Compliance plans

[luvlikesilk]

Hi guys!  Love the forum!  It has been extremely informative.

I plan on starting my own medical billing business from home.  I have 8 1/2 years of experience doing this, in one form or another, through our local trauma center here in SC.  Because of a job freeze that the hospital has had for several years I've managed to learn coding, billing, insurance verification, and quite a few other things because we had to be flexible and do three to five jobs for the salary of one.  I've even assigned beds to patients and arranged transfers to other facilities.  When they downsized I left to teach high school English ( I have a degree in this) but now I'm looking for more control in my life and career and I want to also draw on my hospital experiences and make this work for me.

My question is about compliance plans.  Should this be written in conjunction with an attorney?  If so, what kind of an attorney would specialize in this matter?  I thank you for your advice.


Kim Ford

[Michele]

I would suggest writing the compliance plan and then having the attorney look it over along with the contract.  It's not necessary to have the lawyer write the compliance plan. 

I wish you much success!

Michele

[PMRNC]

I agree with Michelle, if you follow the OIG guidelines you will not have a problem, address every compliance portion as they recommend. On other hand if you are getting an attorney on retainer for other things like contracts, then it wouldn't hurt to have them look it over Some will just pay a flat fee to have a contract drafted, It's up to you, I have an attorney on retainer because he will add/change/modify anything I need for the contract when I need it and many times one cookie cutter contract doesn't cut it, also he's available to me should I have any problems.

[luvlikesilk]

Thanks Michele!  I've purchased a few of your books and they have been extremely informative. I appreciate all of your help!


Thank you Linda!  I do plan on retaining a lawyer because you never know when you'll need one.  Your advice on other topics have been very helpful and enlightening.  The compliance plan did seem intimidating but after going over the OIG instructions I do believe I can tackle it but I will take your advice and have an attorney check it out.  Thanks again!

Kim

[aksharhealth]

I am drawing new compliance plan per Michelle and Alice's guidelines in contract book. I have also drawn a new contract and has given to lawyer for review and redraw. He is going to charge me 200.00 for contract. I want to work on retainer basis with lawyer so he can reivew compliance plan and all future contracts. He is asking me that how many approx contracts I will have him review in a year. I am starter so I don't have any idea. Can any one tell me how much retainer fees I should pay to lawyer?

I have two small clients w/o E&O insurance. Now before I go with third client I want to get E&O insurance. I have application from one of my local company which is asking me millions of questions. Can any one give me idea what should be covered in E&O and how much limit we should have?

Right now I am talking with one client and one of the question he asked me is do I have Collection Agency? I told him that I will give me more information on that once he is ready to sign contract. To be very frank I do not have any collection Agency affiliation. Can some one give me name of some good collection agency. Also how does it works? Do we hire collection agency or client? With the billing company that I worked, they had their own collection agency so I am confused now what to do how to deal with collection agency?

[PMRNC]

A General Practicing attorney is good for contracts.. however you want someone well versed in Health care laws/regulations and administrative regulation in order to help you with your compliance plan. He/She CANNOT write this for you, you have to put it together, the attorney will merely look it over to make sure state/federal guidelines have been implemented.

As for E/O, general guidelines suggest 3 million.  You can  look into naplia.com who will gather your information and actually do the shopping for you!

As for collection agencies, I suggest going local because, in addition to having a collection agency locally to speak with your clients about their services, you can also network with them. I've obtain a few clients back in NJ when I worked with a small (now larger) collection agency.  I liked having them local. Oh and I also try to get 2 or 3 to work with because I can offer the choices to the client as well.  I try to stay away from the big companies.

[aksharhealth]

A General Practicing attorney is good for contracts.. however you want someone well versed in Health care laws/regulations and administrative regulation in order to help you with your compliance plan. He/She CANNOT write this for you, you have to put it together, the attorney will merely look it over to make sure state/federal guidelines have been implemented.

As for E/O, general guidelines suggest 3 million.  You can  look into naplia.com who will gather your information and actually do the shopping for you!

As for collection agencies, I suggest going local because, in addition to having a collection agency locally to speak with your clients about their services, you can also network with them. I've obtain a few clients back in NJ when I worked with a small (now larger) collection agency.  I liked having them local. Oh and I also try to get 2 or 3 to work with because I can offer the choices to the client as well.  I try to stay away from the big companies.

Thank you Linda. I appreciate for response. And yes I am making compliance plan and Lawyer will review the plan.

[taxlady28781]

I too am reviewing my compliance plan after reading the Contract book.  On the written policies & procedures part, do you put your policies & procedures in your compliance plan or as a separate document?  I was under the impression to have that separate, but include in your compliance plan that you do have and have implemented written policies & procedures.

[PMRNC]

I was under the impression to have that separate, but include in your compliance plan that you do have and have implemented written policies & procedures.

That's correct

[taxlady28781]

Thanks Linda!  That's what I thought