Compliance Program Services
Is your practice at risk due to non-compliance?
Why does a Healthcare Practice Need a Compliance Program?
Compliance plans have been in the forefront of healthcare news publications for some time. A proactive approach to compliance will help the Practice uncover inefficiencies, and possibly items or procedures that could be considered fraud and abuse by the government. It is a good business policy that indicates good faith effort to comply with all applicable laws and regulations.
Having a program is a condition of enrollment with Medicare. NYS OMIG requires providers who meet specific standards to implement and certify annually that they have a program.
Developing a Compliance Program
There are 7 basic elements to the Compliance Program:
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Written Standards of Conduct which includes policies of non- intimidation and non- retaliation
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Designation of a Compliance Committee and/or Compliance Officer
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Training and Education
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Effective Lines of Communication
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Disciplinary Procedures
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Auditing and Monitoring
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Investigations and Corrective Actions
Each healthcare Practice is unique, so each Compliance Program must also be unique. All Compliance Programs should be built upon the foundation of the seven basic components as listed in the Federal Sentencing Guidelines. However, the size and nature of the Practice will determine what and how each issue is to be addressed.
Because of the changing nature of healthcare regulation, the Compliance Program will be a “work in progress”. The program should be monitored and updated at least annually, and more frequently if necessary to provide for an up-to-date compliance program.
Today’s healthcare environment is more complex than ever. There are a multitude of regulations and guidelines that providers are expected to know and follow. It is hard enough to keep up with the day to day operations, patient care and keeping the practice financially viable. Let us help get you on the right track so that you can navigate and avoid the perils that can sneak up and bite you when you least expect it.
Providers need to be proactive now more than ever. Developing a culture of compliance starts at the top. It is the only way an organization or practice can ever hope to develop an effective and ethical program. We can teach compliance, but we cannot teach you ethics. Everyone in the practice or organization is responsible for compliance, and should understand that it is a condition of employment.
We have the right people and the right tools to help you develop, implement, and manage an effective compliance program. Don’t be intimidated, if you are not sure where or how to get started. Call us today to ask how we can help.
We can help with:
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Compliance program development and implementation support
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Tutorial and mentor support staff and boards
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Interim compliance officer
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NYS mandatory compliance program adoption & certification support
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Corporate integrity agreement compliance support
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90 day program implementation
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IRO services
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Reporting requirements
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Education
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Documentation, coding, billing compliance
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Benefit from our team's extensive experience and the compliance process that we have mastered.
ProCode Compliance Solutions offers a complete suite of compliance services for all provider types. Compliance is a process, and we know it can be challenging, confusing, and resource intensive. Our team has decades of experience, and we take pride in setting our clients up for both short and long term success.
