“Healthcare compliance professionals face significant challenges when managing who is responsible for completing compliance activities. From identifying the right individuals to ensuring accountability and avoiding duplication, the process can be fraught with inefficiencies.”
Continue reading
“The first thing that you should understand is this: you don’t have to build the perfect program. Your education program just needs to be good enough to ensure employees have the training needed to demonstrate core knowledge and pass audits and inspections.”
Continue reading
“As regulations change or investigations are needed, we often get pushed to work faster, meet tighter deadlines, and juggle multiple tasks simultaneously. While this approach might seem efficient on the surface, it often leads to several downsides—burnout, decreased productivity, and a decline in the quality of work.”
Continue reading
“Radiology services have unique characteristics, and some unique compliance considerations that accompany them include compliance rules associated with physician orders, medical necessity, local coverage determinations, and teaching physician settings.”
Continue reading
“There’s another incredibly helpful resource that some might not be as familiar with: the list of services that Medicare Administrative Contractors (MACs) include in their Target, Probe and Educate (TPE) plan.”
Continue reading
“Compliance is not just about enforcing rules – it is about guiding your organization towards a culture of integrity and excellence. By embodying these principles, you can demonstrate competence, credibility, and collaboration.”
Continue reading
“Whether you’re resolving a complex billing issue, or advising your leadership team about a business proposal, the ability to effectively make decisions is a valuable asset for any compliance officer.”
Continue reading
“Keep in mind that your healthcare leaders often will not be as knowledgeable about requirements in regulations or something else as you are. For that reason, what may seem like an obvious concern to you may not be so obvious to them. Be open to the fact a gap may exist, and give them grace if they made a decision that unintentionally creates an issue that needs to be corrected.”
Continue reading
“There is no silver bullet to solving medical necessity risks as they relate to medical claims submitted to payers such as Medicare. That said, these tips can be a starting point for compliance programs who know they need to minimize their compliance risk around medical necessity.”
Continue reading