How compliance saves your income – Part 1

How can you avoid giving your hard-earned income away to lawyers or the government for fines, penalties or huge settlements?  Most healthcare providers work long hours to earn a living practicing medicine.  One effective way our healthcare provider clients protect their incomes and prevent large, unnecessary payouts, are to implement an active compliance program.

Find out in this multi-part series.  (To get this multi-part series delivered to your inbox CLICK HERE)

A “real” compliance plan is much more than a book on a shelf in some remote part of your office.  It is a “quality assurance” program that has the practice proactively looking for problems and fixing them before they cost you big money.

If you are like most healthcare providers, you have a compliance plan in a binder but not much more.  If you don’t have a compliance program, you need to implement one immediately because the government’s physician compliance guidance has existed for 14 years.  OIG Compliance Guidance

In our last blog post, we wrote about Johns Hopkins paying $190 million for the inappropriate actions of one of its doctors.  We recommended that your practice have a “living breathing” compliance program that is searching out problems every day.  But how do you get your compliance plan working?

First, start with reviewing the compliance plan that you have.  Does it need to be updated based on new laws and regulations?  If so, do it now.  Your compliance plan should be looking at all potential problems in the practice.  For example, have you updated it to include new documentation policies after implementing an electronic health record (EHR)?

Remember that if an investigator comes into your practice, they will want to see your compliance plan.  The investigator is going to hold you responsible for the policies you have in your written compliance plan.  If your plan is out of date or your practice is not following your own policies, you will have to pay fines for being out of compliance.

When is the last time you had an audit done of your medical documentation and billing?  A small sample of records can save you money and make money for your practice, too. A good audit can show you what you are doing right and what an investigator would say you are doing wrong and save you money by fixing the problem before the investigator has a chance to impose fines. A good audit can also make money for your practice when it finds items that could have been documented for a proper increase in reimbursement.  Often, the suggestions made in the audit save you more money than the cost of the audit itself.

In our next blog post, we will continue this series on How Compliance Saves Your Income.  To get this income saving series delivered directly to your mail box, 

Do you need help implementing or updating your compliance plan?  We can help. To contact us about your compliance plan or your other legal needs:  CLICK HERE.



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