Tuesday, March 15, 2011

Achieving Effective Healthcare Compliance

Did you know that there are close to 1.2 billion outpatient and physician office visits per year in the US? According to CDMatters, most of these patient records and documentation are quite inferior and generally contain substandard clinical documentation. Healthcare professionals like you generally face quite a prolific set of compliance requirements that are related to operational practices, service delivery procedures and management of records. The general regulatory compliance requirements and industry standards include HIPAA, HITECH and several other patient safety regulations put forward by the state and healthcare institutions that have to ensure that all medical records are maintained safely and securely. 

For healthcare professionals, healthcare compliance issues fall under their realm and it is their  responsibility to see that have what it takes to provide best possible care for their patients and also ensure that they abide as per all the compliance guidelines efficiently, because if they don’t then they are setting  themselves up for any kind of healthcare fraud investigation. Healthcare fraud investigations can be carried out if you as a healthcare professional don’t have a compliance program that assists you in responding to different healthcare compliance issues. 

Your compliance program needs to offer you a complete solution that addresses all compliance shortcomings and helps reduce errors coming up in internal audits. This means, for instance, that you need to have a program that has an efficient auditing process that assesses medical billing issues completely. It should also provide you with means and ways to address concerns and issues among your patients, employees, insurance officials etc. Your program should also help in the billing and coding compliance requirements for different treatments and also assist in correct assessment of risks. Appropriate documentation is also an important aspect of healthcare compliance since it is the proof that can be provided during audits etc. An optimized healthcare compliance program helps healthcare professionals to stay clear of unseemly treatments, lawsuits and other issues that crop up amongst patients and their insurance claims. The program must also ensure that you opt for a compliance healthcare solutions partner that can help keep you abreast of all regulatory compliance changes and updates that occur in real time. So with the right solutions provider you can ensure that all your concerns about HIPAA compliance, information security, and data protection among others can be finally put to rest. 

The basic idea behind having an optimized healthcare compliance program is to be equipped with the necessary expertise and tools that can help you achieve and maintain healthcare compliance easily. 

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