Question

Point out examples and evidence from the sample compliance plan to show that it follows the seven principles outlined above. If you feel there is no evidence for one or more principles, indicate the same with justification.

Are there areas of improvement and changes that you would like to make to this sample compliance plan.

If you were appointed as the Compliance Coordinator (whose responsibilities are outlines in the sample compliance plan), what are some of the top-priority tasks you need to complete in order improve compliance at your organization (one example includes

arriving at an educational program for employees/coders).

1, Designation of a compliance officer and a compliance committee

2. Development of compliance policies and procedures, including standard of conduct

3. Developing open lines of communication

4. Appropriate and education

5. Internal monitoring and auditing

6. Response to detected deficiencies

7. Enforcement of disciplinary standards

Answer 1

1. Compliance officer
   • Every billing companies should designate a compliance officer to serve as the focal point for compliance activities
   • Primary responsibilities of compliance officer-
     • Revsing the program in accordance with the changes periodically
     • Reviewing employee s certificatiooverseeing and monitoring the implementation of the compliance program
     • Reporting on a regular basis to higher authority.
     • Developing , coordinating and participating educational and training programs
     • Coordinating personal issues
     • Assisting billing companies financial management
     • Developing policies and programs
     • Continuing the momentum of the compliance program
2. Compliance committee
   • If possible it is recommended that compliance committee br established to guide the compliance officer and asist in the implementation of compliance program
   • And while assembling a team, the company should include individuals with a variety of skills. Appropriate members of a compliance committee includes the director of billing and director of coding
   • Compliance officer manage compliance committee
   • Responsibilities:-
     • Analyzing the legal requirements and the organization's regulatory environment
     • Monitoring internal and external audits
     • Assessing existing policies and procedures
     • Working with appropriate departments to develop standards of conduct and policies
     • Recommending and monitoring in conjunction with the relevant details it's
     • Determining appropriate strategy to promote compliance with the program and detection of any potential violations.
     • Developing a system to solicit, evaluate and respond to complaints and problems
3. Development of compliance policies and procedures
   • Define all key terms used in the documents
   • Anchor the documents in cited authority
   • Write the documents in active voice
   • WeEnsure all policy statement s are short, declarative and specific to a single issue
   • Standardize policies in forms and format to avoid confusion
   • Confirm that the policy does not conflict with other policies
4. a) Access to the compliance officer
   • An open line of communication between compliance officer and the billing company personal
   • Hotlines and other forms of communication