Banner Health Compliance Training

Prohibited Billing Practices Submitting claims for payment by Federal health care programs that contain incorrect or inappropriate diagnostic or procedural codes may violate the Federal False Claims Act. Incorrect or inappropriate coding may be caused by incomplete documentation or not understanding the coding guidelines. Banner’s policy entitled Compliance: Basic Requirements for Third Party Billing; Prohibited Billing Practices , spells out four major prohibited billing practices. Any violation of this policy that appears to be intentional must be immediately reported to the Ethics & Compliance Department. If violations are discovered, Banner will take all reasonable steps to cure any harm caused by the discovered violations. Billing for Items or Services Not Rendered Billing for items or services that have not been rendered is a prohibited billing practice. This includes items that were ordered but never actually performed.