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Message From the Chief Compliance Officer



Dear Faculty and Staff:

As you know, health care delivery and hospital operations have become very complex. The Compliance Program at UChicago Medicine is designed to help ensure adherence to all laws and regulations pertaining to the delivery and billing of health care services.

The Code of Conduct is a critical component of UChicago Medicine's Compliance Program and guides us in carrying out our daily activities within appropriate ethical and legal standards.  The standards set forth in the Code of Conduct requires us to follow all applicable laws, rules, regulations, and organizational policies, particularly those related to the scope of each of our duties and responsibilities.   The Code is a reference point and is to be used in conjunction with other compliance and  UChicago Medicine policies.

Each member of our faculty and staff plays an important part in the continued success of our Compliance Program. If you have questions or concerns about our policies, please feel free to contact me at 773-702-9785 or tvolel@bsd.uchicago.edu.



  Call the toll-free Compliance Resource Line at 1-877-440-5480 or 1-773-834-3222.

You can call the Compliance Resource Line to report possible instances where you think we may not be in compliance.  All calls are confidential -- you need not give your name.  The Compliance Resource Line is available 24 hours a day.

Training Requirements:


1.  All New Employees will be introduced to the Compliance Program at new employee orientation.

       2.  Additionally, residents/ fellows, non-physician prac­titioners, faculty physicians, individuals who hold leadership roles, and employees involved in  patient care, medical record documentation, or any aspects of the revenue cycle or financial operations of  UChicago Medicine are required to participate in Compliance Fraud Awareness training as follows:

-  Within 45 days of hire, new employees must complete their online Compliance Fraud Awareness class through Oracle.*

-  Annually, employees must complete Compliance Fraud Awareness training by the end of each fiscal year. Training can be satisfied by completing their online class in Oracle or by attending an education session sponsored by the OCC. 


-  The OCC will ensure that employees are enrolled into the appropriate Compliance Fraud Awareness class in Oracle. Once enrolled, employees will receive an email with instructions as to how to access and complete the class.

* As of March 2017, the OCC transitioned its Compliance Fraud Awareness online classes to Oracle.  Previously employees accessed training through the HCCS link which required a unique user ID and password.  If you still have access to the HCCS link, do not use it. You will not get credit for any training completed in HCCS.  All online Compliance Fraud Awareness training must be completed through Oracle using your UCHAD ID and password.  If you have any questions, contact the OCC at compliance@bsd.uchicago.edu.

All Education Sessions:

Please note that if a Compliance session has less than five registrants, the OCC reserves the right to cancel the session.

REGISTER HERE for any of the sessions listed below.


Topic

Date

Time

Location
2024 PFS Changes (Professional Changes)
 12/21/23
 12:00PM
 Zoom
2024 PFS Changes (Professional Changes) 1/3/24 11:00AM Zoom
2024 PFS Changes (Professional Changes) 1/19/24 12:00PM Zoom
2024 PFS Changes (Professional Changes) 1/24/24 12:00PM Zoom
2024 PFS Changes (Professional Changes) 1/30/24 2:00PM Zoom





















































































































To request or inquire about a specialty specific compliance session, contact your department administrator or the Compliance Office at omcc-edu@bsd.uchicago.edu

Physicians

    FY2019 Compliance Education Completion Options

Compliance Sessions (formerly "Physician Documentation Workshops (PDW)")

Please note that if a Compliance session has less than five registrants, the OCC reserves the right to cancel the session.

Topic

Date

Time

Location

Registration


































































To request or inquire about a specialty specific compliance session, contact your department administrator or the Compliance Office at omcc-edu@bsd.uchicago.edu

Revenue Cycle Management Brown Bag Sessions    

Click here to view schedule and registration information. Please note seating is limited.

Compliance Sessions

Topic

Date

Time

Location

Registration





























































Policies & Guidances

UChicago Medicine  and the Office of Corporate Compliance (OCC) are committed to fostering a corporate culture of ethical behavior and integrity in all matters related to compliance with the laws that govern the delivery and billing of health care services.  The consequences of failure to comply with these laws, particularly as they relate to billing, coding, documentation, privacy, and relationships with industry, can be severe.  The federal government remains committed to preventing fraud and abuse against the Medicare and Medicaid programs through active auditing and other enforcement activity.  Below are resources to guide your decisions and actions with respect to these laws.



INTERNAL RESOURCES

OCC Newsletter - December 2022
Code of Conduct
Compliance Policies 
Critical Care Tip Sheet
Non-Physician Practitioner (NPP) – Billing Tip Sheet
Split-Shared Billing Pocket Guide
EHR Documentation Compliance Guidance (Updated 6/9/21)
Fraud and Abuse Primer
Fraud and Abuse Resource Reference (February 2019)
Modifier 22 Increased Procedures Tip Sheet
Modifier 25 Minor Procedures Tip Sheet
Co-Surgeon & Assistant at Surgery Modifiers
Global Period Tip Sheet
Adding Modifiers in EPIC
Guide to Attestation Statements
Teaching Physician and Medical Student Documentation Instructions
PA and APRN Student Documentation
Cataract Tip Sheet
Retrospective Documentation Changes Tip Sheet
No Surprise Billing Act Decision Tree
Important Message from Medicare Guidance
2022 Critical Care Billing Changes Video  Material
2022 Split Shared Billing Changes Video  Material
2022 Teaching Physician Billing Changes (Otpt) Video  Material

INPATIENT & OUTPATIENT E/M

2023 Provider E/M Tip Sheet
2023 Nursing Facility E/M Services
2023 Inpatient & Observation Pocket Card
2023 Outpatient E/M Pocket Card
2023 E/M Services Tip Sheet
Outpatient LOS Calculator Steps
Same Day Prolonged Svcs for OP 99202-99215 "Illustrated Steps"
Same Day Prolonged Svcs for OP 99202-99215
Prolonged Same Day OP Demo - Regular
Prolonged Same Day OP Demo - Telehealth
COVID-19 INTERNAL RESOURCES

OCC COVID-19 Newsletter (Archived)
OCC COVID-19 Telehealth FAQs
OCC COVID-19 Provider Billing Tip Sheet
OCC COVID-19 Medical Student Tip Sheet
OCC COVID-19 General Telemedicine Pocket Card
OCC COVID-19 Behavioral Health Telemedicine Pocket Card
OCC COVID-19 Annual Wellness Visit Pocket Card



   
    Telehealth Attestation Demonstration Videos:
    Outpatient - Teaching Physician supervising PCE Housestaff
    Outpatient - Teaching Physician supervising Housestaff
    Outpatient - Housestaff, APP or Attending providing service to outpatient
    Inpatient - Teaching Physician supervising Housestaff
    Inpatient - Housestaff, APP or Attending providing service to inpatient
   



EXTERNAL RESOURCES

Medicaid-Related Sites-General
        Medicaid.gov
        Illinois Association of Medicaid Health Plans: Comprehensive Billing Manual
 Medicare-Related Sites-General
        Regulations and Guidance
        Medicare home page (including payment systems)
        Medicare Learning Network
        CMS WebWheel
        CMS Acronyms
        Recovery Audit Program
 
         Medicare-Related Sites-Hospital
         IPPS-Home Page
         OPPS Home Page
       
         Medicare-Related Sites-Physician/Practitioner
         Guidelines for Teaching Physicians, Interns, and Residents (March 2017)
                           
         UChicago Medicine's Medicare Advantage Sponsors
               Aetna (CVS Subsidiary)
                    How to report a concern
                    Code of Conduct
               Humana
                    How to report a concern
                    Compliance Policy
               Blue Cross Blue Shield of Illinois
                    How to report a concern
                    Code of Conduct               

         OIG Sites
         Home Page
         Compliance Resource Portal
         Work Plan

         Regulations and Statutes
         Affordable Care Act (ACA) Information
         CFR Title 42 - Electronic Version
         Code of Federal Regulations (Federal Regulations Annual Edition)
         Federal Register
         Social Security Act, Title 18 (Medicare)


           Coding and Clinical Resources
           Evaluation and Management Services Guide
           HCPCS Release & Code Sets
           ICD-10-CM Official Guidelines for Coding and Reporting (FY2017)
           Merck Manual Online
           National Government Services













Employee Screenings

Overview

The UChicago Medicine checks prospective employees against several sanction databases at the time of hire, as well as incumbent employees on a monthly basis.  The purpose of the sanction screening is to determine whether any employee or applicant has been convicted of a criminal offense related to health care or is listed by a federal agency as debarred, excluded or otherwise ineligible for federal program participation.  UChicago Medicine screenings are processed by UChicago Medicine Human Resources and Biological Sciences Division (BSD) screenings are processed by the OCC.

The OCC will not condone the hiring or retaining of an employee or applicant that has been convicted of a crime related to health care or who has been excluded from participation in a federal program.

Submission Process

Screenings of prospective BSD employees are performed by the OCC.  Screening form is to be filled out completely and faxed to the OCC at 4-3898 with included fax coversheet, or emailed with the instructions below.  Once OCC staff is in receipt of the request by 2:00 p.m. and verifies the form is filled out in its entirety, the results will be e-mailed as a PDF file by 10:00 a.m. the next business day.

Email sent to: compliance@bsd.uchicago.edu.



Subject Line: Compliance Screening – “Name”

Body of the email:
Date:
Requestor Name:
Requestor Department:
Requestor Email Address:

Screening Process Performed by OCC

Table Outline of Screening Process
Database Purpose
Office of the Inspector General's (OIG) database: List of Excluded Individuals/Entities Includes over 32,000 excluded individuals for healthcare compliance infractions and is updated monthly.
System for Award Management Includes an additional 7,000 individuals excluded for non-healthcare violations and is updated weekly. The BSD honors both healthcare related and non-healthcare related exclusions.
State of Illinois Healthcare and Family Services Office of Inspector General Provider Sanctions Database Illinois-specific search engine that houses both provider and individuals with sanctions.
U.S. Treasury's Specially Designated Nationals List Contains data related to economic and trade sanctions based on US foreign policyand national security goals against targeted foreign countries, terrorists, internationalnarcotics traffickers, and those engaged in activities related to the proliferation of weapons of mass destruction.