Institutional Healthcare Billing Compliance Overview
UTHealth is committed to providing high-quality patient care and to complying with applicable laws and regulations. All claims for professional fee reimbursement made by or on behalf of UTHealth shall adhere to applicable federal and state laws and regulations, The University of Texas System Board of Regents’ Rules and Regulations, and UTHealth policies. The institution will follow all legal and regulatory guidelines for billing hospital and physician services. Any contractors engaged to perform billing or coding services are expected to ensure that all billings for government and commercial insurance programs are accurate. UTHealth shall collect only those amounts to which the institution is entitled and refund amounts billed and/or collected in error. Employees and medical staff members will receive disciplinary action for failure to abide by the applicable federal and state laws and regulations, The University of Texas System Board of Regents’ Rules and Regulations, and UTHealth policies.
Examples of unacceptable billing practices include, but are not limited to:
- Billing for items or services not accurately documented in the medical record;
- Billing for items or services that were not actually rendered;
- Billing for items or services that were not medically necessary; and
- Duplicate billing.
If you believe any unacceptable billing practices have occurred or have any billing compliance concerns, you should discuss the issue with your supervisor. If you do not feel comfortable discussing the issue with your supervisor, you may contact the Office of Institutional Compliance at (713) 500-3294. You may also contact the Compliance Hotline at (888) 472-9868.