Medical Office Compliance and Risk Management

You may have not planned your practice around compliance and risk management, but you know what they say? If you fail to plan, you plan to fail. Compliance programs are new to many private practices. What does a compliance program mean for your practice? The program is meant to be a series of checks and balances to ensure the practice is meeting standards. Why do you I need a compliance program?

A compliance program can prove to anyone that practitioners are making a reasonable attempt to comply with all regulatory requirements and have established the necessary procedures to do so. One reason why you might need a compliance program is to ensure staff applies the appropriate billing guidelines correctly. Medical documentation is important from a financial point of view. If a healthcare provider forgets to write something down in a patient’s chart, whether it regards to treatment, surgery, or a minor procedure, the facility will not be paid for it. Without documentations there is not proof that a patient received any services. Documentation and easy access to medical records can ensure patient confidentiality as well as a patient’s life in dire situation. If standards of care are being met then there will be thorough documentation. An important aspect of documentation comes from setting a standard for employees to follow including:

Work Performance
Break down work performance into three sub-categories: expectations, reviews and insubordination. Your expectations can apply to work performance reviews. Are employees meeting the expectations you have set for them? Based off of your reviews you will know who is going above and beyond and who is underperforming.

Discipline Policy
A discipline policy can start with a broad statement: “The Company reserves the right to…” Then, list actions that are considered unacceptable both inside and outside the office. Your employees must know that they are representing the company even when they are not on your turf. Have employees sign and confirm to make sure they are aware of what your employment policies are.
Communicating checks and balances to your employees fosters a trust and competency that employees will appreciate. As long as employees know that you are using the information to promote compliance and not micromanaging their every move.