Medical Billing Compliance

In the medical billing industry, all parties have compliance responsibilities. Any provider dealing with Medicare and/or Medicaid has mandated compliance responsibilities from OIG and others, plus an ACA requirement for a formal compliance plan. The OIG Compliance Program Guidance for Third-Party Medical Billing Companies forms the basis for the AdvantEdge compliance plan. AdvantEdge has always treated compliance as an integral part of the coding and billing process. Every employee takes a comprehensive compliance course at least once a year and AdvantEdge endorses and fosters a culture of compliance in all phases of company operations. The goal is for each client to obtain the full reimbursement to which they are legally and ethically entitled,  in a manner that fully complies with both the letter and the spirit of all applicable regulations and guidelines.

Compliance Services

In addition to the compliance “built-in” to other AdvantEdge services, the company offers physician groups and hospitals a variety of compliance services. They include coding and compliance reviews and audits, compliance training, compliance plan review and compliance plan development.


Call 877 501-1611 today to learn more about how AdvantEdge can substantially reduce the risks faced by your practice or hospital.

The AdvantEdge Compliance Program//

The Compliance Program is led by the Compliance and Privacy Officer, who is an experienced member of senior management. The program has been designed using guidelines from the Compliance Program Guidance for Third-Party Medical Billing Companies issued by the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS), the Centers for Medicare and Medicaid Services (CMS), HIPAA Administrative Simplification, and ASA. As guidelines evolve and new ones emerge, the AdvantEdge Compliance Program stays current. The Compliance Officer and staff members, including each Certified Professional Coder, regularly participate in seminars on compliance matters in order to stay abreast of developments and interpretations.


AdvantEdge clients are secure in the knowledge that the Compliance Program, the Compliance Manual, employee training and the company’s Code of Conduct — which follows OIG guidelines — are in place and followed, resulting in an overall culture of compliance.

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