Chapter 2 talks about Coding Compliance issues that influence reimbursement and the idea here is for students to learn the requirements of the OIG when it comes to compliance. The OIG Plan is all about compliance for different healthcare facilities and scenarios. The assignment is asking for the identification of potential areas that could be placed on an auditing schedule and educational schedule in an “impatient facility”
There are many areas in an inpatient facility that could potentially be placed on both, audit and education schedules; the Coding section of the HIM Dept. for up-coding also called “illegal optimizing “or down-coding, the Billing dept.is another area as they handle bills and they are usually audited not only by the OIG, but by payors for over-billing also called “unbundling”.
The memo should address the need for audits and education for the areas you choose from an impatient healthcare facility that has compliance issues. The focus should be the area, the compliance issue/problem and the recommendations and reasons for an audit(s) and training of the staff from those areas.