William Friedel Email and Phone Number

The billing compliance program includes all institutional processes that affect or impact on the accuracy of hospital and physician claims, including patient registration, ordering and scheduling tests and services, delivery and documentation of care by clinical staff, charge capture and transmission processes, assignment of billing codes, claim development, claim scrubbing, fee schedule management, accounts receivable activities, federal and state reimbursement regulations, federal and state enforcement activities, managed care contracting, and the billing of patient care services to patients enrolled in clinical trials. -Ensure effective and efficient daily operations of the billing compliance program; manage a billing and coding audit and education program that encompasses both hospital and physician billing and $2.2 billion in net revenues.-Interface with staff at all levels throughout the institution, including senior leadership, to act as a resource on billing policies and regulations.-Manage a staff of three Compliane Analyst/Educators and one Compliance Support Specialist.-Collaborate in the development of an audit plan based on risk assessment, results of past audits, enforcement initiatives and other factors.-Lead investigations and document work performed for investigations that involve hospital or physician billing issues; make recommendations for process improvements resulting from investigations.-Identify potential misconduct through audits and other proactive activities. -Member of the Institutional Billing Compliance Committee, Clinical Information Steering Committee and ad hoc institutional committees and work groups o address issues related to physician or hospital billing.

-Educated physicians on documentation guidelines for Evaluation and Management (E&M) services.-Conducted audits of physician documentation to ensure documentation supported physician billing.-Responded to questions from clinical areas and Physician Billing Department staff.-Resource for staff of three Compliance Analysts.-Managed the annual update of CPT and ICD-9 codes.-Responded to Medicare and other external audits.

-Responsible for the planning, development, coordination and supervision of the Account Specialist staff, who are responsible for responding to all patient inquiries and following up on outstanding balances related to physician bills. -Resource for staff of 42 Account Specialists, including four Group Leaders with direct responsibility for 21 Account Specialists, two Group Leaders and two telephone operators. -Integral contact for Patient Representatives, Patient Accounts and clinical areas to resolve patient issues.-Identified, researched and escalated reimbursement issues for further analysis.

-Acted as a liaison between staff and management to facilitate the exchange and dissemination of information. -Informed and consulted supervisor on existing and anticipated problems in work flow and made recommendations to resolve these problems. -Initiated follow-up through priority reports, work files and accounts established through incoming inquiries within established time frames while maintaining quality; resolved outstanding patient account balances.

-Responded to patient telephone inquiries in a prompt and courteous manner.-Reviewed and analyzed patient accounts; resolved outstanding patient account balances.-Identified, researched, and escalated issues requiring further management intervention.