Author Topic: COMPLIANCE PLAN  (Read 1574 times)


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« on: January 19, 2012, 06:30:36 PM »
Hello Every One

I need help can some one give me some insight on what my compliance plan should have in it I have read the OIG Compliance Guide for third party billing companies and am still lost help please any insight  will be grateful :-\


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« Reply #1 on: January 20, 2012, 07:48:15 AM »
Think of your compliance plan as a road map.  I know that most people get overwhelmed when they look at the OIG's plan but if you are educated and well versed to start this business, it should only overwhelm you, not confuse you. So make sure that is what you are feeling when you look at it first. If you genuinely are confused then you want to do a little more to educate yourself in compliance matter.  One thing I found helpful when I was putting mine together was to sit down and write out all the scenario's I might encounter that would cause me to need to OPEN this compliance plan up for the next step.  Many companies opt to include their compliance with their P&P which is what I did. I have a huge binder and in it is my compliance plan, policies & procedures, and insurance policy paperwork/outline, and I even have a section, that, if god forbid I were to die tomorrow, the person needing to do something with my business (hubby, daughters, etc) could go in and their options are there on what to do, who to call, etc.   So in essence my compliance plan is my business road map. It is there for me to refer to when I have questions or situations that need to be addressed. It's a uniform way of handling things.   Scenario:  Your client has just received a request for a formal audit, what to do?  consult my compliance plan and it will tell me step by step what to do to prepare. His audit is my audit so I have just as much to lose.

The goals of a compliance plan go like this:  --->  Assess  ----->  Plan ------>  Implement ------> Monitor 
Just because you build it doesn't mean your in compliance. You have to assess your risk, assess your business,  plan your compliance, how you will comply, what you will do in different scenario's (this is why creating that list of scenario's comes in handy!), IMPLEMENT the plan, make that compliance real, don't just say your compliant, be compliant in every facet of the plan!  Finally you will monitor. When you have placed that nice picture on your mantle you will dust it and clean it and so you will monitor, update and freshen up your compliance plan periodically or when needed (reg changes, law changes, etc)

Hope this helps.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers