Which type of errors are compliance programs primarily designed to prevent?

Compliance programs are primarily designed to prevent billing and coding errors because these errors can have significant implications for healthcare organizations. These include issues such as improper claims submissions, fraud, and issues with reimbursement.

Billing and coding errors can lead to denied claims or overpayments, which can ultimately affect the financial viability of a healthcare provider. Compliance programs implement policies and procedures to ensure that coding is done accurately, services are properly documented, and that claims submitted for reimbursement are consistent with regulations and guidelines.

While medical and legal errors, service and financial errors, and patient and clinical errors are certainly important areas of concern in healthcare compliance, the primary focus of compliance programs is to safeguard against inaccuracies in the billing and coding process. These programs aim to educate staff, promote adherence to ICD-10, CPT, and other coding standards, and ensure that all billing practices comply with applicable laws and payer requirements, thereby minimizing financial risk and regulatory exposure.