Operations implementation of Healthcare compliance

Our Healthcare compliance program is an amalgamation of healthcare compliance and HIPAA. We have used Administrative, Physical and Technical Safeguards governing PHI as the bedrock of our compliance program and together, they provide strategic and tactical guidelines across the organization on the various aspects of healthcare compliance and HIPAA.

Administrative Safeguards

  • BAA with all our clients and a customized NDA with all our employees.
  • PHI is not shared with any of the company’s’ vendors.
  • Designated committee to oversee all Healthcare compliance activities.
  • Written policies and procedures covering privacy and security.
  • Written policies covering medical coding and billing integrity.
  • Training and tests on the policies and procedures.
  • Evaluation of policies and procedures including risk assessments.
  • Reporting channels and protocols to register non-compliant activities.

Physical Safeguards

  • Security guards and card-based electronic access with limited access to the facility.
  • Cameras governing every key entrance and exit, including the server room.
  • Limited access to printers, drives, phones and devices that can be used to capture data.
  • Hard copy disposal practices to make sure that any printed material is appropriately disposed of.

Technical Safeguards

  • Limited access to the internet and monitoring of internet activities.
  • All digital media devices have been disabled on production systems.
  • Password protection and encryption of all PHI transmitted via email.
  • Encrypted connections to all client systems in the US.

Common issues in Medical Billing:

  • Losses due to AR underperformance or unsustainable costs.
  • Inability to attract and retain quality staff.
    • - Backlogs in coding and billing.
    • - Understaffing when onboarding new practices.
  • High past-dues, dues over 120+ days; other aging buckets, payer or service.
  • Piloting and testing new initiatives.

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