Tailoring a corporate compliance program for an IDS.
Integrated delivery systems (IDSs) face a particular challenge in implementing a corporate compliance program--that of ensuring the program addresses issues of compliance with payment rules and regulations consistently across every component of the health system. To successfully implement an effective compliance program, the various components of the IDS first must understand what such a program is intended to accomplish, and any internal resistance to developing the program must be overcome. The IDS then can undertake identifying and assessing areas of the health system at risk of being in noncompliance, designing and implementing the program, auditing claims processing and cost reporting throughout the health system to ensure systemwide compliance, and maintaining the program through ongoing monitoring and training.
Berkey
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ZA Consulting, LLC, Jenkintown, PA, USA.
D003365:Costs and Cost Analysis; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration* / Q000592:standards; D005607:Fraud / Q000517:prevention & control; D019983:Guideline Adherence / Q000458:organization & administration*; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration; D007345:Insurance Claim Review; D009013:Morale; D009936:Organizational Innovation; D010934:Planning Techniques; D016730:Program Development; D014481:United States