Revenue Cycle Compliance
UCSF is committed to the submission of accurate, timely and medically necessary claims.

The UCSF Office of Healthcare Compliance and Privacy established and maintains a Revenue Cycle Compliance Program to ensure that the UCSF workforce has the training and resources needed to perform their duties, report issues and concerns, and refer questions to our office when additional guidance is needed. 

Program Scope

The Revenue Cycle Compliance Program (RCC) promotes compliance with applicable laws, regulations, and policies pertaining to billing and reimbursement of professional, hospital, and clinical research activities. Our program is designed to reduce the potential for noncompliance with government and other third party payors by fostering the elements of an effective compliance program across the UCSF healthcare enterprise.

Major Focus Areas

Professional Services

The Professional Services team focuses on compliance with documentation, coding, and billing requirements for professional fee services provided by UCSF Faculty, Advanced Practice Providers, and Affiliates.  

Government Audits

The Government Audit team facilitates the processing and response to billing and reimbursement-related audits and investigations by Federal and State payors and regulatory agencies. 

Hospital Services

The Hospital Services team focuses on compliance with documentation, coding, and billing requirements for hospital services provided by clinical staff at UCSF Medical Center, UCSF Benioff Children's Hospitals and Langley Porter Psychiatric Hospital and Clinics.

Clinical Research Billing 

The Clinical Research Billing (CRB) team focuses on compliance with documentation and billing requirements for clinical trials conducted at UCSF. The team works with school and campus departments to promote compliance with federal and state laws, regulations, and policies.

Examples of Our Activities

  • Auditing and monitoring compliance with coding, documentation, billing rules and regulations
  • Monitoring the accuracy of diagnosis and procedural coding
  • Assessment of the medical necessity of services provided
  • Identification of deficiencies in documentation
  • Education focused on current regulations and audit findings
  • Promoting accurate reimbursement to the organization