Q. What is the selection process for documentation review?
A. The Compliance Office is charged with reviewing all clincially active "new" faculty (hired since 1/1/00) as soon as possible. Faculty with more than a year tenure are reviewed in order of projected revenue production to enable the maximum in risk reduction and operational efficiency of educational intervention.
Q. How are services selected for review?
A. Unbilled services are selected to reflect the general nature of the physician's practice. Inpatient and Outpatient Vists, Consults, Surgeries etc. Ten to Fifteen services are reviewed for each physician.
Q. How am I informed of results, and who is provided with such results?
A. The Manager of Compliance Services or a Compliance Analyst will schedule a private clarification session to discuss the results. Individualized training is provided and relevant interventions discussed if any are necessary. Once the clarification session is completed results are amended as need be. The Clincal Chair and/or Divsion Chief is (are) provided a summary of the review once a number of faculty in a department have been reviewed. Every three weeks the Chief of Clinical Operations and the Chief Executive Officer of the Clinical Practice Group are provided updates.
Q. What is the Review cycle?
A. Beginning January 1, 2001 the Compliance Office will review all "new" Faculty within 180 days of hire. Such reviews will commence no earlier than 90 days after hire. Each fiscal year Faculty with more than a year service and revenue goals in the top 75% of projected revenue will be reviewed. The Compliance Office satisfies all requests for ad hoc or out-of-cycle review and education on an as-requested basis. |