Biomaterial Database

The ABCs of physician billing compliance plans. 1996

G J Apple, and B Bowman

As it evolves, an organization's compliance plan will become an effective risk-management tool. As the price for noncompliance becomes ever higher, the development and implementation of a corporate compliance plan makes both common and fiscal sense. A compliance plan should not be a program that is rolled out and then allowed to sit on the shelf and gather dust. The only thing worse than not having a compliance plan is having one and not following it.

UI	MeSH Term	Description	Entries
D007345	Insurance Claim Review	Review of claims by insurance companies to determine liability and amount of payment for various services. The review may also include determination of eligibility of the claimant or beneficiary or of the provider of the benefit; determination that the benefit is covered or not payable under another policy; or determination that the service was necessary and of reasonable cost and quality.	Claims Review,Insurance Audit,Insurance Claims Processing,Analysis, Claims,Claim Review, Insurance,Claims Analysis,Insurance Claims Analysis,Review, Claims,Review, Insurance Claim,Analyses, Claims,Analyses, Insurance Claims,Analysis, Insurance Claims,Audit, Insurance,Audits, Insurance,Claim Reviews, Insurance,Claims Analyses,Claims Analyses, Insurance,Claims Analysis, Insurance,Claims Processing, Insurance,Claims Reviews,Insurance Audits,Insurance Claim Reviews,Insurance Claims Analyses,Processing, Insurance Claims,Reviews, Claims,Reviews, Insurance Claim
D008910	Minnesota	State bordered on the north by Canada, on the east by Lake Superior and Wisconsin, on the south by Iowa, and on the west by North Dakota and South Dakota.
D012051	Reimbursement Mechanisms	Processes or methods of reimbursement for services rendered or equipment.	Mechanism, Reimbursement,Mechanisms, Reimbursement,Reimbursement Mechanism
D005607	Fraud	Exploitation through misrepresentation of the facts or concealment of the purposes of the exploiter.	Fraud, Health Care,Health Care Fraud,Kickbacks,Drug Counterfeiting,Healthcare Fraud,Counterfeiting, Drug,Fraud, Healthcare,Health Care Frauds,Kickback
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man