State the Purpose of Your Two Compliance Plans for Your Company
The compliance plans in this paper are billing compliance plan and corporate compliance plan. The billing compliance plan creates a centralized and comprehensive system of oversight for discipline (policies and regulations), reporting, chart review, education, and bill coding. The billing compliance plan intends to enhance encouragement of compliance through a centralized audit system (Boyd, & Meade 2007). Besides, each in the healthcare system has the responsibility of being involved in the billing process in complying with the law. The purpose of the billing compliance plan in the healthcare centers is ensuring that the clinical services are appropriately documented. It also makes sure that the coded bills are only submitted for the services which are recorded.
On the other hand, the corporate compliance plan specifies the healthcare facility actions, procedures and policies within the compliance process to prevent violation of the laws as well as detecting the potential violations. The purpose of the corporate compliance plan in the medical facility is to make sure that the faculty are performing the pharmaceutical operations in full compliance with international and national laws (Guinn, 2000). It has both pragmatic and ethical component to compliance which is vital in helping the health centers to manage risk, avoid lawsuits and maintain their positive reputation. The health system personnel and, professional staff commit the health system to compliance. Thus the Corporate compliance is typically designed in a way that it will perpetuate a culture that will prevent, and detect cases of conduct that don’t align with the State’s laws.
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Explain How All Employees Would Benefit By Supporting the Key Elements in Every Compliance Plan
Compliance standards
Typically, by supporting the compliance standards in the corporate compliance plan, all the employees would be able to identify and address the relevant codes, laws, and regulations of the health system. On the other end, by supporting the bill compliance plan, the clinical services bills will be encoded accurately as per the documentation of the services provided. Thus all the employees will be able to maintain the compliance standards and avoid as well as preventing the law penalties.
High-level responsibility
The employees have the responsibility of getting involved in the billing process. This act will benefit the employees by ensuring that their coded bills’ services are correctly documented. Furthermore, the employees should take their responsibility of being taking part in the corporate compliance plan because it will make them understand the policies and laws thus avoiding lawsuits.
Education
On the both Corporate and billing compliance plan, the employees should be educated on the laws and regulations that are governing the provider billing as well as documentation. The training will help the employees by equipping them with the knowledge on the billing process and know the policies to be followed.
Communication
Either on billing or corporate compliance plane, if any employee receives a written or oral inquiry regarding the healthcare facility compliance with any regulation or law should notify the compliance officer before responding to the questions. This act will enable the employees to avoid passing critical information to the outsiders that might be a threat to the company.
Auditing
The central feature of these compliance plans is monitoring of the compliance with the billing rules. In this case, there is external and internal auditing properly the chart documentation and coding. Typically, the internal auditing is carried out by the compliance office’s professional staff. The employees should support the auditing because it will guide them in acting according to the law.
Discipline
Disciplinary actions are taken against the employees who are not complying with the applicable policies, regulations, and laws. According to Ahlin and Weiss (2007), by supporting the discipline, all the employees will, therefore, be able to comply according to the law thus avoiding unnecessary disciplinary action being taken against them.
Response/Prevention
The compliance officer reports of a potential violation of the policies, regulation, and laws to the CCO who authorizes, directs and investigates the allegations as cited in Baer (2009). The employees should support this element because it will enable them to prevent future law violation.
References
Ahlin, P. A., & Weiss, R. L. (2007). Risk management and compliance in pathology and laboratory medicine. Clinics in laboratory medicine , 27 (4), 859-873.
Baer, M. H. (2009). Governing corporate compliance. BCL Rev. , 50 , 949.
Boyd, C. E., & Meade, R. D. (2007). Clinical trial billing compliance at academic medical centers. Academic Medicine , 82 (7), 646-653.
Guinn, D. E. (2000, December). Corporate compliance and integrity programs: The uneasy alliance between law and ethics. In Hec Forum (Vol. 12, No. 4, pp. 292-302). Springer Netherlands.
