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Episode 33: You NEED a Compliance Plan
Manage episode 297185569 series 2949848
Everyone knows that there are lots of rules and regulations in healthcare. In order to help you complying with all of the complicated healthcare laws, I'm going to tell you why you need a compliance plan and what it needs to include.
Before I get started, I want to get one common misconception out of the way. A lot of people think that you only need to have a compliance plan if you participate in government insurance plans. The truth--every practice needs a compliance plan.
Why?
A formal compliance program is an indispensible part of an overall risk management plan for your medical practice.
Compliance programs address billing practices, anti- kickback compliance, state and federal self-referral prohibitions, state fee-splitting laws, licensure and accreditation requirements, labor relations matters, antitrust and price fixing prohibitions, HIPAA and medical records issues and a whole host of other state and federal laws.
The very first thing you need to do is select a compliance officer.
What goes into a compliance plan?
- Standards of conduct for your employees
- Determining what is medically necessary
- Compliance plan for billing--regardless of whether you take government and third party payor or only cash
- Compliance plan for how you market
Now that you know what needs to be included, how do you come up with the compliance plan?
You have to have written guidelines and manuals
You need to train your employees
What happens if there is non-compliance?
Your have to have a plan to address non-compliance is handled that defines how issues are reported and evaluated. And, of course, every aspect of the investigation requires a paper trail.
And one of the most important parts of a complete compliance plan is the audit. You can demonstrate your compliance by being proactive and auditing yourself. This goes a long way if you are ever involved in an investigation.
In the end, being compliant really is nothing more than having a tangible, systematic plan for doing the right thing.
For a full searchable copy of the transcript, https://www.thepracticebuildingmd.com/podcast
Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com
Join my FB group, The Private Medical Practice Academy.
Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.
Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.
Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!
78 episodes
Manage episode 297185569 series 2949848
Everyone knows that there are lots of rules and regulations in healthcare. In order to help you complying with all of the complicated healthcare laws, I'm going to tell you why you need a compliance plan and what it needs to include.
Before I get started, I want to get one common misconception out of the way. A lot of people think that you only need to have a compliance plan if you participate in government insurance plans. The truth--every practice needs a compliance plan.
Why?
A formal compliance program is an indispensible part of an overall risk management plan for your medical practice.
Compliance programs address billing practices, anti- kickback compliance, state and federal self-referral prohibitions, state fee-splitting laws, licensure and accreditation requirements, labor relations matters, antitrust and price fixing prohibitions, HIPAA and medical records issues and a whole host of other state and federal laws.
The very first thing you need to do is select a compliance officer.
What goes into a compliance plan?
- Standards of conduct for your employees
- Determining what is medically necessary
- Compliance plan for billing--regardless of whether you take government and third party payor or only cash
- Compliance plan for how you market
Now that you know what needs to be included, how do you come up with the compliance plan?
You have to have written guidelines and manuals
You need to train your employees
What happens if there is non-compliance?
Your have to have a plan to address non-compliance is handled that defines how issues are reported and evaluated. And, of course, every aspect of the investigation requires a paper trail.
And one of the most important parts of a complete compliance plan is the audit. You can demonstrate your compliance by being proactive and auditing yourself. This goes a long way if you are ever involved in an investigation.
In the end, being compliant really is nothing more than having a tangible, systematic plan for doing the right thing.
For a full searchable copy of the transcript, https://www.thepracticebuildingmd.com/podcast
Want to hear more tips on how to start, run and grow your practice and related medical businesses, please sign up for my newsletter at https://www.thepracticebuildingmd.com
Join my FB group, The Private Medical Practice Academy.
Enroll in How To Start Your Own Practice and get the step-by-step process for opening your practice.
Join The Private Medical Practice Academy Membership for live group coaching, expert guest speakers and everything you need to know to start, grow and leverage your private practice. The course, How To Start Your Own Practice is included in the membership, as a bonus.
Rate, Review, & Follow on Apple Podcasts"I love Sandy Weitz and The Private Medical Practice Academy Podcast." <-- If that sounds like you, please consider rating and reviewing my show! This helps me support more people -- just like you -- move toward the practice they want . Click here, scroll to the bottom, tap to rate with five stars, and select “Write a Review.” Then be sure to let me know what you loved most about the episode!
78 episodes
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