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The Importance of a Compliance Program for Your Medical Practice

There are few things more important than medical compliance, and few things more dangerous than a medical practice that is not in compliance.

Compliance is what makes an office run smoothly and allows everybody to understand the proper procedures and expectations in providing high-quality care without running the risk of injury to a patient or staff member. That is why health care organizations are held to standards and laws of the strictest order both on the state and federal levels.

At the same time, having laws on multiple levels of government means that sometimes it can be a task to keep up to date with the latest changes. Whether it is the Social Security Act, HIPAA or the False Claims Act, there are more regulations than some people could even imagine. And a health care office is also subject to OSHA and the Equal Employment Opportunity Commission.

Most doctor’s offices and medical facilities have a compliance officer or a fully-staffed compliance department dedicated to making sure they are up to date on any needs and issues that may arise between different regulations. Whether it is one person or one dozen people, being able to have the authority to explain and enforce compliance in a practice, no matter the size, is imperative to implement an effective compliance program.

The First Step to an Effective Compliance Program

That is only the first step, though. A healthcare practice must make sure that patient privacy is covered completely with the different laws that protect doctor-patient confidentiality. Laws such as HIPAA establish standards for privacy and determine when patient information can be disclosed. That’s because security is important in the quality of care. If you do not take security seriously, a whole host of problems can arise, including insurance issues, scams and fraud, or even identity theft.

Managing those records is a challenge for compliance officers. Between all the issues, it is important that there are compliance programs that focus on clearly distributing and implementing policies, procedures, and standards of conduct for all workers in a practice that can ensure consistency and improve the quality of care for patients.

Protection from Non-Compliance

They also help protect an organization in the event of an incident of noncompliance. Setting forth and establishing a culture of compliance throughout the organization allows employees to understand its importance and, in some cases, be able to understand when there are compliance violations occurring in front of them. Encouraging education, culture and open communication is one of the easiest and most effective ways to lower your practice’s risk of legal repercussions in the future.

If a compliance issue comes up, a compliance officer should be able to respond immediately, determine if mistakes have been made, and follow through on education and corrective action. Health care compliance is an essential part of protecting your organization, providing patient care, and ensuring operations run efficiently.

The Importance of a Compliance Officer

You may wonder, ‘how do you become a compliance officer?’ The minimum requirement is usually a bachelor’s degree, and in some cases a MBA would also be required for advanced levels. Officers are expected to have several certifications that show proficiency in health care compliance and other disciplines, not only passing the initial certifications but also having regular renewals on a two-year basis. Its importance overall in an organization is why the Wall Street Journal once labeled compliance officer as one of the hottest jobs in America because of being such a position of need throughout the medical community.

Between being able to effectively listen to co-workers throughout a practice and then be sure to implement needed changes and serving as a model of efficiency and professionalism even in turbulent times, being a compliance officer can oftentimes feel like a thankless position, but it is an extremely important position.

The Benefits of Outsourced Compliance

There are many benefits to teaming up with Med USA. We have dedicated CPC certified coders with at least three years’ experience apiece, and our coders attend regular training and educational seminars to make sure they know the latest rules and regulations. We have provider documentation, training and feedback meetings that allow for transparency of your coding outcomes. With proprietary coding software and custom edits, we can provide free coding audits and reviews as well.

We also have a full-time compliance officer with over 20 years of experience in interpreting regulations and implementing policies in clear and functional ways.

With nearly four decades of experience in providing services throughout numerous specialties, the Med USA culture is built on service, adaptability, compliance and software. We can either act as an a la carte partner or as your full-service revenue cycle management firm. Get in touch with us today through any of our social media channels and find out what the Med USA experience is all about.

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