Regulatory Compliance Support (APS) Policies & Procedures
- Physician Certification and Recertification for Post Acute Services REGS.APS.001
- Outpatient Rehabilitation Therapy Services REGS.APS.002
Regulatory Compliance Support (BILL) Policies & Procedures
- Outpatient Self-Administered Drugs REGS.BILL.003
- Stat, Call Back, Stand-by and Handling Charges REGS.BILL.006
- Billing for Investigational Devices REGS.BILL.007
Regulatory Compliance Support (COD) Policies & Procedures
- Coding Documentation for Inpatient Services REGS.COD.001
- Coding Documentation for Outpatient Services REGS.COD.002
- Coding References and Tools REGS.COD.003
- Coding Help Line REGS.COD.004
- Coding Orientation and Training REGS.COD.005
- Coding Continuing Education Requirements REGS.COD.006
- Reimbursement of Professional Exam Fee to Obtrain Credentials REGS.COD.007
- Prohibition of Contingency-Based Coding Arrangements REGS.COD.009
- Coding Documentation for Rehabilitation Facilities/Units REGS.COD.013
- External Coding Vendors for Coding Services, Reviews and Related Education REGS.COD.017
- Inpatient and Outpatient Coding Compliance Monitoring and Auditing REGS.COD.018
Regulatory Compliance Support (DOC) Policies & Procedures
- Clinical Documentation Improvement (CDI) - Implementation Requirements REGS.DOC.001
- Query Documentation for Clinical Documentation Improvement (CDI) & Coding - Compliance Requirements REGS.DOC.002
- CDI Orientation and Training REGS.DOC.003
- CDI Continuing Education Requirements REGS.DOC.004
Regulatory Compliance Support (GEN) Policies & Procedures
- Advance Beneficiary Notice of Non-coverage Outpatient Services REGS.GEN.003
- Billing - Orders for Hospital Outpatient Tests and Services REGS.GEN.004
- Billing & Billing Related Continuing Education Requirement REGS.GEN.007
- Hospital Evaluation and Management Services REGS.GEN.008
- Outpatient Services and Medicare Three Day Window REGS.GEN.009
- Medicare - Hospital Issued Notice of Non-Coverage REGS.GEN.010
- Medicare - National and Local Coverage Determinations REGS.GEN.011
- Refunds for Medically Unnecessary Services for Federal Payers REGS.GEN.012
- Responding to Governmental Requests for Claims Reviews or Surveys REGS.GEN.013
- Medicare Order Form for Patient Status REGS.GEN.014
- Correction of Errors Related to Federal and State Healthcare Program FFS Reimbursement REGS.GEN.015
Regulatory Compliance Support (HHA) Policies & Procedures
- Advance Beneficiary Notice of Non-Coverage – Home Health and Hospice Services REGS.HHA.001
- Responding to Governmental Requests for Home Health or Hospice Agencies Claims Reviews or Surveys REGS.HHA.002
- Correction of Errors Related to Federal and State Healthcare Program FFS Reimbursement for Home Health and Hospice Agencies REGS.HHA.003
- Medicare – National and Local Coverage Determinations for Home Health and Hospice Services REGS.HHA.004
Regulatory Compliance Support (LAB) Policies & Procedures
- Billing - Outpatient Specimen Collection REGS.LAB.006
- Billing - Custom Profiles REGS.LAB.007
- Referred Laboratory Testing REGS.LAB.009
- Laboratory - Reflex Tests REGS.LAB.010
- Laboratory - Client Billing Practices REGS.LAB.023
- Maintenance of Company Standard Laboratory Chargemaster REGS.LAB.025
- Hematology Procedures, Urinalysis Procedures, and Organ or Disease-Oriented Panels REGS.LAB.026
Regulatory Compliance Support (OSG) Policies & Procedures
- Coding Documentation for Non-Hospital Entities REGS.OSG.001
- Advance Beneficiary Notice of Non-coverage for Physician Professional Services and Non-Hospital Entities REGS.OSG.002
- Coding Reference and Tools for Non-Hospital Entities REGS.OSG.003
- Coding and Billing Help Line for Non-Hospital Entities REGS.OSG.004
- Coding Orientation and Training for Non-Hospital Entities REGS.OSG.005
- Coding Continuing Education Requirements for Non-Hospital Entities REGS.OSG.006
- Medicare-National and Local Coverage Determinations for Physician Professional Services and Non-Hospital Entities REGS.OSG.007
- Coding: Additional Compensation Plans for Coding Services Submitted on 1500 Claim Forms REGS.OSG.008
- Prohibition of Contingency-Based Coding Arrangements for Non-Hospital Entities REGS.OSG.009
- Physician Supervision Requirements for Diagnostic Tests Performed in Freestanding Entities REGS.OSG.010
- Certified External Vendors for Coding Related Education for OSG Entities REGS.OSG.011
- Responding to Governmental Requests for Non-Hospital Entities Claims Reviews or Surveys Policy REGS.OSG.012
- Billing Continuing Education Requirements for Professional Services REGS.OSG.BILL.001