Correct Coding and Navigating Payer Expectations.

Abstract

In this commentary, the author examines the root cause and barriers to billing compliance due to varying payer (insurance) requirements. The author examines uniform code set requirements enacted with the Health Insurance Portability and Accountability Act (HIPAA) and offers practical recommendations for health information (HI) professionals striving for compliance. Recommendations offered by the author include proactive approaches for compliance, monitoring techniques, and policy development.