Hayes' Healthcare Blog

Want to Ensure Greater Compliance? Look at Things from a Provider’s Point of View

Posted by Robert Freedman on September 27, 2018 at 9:09 AM

Healthcare providers are focused on delivering the most effective care for their patients. In recent years, however, it has become increasingly challenging for them to carry out that mission due to the growing regulatory demands and accompanying documentation requirements.  Failure to adhere to these requirements can result in painful consequences, such as lost revenue, heavy financial penalties, or significant reimbursements due to poor claims documentation. 

Compliance leaders bear the responsibility for ensuring their organizations avoid these adverse consequences by making sure their providers are complying with the mountain of regulatory directives. To carry out their charge, compliance professionals audit the providers to identify areas of risk and remediate any potential non-compliance issues. In many cases this puts physicians and compliance teams at odds, as we've noted in other recent blog posts.

The tools compliance teams use can also create strained relations between these two groups; by focusing attention on claims and coding errors, they can create a negative feedback loop in which auditors circle back to providers to hold them accountable for errors that may have occurred.  Frustration between the two groups can grow from there.

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Topics: Healthcare Regulatory Compliance

Implementing a Plan to Unite Clinicians, Compliance and Revenue Cycle Teams

Posted by Vasilios Nassiopoulos on September 12, 2018 at 3:09 PM

This is the fourth and final post in our series of blogs discussing how a revenue integrity program can help clinical, compliance and revenue cycle teams join forces to address the increasing challenges of compliance. In our first post, we discussed how a revenue integrity program can be a unifying force in the organization. In the second, we explored the impact to physician practices as regulatory demands have grown. In the third post, we showed how the increasing rules and regulatory burden have strained the relationships of the three key stakeholder groups. 

In this final installment, we lay out a plan that shows how to break down silos and bring the three groups together under the umbrella of a strong revenue integrity program. Following these steps will not only enhance morale, but will dramatically improve the financial health of your organization.

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Topics: Revenue Cycle Health, Healthcare Regulatory Compliance, Telehealth

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