decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Compliance / Step Five_Responding to detected violations
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Article Overview
This article covers the compliance response process a health care practice may follow after identifying possible violations or suspected non-compliance. It is aimed at compliance staff, practice managers, and other health care administrators who need a broad understanding of corrective action planning, internal assessment, self-disclosure considerations, and ongoing compliance program maintenance. The discussion also references general monitoring indicators and the use of major coding systems as part of compliance oversight.
Why This Topic Matters
Knowing how to respond to suspected violations helps a practice protect its compliance program, address potential reporting obligations, and reduce the risk that problems recur. The article is relevant to organizations that monitor billing, documentation, and coding activity for compliance issues.
What You Will Learn
- How practices may evaluate suspected compliance violations
- What broad corrective actions may be considered after a violation is detected
- Why internal assessment and follow-up are important
- How compliance programs may be adjusted after issues are found
- What types of monitoring indicators may signal a possible problem
Who Should Read This
- Compliance officers
- Practice managers
- Health care administrators
- Medical billing and coding staff
- Physician practices
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