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