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Corporate Compliance

Site-specific Fraud, Waste and Abuse education and Corrective Action Plans.

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Are You Aware of the OIG's Seven Elements of an "Effective" Compliance Program?

An effective Corporate Compliance Program includes:

  • Standards and Conduct
  • Oversight
  • Education and Training
  • Reporting
  • Monitoring and Auditing
  • Enforcement and Discipline
  • Response and Prevention

At Healthcare Compliance Pros, your compliance specialist helps to define your obligations and create an effective compliance program for your organization.

Your Corporate Compliance Program includes:

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Policies and Procedures

HCP provides customized policies for your organization including among others: Code of Conduct; patient confidentiality; records retention; and documentation practices; and effective lines of communication.
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Exclusion List Monitoring

LEIE, SAM

HCP monitors all employees, contractors, business associates and vendors. Monthly checks are done against the OIG's List of Excluded Individuals and Entities (LEIE) and System for Awards Management (SAM). Clients are emailed a monthly report and made aware of any exclusion matches. These reports are then archived online.
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Fraud Waste & Abuse (FWA)

Learn how to identify fraud, waste and abuse, and what actions to take if it occurs. The program also includes the Civil False Claims Act, Health Care Fraud Statute, Sunshine Act, and Criminal Fraud.


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Internal Monitoring and Reporting

Learn how to monitor and properly report potential non-compliance that complies all federal regulations. We identify Medicare Compliance Officers and other key personnel and how they can be notified in the event of non-compliant incident.
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Discipline and Corrective Action

Receive policies and risk assessments to evaluate what proper disciplinary measures should be taken in the event of non-compliance. HCP provides guidance on investigation of complaints and infractions as well as your grievance procedures.
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Compliance Hotline

Give your employees and others the opportunity to anonymously report any questions or concerns they may have. The compliance hotline includes a portal where information can be submitted, as well as a voicemail line where messages can be left. This information is routed to the administrator for further review and repairation.


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Stark Law, Anti-Kickback Statute

Receive guidelines to comply with the Stark Law (prohibiting offering, paying, soliciting or receiving anything of value to induce or reward referrals or generate Federal health care program business) and The Anti-Kickback Statute (prohibits a physician from referring Medicare patients from designated health services to an entity with which the physician has a financial relationship with, unless an exception applies).
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Medical Assistant Credentialing

In the event that you have any non-certified medical assistants that you need to perform the CPOE function in your EMR, you can have them take our approved Medical Assistant Credentialing course which, upon passing, allows non-certified MAs to perform this function.

Remember, you also have access to all features of our Core Compliance solution

MIPS

PLUS+

Healthcare Compliance Pros (HCP) recognizes, that in the ever-changing, increasingly burdensome world of CMS physician payment programs, you might need extra education and support. Our MIPS Plus program provides both exclusive educational materials and leading edge tools to help your organization achieve success in CMS' MIPS program.

Exclusive "members only" MIPS Webinars. Clients have an exclusive portal and login to participate and ask questions during MIPS educational webinars. Webinar recordings will be made and available to program participants.

MIPS Insider Newsletters - Continuing MIPS Education. Clients receive continued educational materials through our MIPS newsletter, to provide timely updates on continued CMS guidance and analysis for your practice implementation.

HCP MIPS Tracker. We provide online tool stores to track your MIPS documentation, reporting metrics, and attestation process in one location. Deadline reminders and updates are included in the tracking program.

Coding 

PLUS+

Encounter Review and Coding Audits

Healthcare Compliance Pros is excited to bring our decades of compliance and billing management experience to the coding process. With the "Coding Plus" program. HCP has formalized services we are already providing to our clients and brings our highly regarded service professionals into your coding audits.