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Case Scenario: Although you are new to your role as revenue cycle manager, you are nonetheless
surprised to learn that there have been recent reports of fraud. You are also surprised to learn that
there are no formal processes in place for identifying and preventing fraud and abuse. You
recognize that this would be generated from a focused approach for internal or external auditing,
leading to identification of coding compliance concerns and opportunities for coder education.
Draft a risk management plan to be presented to the coding supervisor. The plan is to be in
paragraph form. The plan will include a minimum of four best practices for determining focus
areas for auditing and monitoring of coding compliance.

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Case Scenario- Although you are new to your role as revenue cycle mana.pdf

  • 1. Case Scenario: Although you are new to your role as revenue cycle manager, you are nonetheless surprised to learn that there have been recent reports of fraud. You are also surprised to learn that there are no formal processes in place for identifying and preventing fraud and abuse. You recognize that this would be generated from a focused approach for internal or external auditing, leading to identification of coding compliance concerns and opportunities for coder education. Draft a risk management plan to be presented to the coding supervisor. The plan is to be in paragraph form. The plan will include a minimum of four best practices for determining focus areas for auditing and monitoring of coding compliance.