Tip: How to handle instances of noncompliance
Healthcare Auditing Weekly, September 2, 2008
Deciding what to do when there’s an instance of wrongdoing may be the hardest part of an auditor’s or compliance officer’s job. Although handling these situations can be tricky, there are some commonly used guidelines for collecting and handling reports of noncompliance.
- Report problems to the appropriate place. When you uncover an instance of noncompliance, consider the best place to report the problem, such as management. If it’s a simple billing mistake, analyze why it happened and send the money back to its rightful entity. Take a corrective action so the problem does not happen again.
- Know and follow your organization’s protocol. In most cases, auditors report compliance problems to the hospital’s compliance officer. Professional standards and some laws may require you to go to the company’s board or governing entity.
- Advocate for your position. If you are a compliance officer or an auditor trying to convince the board of directors to authorize an investigation, know that your presentation style could affect your decision.
- Get professional assistance. If a situation calls for self-disclosure, providers should rely on counsel—either in-house or outsourced—to assist with the process.
This tip is adapted from The Healthcare Auditor’s Handbook. For more information about the book or to order your copy, visit HCMarketplace.
0 comments on “Tip: How to handle instances of noncompliance ”
- Complications from immobility by body system
- OB services: Coding inside and outside of the package
- Differentiate between types of wound debridement
- What does case-mix index mean to you?
- Don’t forget the three checks in medication administration
- Note similarities and differences between HCPCS, CPT® codes
- Pneumonia with a negative chest x-ray: Clinical diagnoses, physician documentation, and coding guidelines
- ICD-10 tip: Coding for infectious and parasitic diseases
- ICD-10-CM coma, stroke codes require more specific documentation
- Initiative launched to prevent physician, medical trainee suicides
- Stress Management
- Q/A: Coding for blood glucose checks
- How surviving a disaster changes the disaster plan
- HCPro's White Papers on the ANCC Magnet Recognition Program®: Collecting evidence for the written documentation
- Gap analysis: Three big issues
- Fetal non-stress tests represent important part of maternal and fetal health
- Don't let improper discharge disposition codes fly under the radar at your facility
- Coding, billing, and documentation tips for teaching physicians, interns, residents, and students
- Code arthroscopic knee procedures using G0289
- CMS launches new online tool to make Quality Payment Program easier for clinicians