“This three-pronged strategy focuses on educating patients and staff about how to avoid misconduct. It also emphasizes training individuals on how to recognize and report FWA violations when they see them.”
Continue readingProject Management Methodologies for Healthcare Compliance
“As a compliance officer, you undoubtedly manage a multitude of simultaneous projects of different scope, size, and duration. It isn’t always easy, but it is worthwhile to continuously evaluate your project management methodologies and look for ways to enhance your skill set.”
Continue readingSignificant Upcoding Risks Emerge with Medicare Advantage
Christi Grimm, the Inspector General of HHS, gave a recent keynote address to compliance professionals. In it, she said, “Simply put, the financial incentives created by risk adjustment may be driving upcoding in the severity of diagnoses to garner additional payments.”
Continue readingHow to Sell Compliance without “Selling” Compliance
If we want to improve our organizations’ compliance culture, then we need to interact with our healthcare leaders in a way that sells compliance without “selling” compliance.
Continue readingHow to Deliver Patient-Centered Care in a Post-Covid World
A “reframe, regroup, refocus” approach enables compliance teams to work with other departments to provide excellent patient-centered care.
Continue readingHow Social Determinants of Health Influence Compliance Culture
“By being aware of how your leaders think, you will uncover social determinants of compliance and understand their potential impact on the organization. You can then respond and assist accordingly, or remove barriers to successful compliance deliverables.”
Continue readingTelehealth Enforcement Actions
“It behooves all healthcare compliance professionals to be aware of the fraud, waste and abuse risks associated with telehealth services. This mode of delivery holds great promise. For it to fulfill that promise, non-compliance needs to be rooted out and corrected.”
Continue readingIntegrating Compliance into Human Resources Processes
“The secret to my success in reinforcing the value of Compliance’s work comes from partnering with HR. Developing standard interview questions, building leadership competencies, and sticking your neck out to establish strong relationships across the organization are crucial to demonstrating how Compliance delivers value.” – Lisa Herota
Continue readingUncovering $9 Million in Unbilled Services
“My success in uncovering millions of dollars in unbilled services demonstrates how revenue protection is a tangible way Compliance delivers value to healthcare organizations. It also underscores how compliance professionals make an impact across the business through building relationships, shaping culture, preventing fines, and positioning Compliance as true partner.” – Maeve O’Neill
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