Role of Compliance Officer Is Serious Business

Does your practice have a designated compliance officer? Regardless of the group’s size, the compliance officer’s role is key to the success of a compliance plan, says attorney Amanda J. Hill in Build Your Compliance Plan.

This practice staff member:

  • Is responsible for making sure your practice follows coding and billing principles to prevent problems with the U.S. Office of Inspector General, auditors, or other government agencies that monitor fraud and abuse;

  • Must periodically review charts, documentation, coding, and billing — either through internal audits or by hiring outside consultants — to make sure the physician(s) is following federal and state regulations;

  • Needs to keep current with ever-changing regulations regarding fraud and abuse, perhaps through some type of formal training;

  • Is responsible for making sure the practice takes prompt action if a violation is discovered. A violation of fraud and abuse statutes can have serious consequences for physicians, and the compliance officer needs to take his or her role seriously. 

Build Your Compliance Plan is available in the TMA Education Center, along with other continuing medical education courses on compliance. If you need outside help, call on TMA Practice Consulting for a compliance or coding and documentation review.

Published Feb. 17, 2016

TMA Practice E-Tips main page

Last Updated On

December 07, 2016

Originally Published On

February 17, 2016

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Audits | Fraud and Abuse | Risk Management