Do you have a Compliance Management Program in place?
Your Total Compliance Solution represents a comprehensive compliance program for your medical practice or healthcare facility. Whether you’re a solo practice or a large hospital or health system, having a corporate risk and compliance management program in place has become a requirement for doing business in today’s healthcare marketplace.
Made up of a suite of complimentary services, your Total Compliance Solution will help to ensure that your policies and procedures are properly developed, based on the unique needs of your organization, and implemented in a way that sets the stage for success and supports you in the on-going management of your compliance management and risk reduction efforts.
A Baseline Coding and Compliance Audit
Our team performs a retrospective audit to review of your current coding, billing and documentation procedures. This audit is conducted in a way that closely simulates an actual carrier audit. We compare your existing practices to CMS and National Guidelines as well as the medical necessity of the encounters. A distinct advantage that our team has over other firms is access to our proprietary risk assessment tool, Compliance Risk Analyzer (CRA), which identifies encounters that demonstrate high and moderate risk, allowing and helps identify outliers and aberrant coding patterns that typically trigger an audit.
We report on your evaluation and Management (E/M) coding accuracy, documentation, accuracy of procedural coding, accuracy of modifier assignment, bundling as well as potential issues with your Electronic Medical Records (EHR) such as faulty templates. Our report includes recommendations to correct the issues as well as recommendations for training to help mitigate future risk.
Compliance Plan Development and Gap Analysis
Many organizations find it both time-consuming and confusing to attempt to develop a comprehensive compliance plan on their own. Off-the-shelf packages, however, often leave much to be desired can be difficult to implement properly. As a result, clients turn to us to build a comprehensive plan for their organization. Having worked with all sizes of facilities; from the single-physician practice to systems with hundreds of physicians in every specialty, you’ll find that a custom compliance plan can help you save time, money and potentially reduce liability.