What is importance of the compliance program

Reference no: EM133579937

1. Compliance

1. What is the importance of the compliance program? Are there any specific benefits associated with having a formal compliance program? What consequences are there to not having a compliance program? Be sure to support your answers.

2. Analyze the formal compliance program currently in place. Is that the appropriate program for their clinic type, according to OIG classifications?

3. What are the consequences if the plan is not adhered to, and how should the organization monitor in order to remain compliant? any changes need to be addressed to improve the usefulness of the compliance program? Why or why not? Support your answer.

2. Recommendations

4. Recommend what may need to be adjusted to improve and enhance the coding process at this enterprise. Where is additional education needed to better understand the coding process? Support your answer.

5. Recommend improvements in the clinical documentation processes based on evaluation of the workflow processes to accommodate the Systematized Nomenclature of Medicine (SNOMED) process. Be sure to justify why these changes would help.

6. In reference to quality measures, do the improvements recommended accurately reflect the provider's patient population regarding SNOMED? Why or why not? Support your answer.

7. Recommend the training for medical staff necessary to attain the industry standards to meet healthcare data reporting requirements. Consider how industry standards have changed in recent years. Support your answer.

8. What are fraud and abuse? What should the auditors do/what directions should they follow if they suspect fraud or abuse?

9. With consideration to which technology would need supplementing or replacing, what additional technology would you recommend to improve the functions of the current processes in the clinic?

10. What additional resources may be needed for implementing your technology recommendation? Consider resources such as budget, staffing, and training in your response.

11. What intervals are audits scheduled, and are they sporadically scheduled? Who does the organization report issues to if fraud and abuse are detected?

12. After evaluation, would you recommend modifying the workflow process in the clinic, or would an upgrade be sufficient? Why? Be sure to support your choice.

Reference no: EM133579937

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