The auditing and monitoring function serves as one of the seven (7) key elements of the Vanderbilt University Medical Center (VUMC) Compliance Program. The Office of Healthcare Compliance has processes in place for New Provider Documentation & Coding reviews (effective Jan. 1, 2015) and an Auditing & Monitoring Process for established individual providers (effective July 2013.) Both review processes afford the opportunity to evaluate documentation and coding in order to identify potential compliance risks and vulnerabilities and ensure adherence to all policies, processes, applicable Federal and State laws, rules and regulations. Auditing and monitoring presents VUMC the opportunity to examine mechanisms for compliance and establish best practice, fulfill contractual obligations with payers (e.g. government and private) and others.
Also effective July 1, 2013, is the Refund/Rebill Process by which billing errors are to be corrected in accordance with Federal and State laws, rules and regulations.