Compliance and Privacy Program Assessment
and Support

 

As Compliance Programs move from being ‘voluntary’ to being a required function in healthcare, it is important to not only have a program, but also to routinely evaluate the program you have to verify that it still is meeting industry standards. Privacy requirements, as well, have been evolving, and enforcement is now a much more real possibility, especially in the event of a breach.

 

Whether you are undertaking a change in your organization, such as a merger or acquisition, or sprucing up an existing program, we can help with making sure that you are in line with current regulatory and industry standards. In addition, we can provide support in developing policies, procedures, audit tools, risk assessments, educational modules, or work plans, based on our extensive experience with managing compliance programs and healthcare operations.

 

Which Level of Assistance is Right for You? You Choose:

• Compliance and/or Privacy Program Assessment – We can review what you have in place currently, and compare to industry standards and regulatory requirements (both State and Federal), to provide specific recommendations on where your gaps may be and specifically what is needed to fill those gaps.
• Department/Function-Specific Reviews – KHC can focus strictly on a functional area or department to assess compliance with regulatory and industry requirements, such as Physician Contracts, Privacy, Charge Description Master, or Documentation/Coding, and provide expert recommendations and support for those areas.
• Risk Assessment – Annual risk assessments are an expected component of an effective Compliance Program. A risk assessment can be conducted to target those areas where healthcare providers frequently have risk, or are targeted by regulatory agencies. This assessment can be multi-department, and can include, in addition to a summary of risk findings, a useful risk assessment tool for the organization to use going forward to conduct internal reviews. The tool can be developed specifically to meet the needs of your specific organization and the lines of business that you are managing.
• Data Mining Analytics – Uncover hidden patterns that can point to compliance risks. Analyzing claims files can provide account level information that can give you clear insights into potentially troubled areas, focusing audit plan initiatives and ongoing support can help you monitor remediation efforts.
• Ad-Hoc or Ongoing Support – Sometimes organizations just need a little help, maybe with updating policies or pulling together an educational program for Compliance, Privacy, or specific compliance risk areas. We can help, either for one specific project or on an ongoing basis.

 

KOHLER HealthCare Consulting, Inc. (KHC) has been a leader in helping healthcare organizations build and strengthen their compliance programs and operations for over 30 years.

 

More than just performing high-level program reviews, KHC evaluates the substance and effectiveness of policies and procedures, and can do a deeper dive to assess operational compliance when indicated and requested. We will involve operational owners in any of these activities to enhance our understanding of your processes.

 

For any areas of specific concern, KHC can do an audit or review to identify any specific risk areas that should be addressed. As part of these reviews, we will work with process owners to help facilitate their understanding of regulatory requirements and best practices.

 

Why choose KHC? Our team’s wide and diverse experience provides the technical expertise as well as the “big picture” point of view. Our consultants are experts in compliance, nursing, finance and regulatory issues with hands-on experience and credentials. We work with your operational owners and subject matter experts to develop a collaborative, consistent, and compliant approach to problem-solving.

 

Goals May Include:

• Compliance Risk Assessment
• Analysis of specific risk areas
• Tools and training on various topics
• Compliance/Privacy policy development
• Update or assess Compliance and/or Privacy Program

 

Contact us to help

put the pieces together