tci Medicare Compliance & Reimbursement - 2021 Issue Q1
Compliance: Don’t Shirk on Compliance Planning
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Article Overview
This article discusses general healthcare compliance planning for medical practices facing heightened enforcement activity and ongoing pandemic-related disruption. It focuses on broad areas of compliance program development, including laws and regulations, staff training, clear policy language, misconduct definitions, and internal review processes. The piece is intended for practice managers, compliance staff, coders, and clinicians who help maintain policy adherence and audit readiness.
Why This Topic Matters
Compliance planning can help practices organize policies, training, and internal oversight before audits or investigations occur, especially when operations are stressed by staffing issues, telemedicine, and remote work.
Article Sections
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Incorporate These 5 Components
Introduces five broad elements used to strengthen a healthcare compliance program during a period of increased scrutiny and operational challenges.
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Self-Audit Your Compliance
Covers internal review concepts for evaluating an existing compliance plan and involving additional stakeholders or outside reviewers.
What You Will Learn
- The main goals of a healthcare compliance program
- Broad categories that support compliance planning
- How training and policy clarity fit into compliance efforts
- Why self-review and external review can be part of plan evaluation
- Which operational areas may need attention during pandemic-era compliance planning
Who Should Read This
- Practice managers
- Compliance officers
- Medical coders
- Billing staff
- Physicians and clinicians
- Healthcare administrators
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