Services
Our Compliance Membership and Workshops are designed to work together, giving you everything you need to establish and maintain a strong compliance program.
The workshop (available to members only) provides the foundation—helping you draft your compliance plan with essential policies, forms, and templates for your practice.
From there, the membership ensures your compliance efforts stay on track by offering ongoing education, expert guidance, and a robust resource library filled with sample policies, forms, and updates.
Whether you're just starting out or looking to strengthen your existing program, our membership provides the tools, training, and support your compliance officer or designated compliance contact needs to manage compliance confidently and effectively.
COMPLIANCE PROGRAM & IMPLEMENTATION: Its the most important insurance policy you may ever have.
At ProCode Compliance Solutions, we offer comprehensive services tailored to assist healthcare providers in developing, implementing, and maintaining effective compliance programs that align with OIG's regulations.
We’re happy to provide any services your practice may need, but we strongly recommend starting with our Compliance Membership. This membership is designed to equip your practice with the essential tools and ongoing support needed to maintain effective compliance efforts. As a member, you’ll gain access to exclusive discounts on our additional services, plus fresh content added monthly to enhance your compliance initiatives and lighten the load on your Compliance Officer.
Compliance Plan, Program Development and Implementation:
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Customized Compliance Plans: We will assist your Practice in developing a compliance program that meet OIG's mandatory requirements, tailored to your organization's specific risk areas and operational structure.
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DIY Compliance Plans: Our workshops and membership offer the education along with sample plans, policies, resources, training and ongoing support. Optimal for small to mid-size practices.
Compliance Officer and Committee Support:
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Compliance Officer or Compliance Contact: We offer the tools and the support inside our membership so that your Compliance Officer or Compliance Contact and committee feel supported with all the necessary resources for compliance success.
Risk Assessment and Management:
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Comprehensive Risk Evaluations: We work with you to conduct thorough assessments to identify potential compliance risk areas.
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Monitoring and Auditing: We help you implement a plan for ongoing monitoring and auditing processes to proactively address compliance issues and mitigate risks.
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Annual Evaluations and Quarterly Audits: We perform detailed reviews of your compliance program's effectiveness and asses your risk to ensure continuous improvement and adherence to OIG standards.
Training and Education Programs:
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Comprehensive Training: We provide ongoing education for staff helping to keep everyone informed about compliance responsibilities and best practices.
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Membership includes FREE training programs - Become a member
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We offer online self-paced programs to non-members - See all programs
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We are available for custom workshops, presentations and speaking opportunities - Schedule a consult
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Resource Development: Our team develops and disseminates educational materials to help keep your organization updated on regulatory changes and compliance strategies.
Self-Disclosure and Corrective Action:
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Guidance on Reporting: We provide assistance in identifying, disclosing, and rectifying overpayments or other compliance issues in accordance with self-disclosure protocols.
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Corrective Action Plans: Our team develops and helps you implement corrective action plans to address identified compliance issues and prevent future occurrences.
Continuous Support and Updates:
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Regulatory Monitoring: Our membership helps to keep your organization informed about changes in regulations and industry best practices.
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Ongoing Consultation: Our experts are available for continuous support, providing guidance on emerging compliance challenges and opportunities for improvement.
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Denials may be due to credentialing issues.
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Credentialing – ask about our national full-service credentialing team
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Health Plan Enrollments
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State licensure and other registrations
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PECOS and CAQH
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Maintenance packages
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Merger and acquisitions
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New practice and provider onboarding expertise
CMS Revocation & Preclusion Experts
(Discounts available to members)
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Experienced Healthcare and Litigation Support Services
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Investigation related to the revocation and independent assessment of the issues.
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Specialty Specific Subject Matter Experts
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OIG/ SIU investigators and UPIC Audit Experts
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Audit and Appeal Investigations and Reconsiderations
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CMS Revocation & Preclusion Reconsideration response preparation, submission and support
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Corrective Action and Voluntary Rehabilitation ( turn around) Support Team including but not limited to:
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Coordinated CAP Project management and oversight
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Comprehensive Custom Compliance Program, implementation support, and interim CO and committee
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Experienced Outsourced Revenue Cycle Integrity / Management Team
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EMR/ LIS / IT Support
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Auditing and Monitoring with Education
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Credentialing & Exclusion Checking Services
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Reporting if required ( similar to CIA reporting )
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Other Custom Workflow and Compliance related strategies based on the nature of the revocation
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Be proactive! Give your staff and providers the tools and knowledge they need to be successful.
Custom training and education packages are available to suit your specialty and your needs.
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National Speaker
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Multispecialty Documentation and coding compliance
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Evaluation & Management documentation and coding experts
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Fraud Waste and Abuse compliance training
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Enforcement Actions and Risk Mitigation Strategies
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Audits and Enforcement Actions
Revenue cycle integrity starts at the front desk and ends with complete and proper payment.
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RC Assessments
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Documentation and coding compliance
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Analytics support - Simple and complex
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Audits - Multispecialty prospective and retrospective (ask about our niche areas of expertise)
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Statistically valid random sampling
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Workflow assessments and denial management
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RCM Staff quality assurance and education packages
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Independent review of the issues/ dispute
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Affidavits
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EW Reports
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Arbitration & Mediation Testimony experience
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Deposition and trial experience
Schedule a Consult
Unlock tailored solutions for your healthcare compliance needs. Schedule a consultation and let's navigate your path to success together.