[Expert Solution]: Fraud and Abuse Focus – 15 points IV.3

Fraud and Abuse Focus – 15 points IV.3. Evaluate compliance with regulatory requirements and reimbursement methodologies. (5) V.3. Analyze components of risk management as related to a health organization. (4) New to your role as revenue cycle manager, you are nonetheless surprised to learn that there is no formal process in place for isolating potential areas of compliance concern. You recognize that this would generate a focused approach for internal or external auditing, leading to identification of coding compliance concerns and opportunities for coder education. Recommend to the coding supervisor a minimum of five best practices for determining focus areas for auditing and monitoring of coding compliance.