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abuse
Incidents or practices, not usually considered fraudulent, that are inconsistent with accepted sound medical business or fiscal practices.
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authorization
- an individual's formal, written permission to use or disclose his/her personally identifiable health information for purposes other than treatment, payment, or health care
- operations
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breach of confidential communication
breaking or violation of a law or agreement
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CCI
federal legislation that attempts to eliminate unbundling or other inappropriate reporting of procedural codes for professional medical services rendered to patients
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clearing house
an independent organization that receives insurance claim from the physicians office performs software edits and redistributes claims electronically to various insurance carriers
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CLIA
Clinical Laboratory Improvement Amendments
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compliance
the process of meeting regulations, recommendations, and expectations of federal and state agencies that pay for the health care services and regulate the industry
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compliance plan
A management plan composed of policies and procedures to accomplish uniformity, consistency, and conformity in medical record keeping that fulfills official requirements
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confidential communication
A privileged communication that may be disclosed only with the patient's permission.
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