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The Health Care Compliance Professional's Manual

The Health Care Compliance Professional's Manual
Author: Hcca
Publisher: Aspen Publishers
Total Pages: 1080
Release: 2007
Genre: Law
ISBN: 9780735570382

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The Health Care Compliance Professional's Manual gives you all the tools you need to plan and execute a customized compliance program that meets federal standards. It walks you through the entire process, start to finish, showing you how to draft compliance policies, build a strong compliance infrastructure in your organization, document your efforts, apply self-assessment techniques, create an effective education program, pinpoint areas of risk, conduct internal probes and much more. The Health Care Compliance Professional's Manual is used by the Health Care Compliance Association (HCCA) as the basic text for its Compliance Academy - the program that prepares compliance professionals for the CHC (Certificate in Healthcare Compliance) certification exam. The Health Care Compliance Professional's Manual will help you to: Use OIG publications and Federal Sentencing Guidelines to help plan and execute a customized compliance strategy that meets tough federal standards Perform risk assessment to pinpoint areas within your company that pose compliance and operational risks Draft compliance policies that form the foundation for a strong compliance program Build a strong infrastructure for compliance to work, including hiring the right personnel Create an effective education and training program that instills in employees the value of legal compliance Conduct internal probes that uncover legal violations before the federal government does - and mitigate possible penalties Stay up-to-date on all the latest legal and regulatory requirements affecting your facility, including HIPAA, EMTALA, fraud and abuse reimbursement, privacy, security, patient safety and much more! Packed with tools to make your job easier, The Health Care Compliance Professional's Manual will provide: Practical coverage of federal and state laws governing your facility Document efforts and apply self assessment techniques Insight into helpful federal standards on effective compliance programs Step-by-step guidance on implementing a sound compliance program Time-saving sample compliance policies, forms, checklists, and chart The Health Care Compliance Professional's Manual will protect your company if violations do occur: Learn how to apply auditing, monitoring, and self-assessment techniques Discover how to successfully follow the OIG's voluntary disclosure program to resolve overpayment problems and avoid exclusion from Medicare Find out how to enter into a corporate integrity agreement to settle with the federal government and mitigate FCA-related penalties Document your compliance efforts so you leave a protective paper trail that shields you from liability And much more


Guide to Risk Assessments

Guide to Risk Assessments
Author: Kenneth E. Spence
Publisher: HC Pro, Inc.
Total Pages: 182
Release: 2004
Genre: Business & Economics
ISBN: 9781578395279

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Health Care Compliance Professional's Manual

Health Care Compliance Professional's Manual
Author: Wolters Kluwer and the American Health Law Association 
Publisher: Aspen Publishers
Total Pages: 1654
Release: 2020-03-10
Genre: Compliance
ISBN: 9781543822892

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The Health Care Compliance Professional's Manual is one of the most vital, long-standing, and best known resources in the world of health care compliance. It has all the tools you and your compliance team need to plan and execute a customized compliance program. This new edition is filled with industry best practices, sample forms, policies, procedures, and much more to save you time and comply with federal standards. The Health Care Compliance Professional's Manual will help you to: Use OIG publications and Federal Sentencing Guidelines to plan and execute a customized compliance strategy that meets tough federal standards and minimizes enforcement risks Oversee physician compensation and referrals Perform risk assessments using matrixes with step-by-step instructions to pinpoint areas that pose compliance and operational risks Draft compliance policies that form the foundation for a strong compliance program Build a strong infrastructure reinforced by industry best practices Create an effective education and training program that instills in employees the importance of legal compliance Implement a privacy and security plan that ensures patient information is protected Stay up-to-date on the latest legal and state and federal regulatory requirements affecting your facility, in areas such as HIPAA, EMTALA, fraud and abuse, reimbursement, privacy, security, patient safety, and clinical research Study for CCB(R) Certification in Healthcare Compliance (CHC) Packed with tools to make your job easier and more efficient, The Health Care Compliance Professional's Manual will provide: Practical coverage of federal and state laws governing your facility Insight into helpful federal standards on effective compliance programs Step-by-step guidance on implementing a sound compliance program Examples of common risk areas and how to handle them Time savings and peace of mind from sample policies, checklists and forms from members of the American Health Law Association (AHLA) The Health Care Compliance Professional's Manual will help you protect your company if violations do occur: Learn how to apply auditing, monitoring, and self-assessment techniques for conducting internal investigations Discover how to successfully follow the OIG's voluntary disclosure program to resolve overpayment problems and avoid exclusion from Medicare Find out how to enter into a corporate integrity agreement to settle with the federal government and mitigate FCA-related penalties Document your compliance efforts so you leave a protective paper trail that shields you from liability And much more Previous Edition: Health Care Compliance Professional's Manual, Second Edition ISBN: 9781543813265 SKU: 10071961-7777


Risk Management Handbook for Health Care Organizations

Risk Management Handbook for Health Care Organizations
Author: American Society for Healthcare Risk Management (ASHRM)
Publisher: John Wiley & Sons
Total Pages: 672
Release: 2009-04-27
Genre: Medical
ISBN: 0470300175

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Risk Management Handbook for Health Care Organizations, Student Edition This comprehensive textbook provides a complete introduction to risk management in health care. Risk Management Handbook, Student Edition, covers general risk management techniques; standards of health care risk management administration; federal, state and local laws; and methods for integrating patient safety and enterprise risk management into a comprehensive risk management program. The Student Edition is applicable to all health care settings including acute care hospital to hospice, and long term care. Written for students and those new to the topic, each chapter highlights key points and learning objectives, lists key terms, and offers questions for discussion. An instructor's supplement with cases and other material is also available. American Society for Healthcare Risk Management (ASHRM) is a personal membership group of the American Hospital Association with more than 5,000 members representing health care, insurance, law, and other related professions. ASHRM promotes effective and innovative risk management strategies and professional leadership through education, recognition, advocacy, publications, networking, and interactions with leading health care organizations and government agencies. ASHRM initiatives focus on developing and implementing safe and effective patient care practices, preserving financial resources, and maintaining safe working environments.


The Handbook of Patient Safety Compliance

The Handbook of Patient Safety Compliance
Author: Fay A. Rozovsky
Publisher: John Wiley & Sons
Total Pages: 283
Release: 2016-12-05
Genre: Medical
ISBN: 1119386357

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Written for virtually every professional and leader in the health care field, as well as students who are preparing for careers in health services delivery, this book presents a framework for developing a patient safety program, shows how best to examine events that do occur, and reveals how to ensure that appropriate corrective and preventative actions are reviewed for effectiveness. The book covers a comprehensive selection of topics including The link between patient safety and legal and regulatory compliance The role of accreditation and standard-setting organizations in patient safety Failure modes and effect analysis Voluntary and regulatory oversight of medical error Evidence-based outcomes and standards of care Creation and preservation of reports, data, and device evidence in medical error situations Claims management when dealing with patient safety events Full disclosure Patient safety in human research Managing confidentiality in the face of litigation Managing patient safety compliance through accountability-based credentialing for health care professionals Planning for the future


The Healthcare Compliance Professional's Guide to Policies and Procedures

The Healthcare Compliance Professional's Guide to Policies and Procedures
Author: Richard P. Kusserow
Publisher: Hcpro, a Division of Simplify Compliance
Total Pages: 0
Release: 2008
Genre: Medical care
ISBN: 9781601461728

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Ready-made compliance policies and procedures that you can adapt to your facility. Policies and procedures are the backbone of any compliance program. Compliance professionals must ensure that their policies and procedures are effective and up to date. To ensure effectiveness, the OIG expects hospitals to regularly re-evaluate their policies and procedures. Insight from a former Inspector General The Healthcare Compliance Professional's Guide to Policies and Procedures is written by former Inspector General Richard P. Kusserow. He has filled this book with sample policies and procedures that hospitals can use to strengthen their existing compliance program or help build a new one. Customize your program immediately The Healthcare Compliance Professional's Guide to Policies and Procedures provides the easy-to-use policies and procedures you need to ensure that your compliance program runs efficiently and smoothly. With these tools you will be able to: Implement proven, effective policies and procedures by using the sample templates provided Instruct staff with easy-to-comprehend instructions regarding policy and procedure development Identify best practices for policy and procedure development that are most likely to pass OIG investigation Ensure your policies are up to date with all legislation passed through the beginning of 2008 All of these sample policies and procedures can be used right away. Download our sample policies directly from the companion CD-ROM. You can then customize each document to fit your specific situation. It's that easy to develop a proven, effective set of policies and procedures! Take a look at the table of contents to see the variety of sample policies and procedures you will receive with The Healthcare Compliance Professional's Guide to Policies and Procedures: Compliance program oversight policies and procedures Compliance officer duties and responsibilities Confidentiality agreements Compliance officer and legal counsel protocol Records management Standards of conduct Ethics Compliance education and training Billing and coding policies Accurate coding Observation status Accurate documentation Prohibition of fraudulent and abusive billing Medicare's "incident to" rule Charity/uninsured care Medical necessity How to check for medical necessity ABN use for items and services that do not meet medical necessity Conflicts of interest agreements Gifts Vendor relationships Discounts/professional courtesies Reporting compliance problems Hotline use Hotline auditing Responses to complaints Nonretaliation policy (whistleblower protection) Auditing and monitoring Procedures for documenting auditing and monitoring Standards for auditing and monitoring Policies specific to laws and regulations Stark Anti-kickback statute False Claims Act Deficit Reduction Act EMTALA HIPAA Other risk areas Quality of care Clinical trials


Healthcare Compliance Auditor - The Comprehensive Guide

Healthcare Compliance Auditor - The Comprehensive Guide
Author: Viruti Shivan
Publisher: Independently Published
Total Pages: 0
Release: 2024
Genre: Medical
ISBN:

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"Healthcare Compliance Auditor: The Comprehensive Guide" is an essential resource for professionals in the field of healthcare compliance and auditing. This in-depth book offers a thorough exploration of the complex world of healthcare regulations, providing readers with the knowledge and tools necessary to conduct effective and ethical compliance audits. It covers a wide range of topics including federal and state healthcare laws, risk assessment, auditing techniques, and the latest in compliance strategies. Key features of this guide include detailed explanations of healthcare laws such as HIPAA, HITECH, and the Affordable Care Act, as well as practical guidance on conducting audits, identifying risks, and implementing compliance programs. The book is designed to help both new and experienced auditors to develop a comprehensive understanding of the healthcare compliance landscape and to stay abreast of the evolving regulatory environment. Please note that this book contains no images or illustrations for copyright purposes, focusing solely on providing high-quality, text-based content. Whether you're a novice stepping into the world of healthcare auditing or a seasoned professional seeking to enhance your knowledge and skills, this book is an invaluable resource for ensuring compliance and upholding ethical standards in healthcare.


The Compliance Officer's Handbook, Third Edition

The Compliance Officer's Handbook, Third Edition
Author: Robert A. Wade
Publisher: Hcpro, a Division of Simplify Compliance
Total Pages: 0
Release: 2014-04-17
Genre: POLITICAL SCIENCE
ISBN: 9781615693498

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The Compliance Officer's Handbook, Third Edition, gives compliance officers everything they need to take charge of a healthcare compliance program, whether they are new to the field or seasoned professionals who want to incorporate the latest strategies. Packed with legal insights from two experts on the latest OIG regulations, this handbook delivers tools, practical examples, and interpretations to build and maintain programs consistent with best practices for risk assessment, HIPAA compliance, training, monitoring, and auditing for compliance, and a host of other organizational responsibilities. ... The new edition includes: A new, in-depth chapter interpreting HIPAA regulations, including compliance with the authorization and notification requirements related to the privacy, security, and breach notification rules. A comprehensive chapter detailing critical issues for the compliance officer: establishing, monitoring, and documenting fair market value and commercial reasonableness between referral sources to avoid violating the Stark Law and Anti-Kickback Statute, or the False Claims Act. The following new forms: Income Guarantee Monthly Report, Community Need Checklist, Employment Justification Analysis Form, and Non-Monetary Benefit Tracking Form.