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Compliance – How it Affects your Company Day to Day

Every compliance officer knows “The OIG’s Seven Fundamental Elements of an Effective Compliance Program” and strives to place these elements at the core of their organization.

Here’s a review of The Seven Elements…they can be intimidating!

  1. Implementing written policies, procedures and standards of conduct.
  2. Designating a compliance officer and compliance committee.
  3. Conducting effective training and education.
  4. Developing effective lines of communication.
  5. Conducting internal monitoring and auditing.
  6. Enforcing standards through well-publicized disciplinary guidelines.
  7. Responding promptly to detected violations and taking corrective actions.

Once an organization has designated a compliance officer and committee, the committee is tasked with answering two challenging questions:

“How do we put these elements into the actions of our managers, supervisors, customer specialists, and sales team?”

and…

“Can this be done and still succeed in the marketplace?”

Implementing Compliance into the Business Plan

Trying to keep up with extensive and ever-changing laws and regulations can be overwhelming. How can a staff member be expected to know every law and understand how to implement all of them into their specific job duties?

The company’s Compliance Team takes the lead to support and help implement compliant practices in all departments.

An effective Compliance Team supports the strategic and operational goals of their company as well as the legal requirements. They don’t create the vision, ideas or operations of the company. They serve alongside the leadership and teams of people that carry out a company’s vision, and ensure those teams have a compliant foundation to build and operate on.

Constructing Compliance Policies and Conduct Standards

Remember those Seven Elements?  Let’s take a closer look at the first one: Implementing written policies, procedures and standards of conduct.

Policies & Procedures
These should always be job specific so each individual knows how compliance applies directly to their duties. It isn’t hard to follow a procedure if you understand the reasoning behind it. They just need to be trained to do their specific jobs the compliant way.

Standards of Conduct
Conduct is instrumental to ensure your company operates in accordance with applicable laws and regulations.  A company’s Code of Conduct should drive its mission, vision and values within their industry.

Educating Associates how to Make Compliant Decisions

Everyone in the company should understand why conduct matters and be educated on what to do when in doubt about making the ethical, compliant decision.

When in doubt, ASK:

  1. Will my conduct allow us to maintain the trust of all our stakeholders?
  2. Have I thought about others who may be impacted or affected by my conduct?
  3. How will my actions be viewed by the media, public, and government?
  4. Will my family and friends think my conduct is ethical?
  5. Is my conduct legal and compliant with my company’s mission, visions and values?

Companies show integrity when their policies and code of conduct drive company culture and decision making.

We’d love to hear from you! Tell us about your company’s policies and procedures in the comments section below.

By |2019-06-21T14:23:46+00:00May 23rd, 2019|All, Blog, For Doctors, For Payors, For Suppliers, Uncategorized|0 Comments

About the Author:

Joyce has an extensive and diverse background in Systems Management for healthcare, including physician practice management, DME supplier company management, medical billing, physician EMR systems, and medicare and commercial payer compliance.Joyce has been particularly successful in assisting physician practices, outpatient surgery centers, DME companies, and software companies increase their revenues and profitability while maintaining regulations and HIPAA Compliance requirements for Medicare, Medicaid, Private Insurance, Workman’s Comp and other insurance programs.Her experience with HIPAA and Medicare LCD requirements has been a vital resource in assisting in the development of exam and documentation compliance protocols for healthcare entities, and she has assisted physician and DME supplier organizations in meeting billing requirements for compliance purposes. Joyce is currently Director of Compliance for HealthSplash, Inc.

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