Billing Consultants or Contractors

Objective

To ensure that any outside billing consultants or contractors are retained in accordance with University policy.

Policy

The Chief Billing Compliance Officer must review and approve in advance any department’s engagement of outside billing consultants or contractors (including any individuals or entities involved in billing, coding, collections or related activities).

Under CUIMC policy, the University is prohibited from hiring an employee or engaging as a contractor any ineligible person. Accordingly, all individuals and entities engaged as billing consultants or contractors must be screened in accordance with policy number 10022 of this Manual. In addition, all outside billing consultants must complete compliance training.

Outside billing vendors that submit claims, check enrollment, or obtain authorizations must be enrolled as a “service bureau” in Medicaid. Also, billing vendors may not charge a percentage of revenues or collections – they may charge fixed rates for their time or for each claim submitted (irrespective of amount).



Office for Billing Compliance
Policy#: OFBC 10023
Original Date of Issue: 1996
Revised: 3/22/2023
Reviewed: 3/1/2024