Compliance in healthcare is the active, ongoing process to ensure that legal, ethical, and professional standards are met and communicated throughout the entire healthcare organization. Compliance is integral to virtually every area of healthcare, including coding and billing, patient privacy, and patient safety. Coding compliance focuses specifically on efforts to prevent, detect, and resolve activity that could lead to fraud, waste, and abuse. This is accomplished through accurate coding, proper reimbursement and data integrity.
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Compliance: Risks in the Electronic Health Record addresses the challenges related to use of electronic health records (EHR) and provides best practices to mitigate both compliance and clinical risks. Nationally-recognized coding authority, Kim Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO, COC, walks you through what you need to know to ensure your EHR is compliant with administrative and legal requirements. -
Queries are an essential communication tool for compliance, reimbursement, and quality improvement. Mastering the Query Process provides detailed explanations, carefully selected examples, and clear and concise guidance for coding and CDI professionals on the tools and techniques used to create effective and compliant queries. -
Medical Necessity determines if a health care service is reasonable, necessary, and appropriate based on clinical standards of care. It's a key factor in determining eligibility for reimbursement. Nationally-recognized coding authority, Kim Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO, COC, walks you through what you need to know to ensure your documentation and coding will meet requirements for medical necessity. -
Designed to prepare students for a career in coding, Principles of Health Information Management provides an introduction to the HIM function in hospitals including the structure and use of health information, health record data management, health record documentation, healthcare delivery systems, and regulatory and compliance issues.