Compliance Program Audit
The Compliance Program Audit is a two-part technical review of the laboratory compliance activities. The Laboratory’s Compliance Plan is validated to ensure that the written plan is current with the Office of Inspector General (OIG) Hospital Compliance Guidance and the Laboratory Compliance Guidance. In addition, the elements of the plan are evaluated in terms of the active adherence to the plan on a day-to-day basis. The second part of the review is a limited audit of claims to identify claims processing errors.

Laboratory Coding Compliance

HSC validates the laboratory charge file CPT/HCPCS codes to ensure appropriate revenue and to reduce the possibility of claims liability due to incorrect coding.

Management Billing Analyst (Mba) Audit Software
The MBA software application provides a statically valid audit and is a cost-effective solution to meeting the OIG recommendation for ongoing monitoring of claims. MBA gives laboratory compliance and/or hospital compliance the ability to monitor laboratory billing and payment procedures to identify weaknesses in internal systems, detect errors, and monitor for systemic problems. The audit reports documentation can be a mitigating factor in assessing culpability—potentially resulting in reduced penalties and/or more favorable settlement terms.

HSC Subscription Compliance Program
The Subscription Compliance Program provides a resource to the laboratory compliance office for questions and concerns regarding laboratory coding and billing. It is a simple, effective, cost-efficient solution to the daily management of the complex issue of compliant coding and billing of laboratory services.