The USC Office of Compliance has the responsibility of the oversight of the education and training curriculum on coding, documentation and compliance related issues.
Practice Plan/Department Specific Educational Requirements:
- Each practice plan/department will conduct formal provider training in coding, documentation and compliance related issues on an annual basis. This training needs to be conducted by a Certified Coder Monitor, and include trends of monitoring findings, identified risk areas and education to providers on new regulatory requirements as related to billing, coding and documentation.
- Attendance must be taken and documentation maintained by the respective practice plan/department.
Curriculum:
- All educational materials developed by outside vendors to conduct education for physicians/providers on coding, billing, documentation and compliance topics needs to be submitted to the USC Office of Compliance at least ten days prior to the session for review and approval prior to delivery of the education.
- All educational materials whether developed internally or externally need to contain the name and credentials of the instructor, the date and title of the session, as well as learning objectives. Handouts must contain sufficient detail so as to serve as adequate education when distributed to providers unable to attend the education forum. References to authoritative sources should be included as appropriate. Authoritative sources are defined as the American Medical Association’s (AMA) CPT Assistant, as well as the Centers for Medicare and Medicaid Services (CMS) Carrier Manual, the local medicare carrier, Medi-Cal and/or the Federal Register, etc. Practice plans/departments and monitors need to be cognizant and aware of reproducing, copying and distributing material that is copyrighted (e.g. Part B News, CPT Assistant, etc.)
All educational materials must be distributed to physicians who are not able to attend. It is preferable that an absent physician meet one-on-one with the Certified Coder monitor to review the material presented.
Provider Specific Educational Requirements:
Upon hire each provider is required to successfully complete the educational billing compliance module. Additionally, at time of reappointment, each provider is required to successfully complete an addtional billing compliance module.
Additional provider specific education will be provided to all billing providers subsequent to the completion of monitoring as described in Policy MA-500. |
