Audit Totals 2008 Jan-Jun
Month Number of Audits Errors
January-08 15 1. Denver no line, signature, or date.
February-08 15 1. Incorrect birthdate
March-08 9
April-08 13
May-08 12
June-08 10
Total 74|99|
There were 2 deficiencies identified in an audit of 74 case manager charts. A description of the two errors is included in the table above.
Errors or inaccuracies are returned to the nurse for correction. The correction is rechecked, and the bills are submitted once the corrections are completed.
Primary Care Services
Data Entry Review
Patient encounter process remained the same for the ...
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