The Implementation Of The Compliance Plan

As health care workers we are under a legal obligation to protect an individual from any kind of abuse, whether it is physical, financial, emotional, sexual or psychological .Legislation, policies and procedures exist to promote a safer working environment and reduce the potential for risks occurring. They are tailored for the needs of each setting, known and understood by employers and employees and reviewed on a regular basis.

Cooperating with HHS’s Office of Civil Rights (OCR) and other legal entities in any compliance reviews or

The advancement of these types of compliance plan guidance’s is established on our trust that a health care professional can use internally restraint to more proficiently observe adherence to appropriate decrees, regulations and plan requirements. Foundations for an Effective Compliance Program: This compliance guidance for physician practices includes features that the OIG has persisted to be the foundation for an effective compliance program:

In Michigan, the Office of the Inspector General (OIG) was created in 1972 by the Michigan Department of Health and Human Services to help maintain accountability in efficient and appropriate administration of HHS programs (OIG, 2013). The OIG investigates alleged fraud in these programs as well as reviewing policies and procedures and recommending improvements in ways to counteract and detect fraud. In addition, OIG monitors compliance with reimbursement regulations. OIG provides guidance documents for compliance programs for various types of providers to use to develop compliance programs in their facilities. The compliance plans include development of policies, including those for accurate coding, internal monitoring and auditing, naming of a compliance officer, and appropriate training (Peden, 2012).

WHAT: A compliance checklist is developed from all of the HIPAA rules and regulations that govern the handling of a patient’s PHI by oral, written, and electronic means. An effective checklist is divided into the major functional areas of responsibilities such as physician communications, administrative duties, privacy forms, facility and equipment security, employee agreements, business associate agreements, and risk management of both routine PHI and electronic PHI (ePHI). A standard HIPAA checklist of compliance areas can be viewed at, http://hipaanews.org/checklist.htm.

It was published by the Office of Inspector General on October 5, 2000. The reason for the changes in the guidance was a result of the acknowledgement of the financial and staffing resource limitations that are faced by physician practices. The goal is to provide the proper tools to strengthen the efforts of physician practices to prevent and reduce improper conduct; and it can also benefit the practice by helping streamline business operations. The Guidance doesn’t state whether or not to apply all the standard components, but it does advice in developing and implementing a compliance program that is functional for that practice’s needs. It suggest that the seven basic components of a compliance plan be used to form the basis of a voluntary compliance program. Those seven basic components are (Office of Inspector,

This assignment will concentrate on medical billing, and compliance strategies, and the evaluation of these strategies. Many mistakes are made during the billing process, and some of the mistakes that are made could be caused by the strategies, and the processes themselves. In this essay I will offer a quick overview of the strategies, and an evaluation of these strategies. I will also offer my suggestions on how to fix the problems that were found in the evaluation. In this essay I will also attempt to answer these questions: What is the importance of correctly linking procedures and diagnoses? What are the implications of incorrect

To assist in the prevention of errors, abuse and fraud in healthcare, the Federal OIG (the Office of Inspector General) and Medicare respectively publish the Compliance Program Guidance for Individual and Small Group Physician Practices and the Medicare Carrier’s Manual. In order to stay in federal compliance and prevent errors or worse, is it beneficial to be familiar with these documents. In a large company, while the Medical Office Specialist is the person that must be familiar to with the Medicare website this person is also the designated Compliance Officer and is responsible for providing the information on rules and guidance to the coders. To contact your medical office specialist, please refer to the company website or phone directory for your division. Remember, the federal government is not forgiving on errors when your response is ‘I don’t know’.

The goal of adopting the lean system by our health care organization was driven by obtaining the GCI accreditation and becoming one of the lead healthcare organizations in the middle east. At the beginning It was difficult to fully implement that system by a highly hierarchical organization. Until now we have consistent modifications in order to transit from a partial lean approach to a larger scale ( Graban, 2011). One of the most challenging issues in PICU sitting was regarding chronic patients who required long term ventilation. The hospital administration received numerous complaints from the admission office, ER manger, PICU manger and nursing staffs. The bed occupancy of the PICU reduced, which in turn lead to increase the waiting time

The OIG working through the DHHS attempts to guarantee that secured elements act inside the bounds of protection and security laws set up in HIPAA and related federal healthcare legislation. One of the OIG’s principle obligations is respect to the medical billing and coding industry is the avoidance of deceitful movement among secured elements. As a restorative charging and coding authority you should be cautious about potential action that might be fraudulent by the OIG.

My perception as the top health administrator at Well Care hospital is that professional conduct within a health care setting is a crucial necessity that all employees of the organization must adhere to. The professional code of conduct establishes the highest ethical standards also are in accordance with the hospitals mission, vision, and all applicable health care

The Code of Ethics furnishes a definitive model of conduct. The standard of conduct is entrenched in associations, affiliations, confidentiality, and commitment with health care professionals. The Code of Ethics for healthcare quality professionals is dedicated to routine enhancement and preserving integrity by identifying individual accountability and ethical obligation to patients, medical providers, employees, health care organizations, and the community (Oddo, 2011). Ethics are not voluntary in the health care field. They are a vital and central part of medicine. Ethical codes form and assemble moral atmosphere and allotting the ethical accountability and

Maintained policies and procedures for general operation of Compliance Program to prevent illegal, unethical or improper conduct.

There was a promise (bi-lateral oral contract) that drawn Ms. Johnson into an agreement and relied on Mr. Lockhart to preformed as he promised.

Respect of patients as well as co-workers is something that should be on every person’s ethical radar. Showing this respect will help to earn yourself respect from others. When considering respect, one must always consider the other’s person’s cultural background. In today’s society, there are many different nationalities, religions, and personal identifiers that deserve to be respected, regardless of your personal belief system. Another highly used trait is that of integrity ("CSEP: Codes Repository"). Luckily that is one of the words that were written about me. I consider myself to be honest, truthful, and full of integrity. Even if the situation is one in which telling the truth might not be the most beneficial thing, I would still feel as though the truth would be best. Following the law is an important thing to have on a professional code of ethics. On every code of ethics example that I saw, this was near the top of the list. Following all federal, state, and local legislation, as well as any rules and regulations made by the health care facility is paramount ("About ACHE"). Even with the idea that not every unethical act is illegal, you must remember that every illegal act is