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The Office of the Inspector General (OIG) makes it clear:

Federal health care enforcers expect all providers to implement effective compliance programs and to include in those programs specific policies, procedures and other mechanisms to prevent and detect illegal activity.

In response to this requirement, MMA has developed a comprehensive Compliance Program, which includes the following elements:

  1. Model Billing Compliance Plan
  2. Implementation Plan
  3. MDTools.com - Utilization Profiler
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Developing an
Effective Compliance Plan
The Model Billing Compliance Plan provides the medical practice with a customizable document designed to meet the OIG's requirements. The Implementation Plan provides step-by-step instructions and related forms to simplify what can be a very complex process. The Utilization Profiler is a web-enabled tool developed by MMA to benchmark E&M utilization against specialty and locality specific Medicare norms.

This Compliance Program provides you with internal controls and procedures that promote adherence to statutes and regulations applicable to Federal health care programs and private insurance program requirements. It also has a well-defined self-monitoring and self-reporting policy. Using this program not only assists you in preventing and detecting fraudulent activity, it also acts as a legal shield to significantly reduce the penalties if wrongdoing occurs or if mistakes are made.

MMA's Compliance Team provides CPT Coding Training, full service HIPAA Compliance and OSHA training and recertification.

For additional information, please contact: Send MMA an Email


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Medical Management Associates, Inc.
3330 Cumberland Boulevard Suite 200 Atlanta, GA 30339
Voice (770) 951-8427 Facsimile (770) 951-2157
Send MMA an Email
www.medicalmanagement.com