Practice Compliance Solutions

Practice Compliance Solutions

Your medical practice plays a vital role in your community. Whatever your specialty or specialties, your practice will always have a demand, and to meet that demand, your practice has to stay compliant.

Compliance is about more than meeting the minimum requirements for operation — it’s about protecting your patients and taking care of your business. At DoctorsManagement, we offer a range of practice compliance solutions that will keep your facility secure and up to date on the latest guidelines.

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Our Medical Office Compliance Services

DoctorsManagement professionals understand the complexities of compliance and the regulatory landscape. We can provide compliance managers with cost-effective services to help proactively protect your organization and maintain compliance from initial compliance program planning to day-to-day guidance. We understand that meeting hundreds of compliance requirements can be stressful, and we are here to support you.

A few of our services include:

DoctorsManagement has experienced healthcare compliance specialists who are skilled at legal issues involved with the complexities of healthcare compliance. Trust our expert compliance team to offer sustainable, cost-effective compliance solutions that address your organization’s unique needs.

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What to Include in a Medical Practice Compliance Plan

As recommended by the Office of Inspector General (OIG), healthcare practices should implement the following actions into their compliance plan:

  • Determine a compliance officer, committee or contact
  • Implement compliance and practice standards
  • Respond to compliance issues by developing corrective action
  • Conduct appropriate training and education
  • Prioritize open communication
  • Enforce disciplinary standards

Your organization should also frequently assess known risk areas as part of your compliance plan. Common risk areas to focus on include:

  • Possible coding and billing risks
  • Improper inducements, kickbacks and self-referrals risks
  • Documentation risks
  • Reasonable and necessary service risks

Regular monitoring and auditing are also essential aspects of an effective compliance plan. Auditing enables your organization to take a proactive stance and stay updated on regulatory requirements and rule changes. Ongoing monitoring and auditing can also help you:

  • Identify high-risk areas
  • Locate revenue opportunities
  • Improve coding accuracy
  • Lower compliance risk
  • Avoid regulatory fines
  • Apply recent changes correctly

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Examples of Healthcare Regulations

Your organization’s compliance plan needs to account for various government, professional and ethical compliance rules and regulations. Your practice must be diligent in observing these guidelines, medical coding regulations, and state and federal laws to ensure proper submissions of claims and the accuracy of other essential processes. A few rules to address in your compliance plan include:

  • False Claims Act (Civil)
  • Healthcare Fraud Statute (Criminal)
  • Anti-Kickback Statute
  • Stark Law
  • Active Labor Act
  • Emergency Medical Treatment (EMTALA)
  • Occupational Safety and Health Administration (OSHA) guidelines
  • Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security rules

Medical practices must also comply with Federal Trade Commission (FTC) and Federal Drug Administration (FDA) rules and regulations. For doctors who treat patients on Medicare or Medicaid, you must create a medical practice compliance plan in accordance with the Patient Protection and Affordable Care Act.

Why Compliance for Medical Practices Is Important

Having a medical compliance plan in place enables your practice to mitigate risk and improve various operational processes. Creating an effective compliance plan will help you:

Ensure understanding

A compliance plan can assist with educating and training your workforce, enabling them to understand external and internal policies and maintain compliance.

Enhance patient outcomes

Compliance can improve care coordination and patient safety, leading to better outcomes and experiences for patients and their care teams.

Mitigate risk

A comprehensive compliance plan addresses each risk area to help you correct deficiencies and ensure your organization complies with various rules and regulations.

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Frequently Asked Questions

Looking for more information about medical practice compliance? These FAQs can get you started.

How Often Should You Review Compliance Regulations?

At a minimum, your compliance with medical practices should be reevaluated annually. However, in most cases, breaking up the compliance work plan into smaller parts to be done throughout the year enables the organization to stay up to date as regulations can change over time as well as having a minimal impact on operations. You should also analyze your compliance whenever:

  • You fail a compliance review.
  • You receive a regulation update.
  • Your staff changes.

What Regulations Should Healthcare Companies Follow?

As one of the most essential services in society, medical practices face many regulations. Aside from HIPAA, the most well-known medical law, there are many federal, state, and local laws that may apply to you. This includes the:

  • False Claims Act (Civil)
  • Healthcare Fraud Statute (Criminal)
  • Anti-Kickback Statute
  • Stark Law
  • Active Labor Act
  • Emergency Medical Treatment (EMTALA)
  • Occupational Safety and Health Administration (OSHA) guidelines

What Are the Consequences for Noncompliance?

Noncompliance encompasses everything from minor violations to major incidents caused by a failure to meet regulatory requirements. As such, the consequences can vary. In general, though, if your practice is caught in noncompliance, you can expect to pay significant fines, receive citations, and even face jail time or other criminal penalties.

More than that, a noncompliant practice may lose its reputation as a reputable agency, which may cause patients to find treatment elsewhere. Staying compliant in all areas of your medical practice is key to staying relevant and appealing to your target audience.

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Work With Experienced Compliance Consultants

At DoctorsManagement, we maintain a number of medical practice compliance experts on our staff. These professionals are available to assist your organization in defining existing regulations and creating your own internal standards of excellence. Your personalized plan will focus on your most pressing concerns and ensure you meet guidelines defined by OSHA, HIPAA, and more. Please contact us today to discuss your practice compliance needs with one of our specialists.

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