General Compliance Policies

Timely Documentation

Applicability: UW School of Dentistry
Policy Title: Billing Based on Timely Documentation
Policy Number: UWSOD COMP.101
Superseded Policy(ies) or Entity Policy:
Date Established: June 15, 2022
Date Effective: July 1, 2022
Next Review Date: June 2025

Purpose

This policy establishes clear direction for billing based on the creation of medical/dental records for dental encounters. This policy establishes billing requirements to follow in the event that a provider does not meet the documentation timeline requirements applicable to the service to be billed.

This policy is applicable to all UWSOD clinics and providers.

Policy

  1. This policy prohibits billing for a service that is not documented within 30 calendar days of the date of service. If neither the dentist, resident or other licensed provider who saw the patient has documented the clinic visit within 30 days of the date of service, the professional charges may not be billed.
  2. Any documentation completed or amendments made beyond 30 days from the date of service may not be used for billing purposes. Although it may not be used for billing purposes, providers should still complete or amend documentation, even if beyond 30 days, in order to maintain the patient’s record.
    There are three exceptions to this 30-day limit:

    1. A date of service correction may be used for billing purposes without time restriction.
    2. The addition of a missing provider’s signature may be used for billing purposes without time restriction if the provider created the documentation him/herself.
    3. The Director of Compliance has the discretion to determine in individual cases that circumstances justify billing for a service even when documentation is not completed within 30 days from the date of service.

Regulatory/Legislation/References

• False Claims Act (FCA), 31 U.S.C. §§ 3729 – 3733.

Procedure Addendum(s) References/Links

Roles and Responsibilities

Defined within POLICY.

Approvals

/s/Rob Brown 6/15/2022