Premium Essay

Analyzing a Compliance Plan

In:

Submitted By Jubey21
Words 2848
Pages 12
INTRODUCTION
This plan is an integral part of North Side’s ongoing efforts to achieve compliance with federal and state laws relating to billing for clinical services. The Plan creates a comprehensive and centralized system of oversight for bill coding, education, chart review, reporting and discipline (“Discipline,” as used throughout this policy shall include all steps described in the Human Resource policy manual and faculty policies and regulations including, without limitation, termination and tenure revocation). This Plan provides for oversight by a Compliance Program Medical Director and Compliance Officer. Although the intent is to encourage compliance through a centralized audit system, it remains the responsibility of each individual involved with the billing process, from physicians and other providers to clerical staff, to comply with the law. The purpose of this Plan is to ensure that clinical services are adequately documented and that properly coded bills are submitted only for documented services. This Plan is to be read in conjunction with and is an integral part of the University of Rochester Medical Center Compliance Plan, which is set forth in a separate document. In addition, it is anticipated that individual departments of the University will create specialty-specific billing compliance plans, which will be subject to review by the Compliance Program Medical Director and Compliance Officer. The University acknowledges that this plan is only the beginning of its efforts to institute a program and oversee compliance with applicable laws and regulations. The key to success, in which all employees play a part, is ongoing adherence to the highest standards of conduct and the development of a workable system in which employees are educated about compliance and participate in ongoing review of their success in that regard.

PLAN OVERVIEW

Similar Documents

Premium Essay

Week 1 Memo

...Compliance System Training The Compliance System is going to be based on the leadership and firm commitment from the Board of Directors, along with the management team to the highest ethical and compliance standards. It will also include the vision and values set out in the Code of Ethics. The Compliance System will be structured from the following elements: risk management, establishing training and communication plans focusing on the areas on compliance and ethical conduct, and lastly, developing policies and procedures. MEMORANDUM TO: All Managers FROM: Corporate Office DATE: July 18, 2015 SUBJECT: Compliance System Training CC: Board of Directors Description: The System will be structured around the following elements: Risk Management: This process will include identifying, analyzing, and responding to risks factors throughout the entire project and the best interest of the objectives. The company wants to ensure proper risk management that will help control the possibility of future events. Establishing Training and Communication Plans: Training and communication for this project is extremely important. It will take everyone’s effort to come up with a training plan for when the Compliance System becomes available and communication with the user’s to determine if there are any issues that arise. The manager’s will come for a two-day training and are encouraged to ask any questions...

Words: 597 - Pages: 3

Premium Essay

Long-Term Impact On Government Budgets

...pivot tables are inserted to format the data. Blanket purchase orders were created for each category of budget and is useful because it shows whether the item should be included in the current budget or long-term financial plan. After creating monthly budgets, we uploaded the finished documents on the department of state health services websites where other state hospitals in Texas store their financial budgets. Moreover, the budget projection manager, usually follow specific fundamental codes with care and skills to address all compliance requirements and fiduciary obligations. That means monitoring service providers to minimize high costs, selecting the right contractors based on plan, and knowing the legal requirements according to fiduciary responsibilities. Thereby, establishing a plan or budget according to policies to manage risks. Besides, the process of all budget projections was monitored and reviewed to report whether the budget was sufficient to cover all cost and analyze whether the plan pursued were useful, which may require new areas for improvement. This is vital because it is important to meet NTSH financial objectives and apply strategies that selects costs that are within the budget requirements. Understanding the fiduciary and compliance requirements are one step closer to...

Words: 832 - Pages: 4

Premium Essay

Plan-Training-Session

...COMPETENCIES | | | Can I…? | Yes | No | 1. Journalize Transactions | 1.1 Prepare chart of accounts | √ | | 1.2 Analyze documents | √ | | 1.3 Prepare journal entries | √ | | 2. Post Transactions | 2.1 Prepare ledger | | √ | 2.2 Transfer journal entries | | √ | 2.3 Summarize ledger | | √ | 3. Prepare trial balance | 3.1 List account titles and transfer from the balance | √ | | 3.2 Summarize trial balance | √ | | 4. Prepare Financial Reports | 4.1 Prepare financial statements | √ | | 4.2 Analyze financial statements | √ | | 5. Review internal control system | 5.1 Check policy compliance | √ | | 5.2 Prepare policy compliance report | √ | | Evidences/Proof of Current Competencies Evidences of Current Competencies acquired related Job/Occupation Current Competencies | Proof/Evidence | Means of Validating | 1. Journalize Transactions | * Demonstration * Certificate of Employment | * Assessment * Authenticity | 1.1 Prepare chart of accounts | | | 1.2 Analyze documents | | | 1.3 Prepare journal entries | | | 3. Prepare trial balance | * Demonstration * Certificate of Employment | * Assessment * Authenticity | 1. List account titles and transfer from the balance | | | 2. Summarize trial balance | | | 4. Prepare Financial Reports...

Words: 1050 - Pages: 5

Free Essay

Benefits and Challenges of Developing a Records Management Plan

...utilized and require compliance with laws and/or policies. For compliance to work, with electronic records, organizations often search for and implement an electronic records management system or ERMS. An electronic records management system is a system that uses modern technology to help an organization with the formation, sharing, use, preservation, and disposal of electronic records while maintaining compliance to laws and policies. Records management is a useful system if properly integrate and utilized by trained organization personnel. In order, for the system to be utilized, then an organization should develop records management plans prior to purchase and integration should be performed. By preparing and using a plan for an electronic records management system. Then the process of researching and locating a vendor with an organization’s sought ERMS requirements will prove to be stress-free. During the planning process, for the electronic records management system, an organization will uncover the benefits and challenges into integrating a system. Benefits The benefits of developing a records management plans allow an organization to discuss and make a needs assessment of what type of ERMS would best suit their record managing requirements. Essentially, record management plans are conducted to highlight the cost and risk that an electronic records management system would bring if implemented. Cost is one benefit of developing a records management plan, because it...

Words: 894 - Pages: 4

Premium Essay

Risk Prioritization and Mitigation

...Risk Prioritization and Mitigation Project Plan Definition White Hat Inc will develop a risk prioritization and mitigation plan per instructions in the RFP. White Hat Inc will define risks as their priority to the company in terms of their impact on the company. White Hat will also help to define mitigation plans to resolve these risks. We will use several factors to prioritize risk and place each risk into one of three categories High, Medium and Low. To determine what category each risk will be placed we will use the following set of questions and definitions: • Define the Risk • Impact of the Risk on Physical or network aspect of the business • Cost of the Risk • Impact on Compliance • Recovery time and cost of lost business Throughout our audit we will generate several reports on the current status of IT security for The State. To Prioritize Risks for The State faces we will review these reports that include: • IT Security Compliance and Governance Gap Analysis • Data Privacy Legal Requirements and Compliance Requirements • Security Assessment • Data Privacy Security Gap • Security Assessment and Risk Identification • Qualitative Risk Assessment Definition of Risk Categories: • High- exploit of vulnerability that has a high cost to the organization's mission and reputation. This could also entail a risk of death or injury to humans. • Medium- exploit of a vulnerability where the cost of a resource would cause notable loss to the organization's mission...

Words: 590 - Pages: 3

Free Essay

Risk Management

... It can be define as such Risk management is a process for identifying, assessing, and prioritizing risks of different kinds. Once the risks are identified, the risk manager will create a plan to minimize or eliminate the impact of negative events. A variety of strategies is available, depending on the type of risk and the type of business. Outline Risk Management and Patient Safety: The Synergy and the Tension Integrating Risk Management, Quality Management, and Patient Safety into the Organization Benchmarking in Risk Management Risk Management Strategic Planning for a Changing Health Care Delivery System Using Never Events to Reduce Risk and Advance Patient Safety Governance and Board Responsibility to Assure Safety in Health Care Organizations 1. Introduction What is the goal or the idea behind risk management one of their focus is to reduce the financial risk other areas that may seem not important is the regulation. One of the principal issues facing health care risk management is governmental regulation. Over the last few decades, there has been a growing public demand for accountability in health care delivery. The consequent tightening of governmental regulation has led to a greater allocation of an organization's resources to regulatory compliance. Some states, including New York, enacted stringent incident reporting requirements for hospitals, requiring additional staff to investigate and prepare such reports. Additionally, competition...

Words: 4978 - Pages: 20

Premium Essay

Blank Stare

...agencies comply with FISMA requirements and, when necessary, enforcing accountability are major initiatives”. (Herrmann, 2007) Here at the USGA IT department it is our jobs to make sure all the proper paper work is in order before our CIO come to audit us. The OMB give our CIO list of regulations to stay in compliance with the five requirements standard mandate from the Homeland Security. Now through out next couple slide I going discus a strategy plan to put in place in order to be in compliance with the OMB and you see the necessary need for more employee. n Here at USGS one of my main job as IT manger is to put the ball in motion on all policy that was mandate in FISMA and head up information security program on all IT systems. The first task would be to recertify all of our high thread level computer in compliance with the audit guide lines. In order to do this we will need some of our employee to go through a couple of training course. In also we will have to set up different level of security clearance for each employee and put in place some kind monitor process to oversee the system that we just recertify. I believe in order to stay in compliance in the this area we will need some addition staff to stay up to date on all the new certifications and accreditation. At the USGS we like to establish networking relationship between the USGS EA as it relation to IT...

Words: 1561 - Pages: 7

Free Essay

Healthcare

...1. Introduction What is the goal or the idea behind risk management one of their focus is to reduce the financial risk other areas that may seem not important is the regulation. One of the principal issues facing health care risk management is governmental regulation. Over the last few decades, there has been a growing public demand for accountability in health care delivery. The consequent tightening of governmental regulation has led to a greater allocation of an organization's resources to regulatory compliance. Some states, including New York, enacted stringent incident reporting requirements for hospitals, requiring additional staff to investigate and prepare such reports. Additionally, competition among hospitals has also fostered a greater concern over the community's perception of quality of care. Many hospitals have had to compete harder for patients as inpatient lengths of stay decrease and more procedures are performed on an outpatient basis. Risk management in the health care In the past risk management and quality improvement job was separate in the health care organization. Even though, the job function may have been different the goal was the same. Managing risks is the quality of services provided & the safety of patients, their careers & visitors. To manage risks to staff & subsequent risks to service quality. To manage risk of failing to meet national & local priority targets to manage risks to the efficiency of services...

Words: 4796 - Pages: 20

Premium Essay

Risk Mitigation

...risk mitigation.  Contents 2 Overview: Why traditional risk mitigation plans fail 3 Build a comprehensive strategy for risk mitigation 3 Identifying types of risk 4 Business-driven risk 4 Data-driven risk 5 Event-driven risk 5 Risk reach and range: understanding risk and its impacts 6  elating value to risk: quantifying R impact 7 Resilience frameworks: analyzing current risk environments 8 Resilience strategy: designing a blueprint for risk mitigation 9 Achieve optimum business resilience with IBM 11 Look to a market leader in business resilience 11 For more information 11 About IBM solutions for enabling IT governance and risk management Overview: Why traditional risk mitigation plans fail A successful governance and risk mitigation strategy must operate at multiple levels with broad coverage. Risk mitigation plans at many organizations fall short simply because they are not comprehensive and fail to take into account the reach and range of all the risks that they actually face. Often this occurs when organizations only focus on specific areas of risk categories, only plan for certain types of risk or don’t understand all the different areas in their organization that particular risks will impact. For example, in the area of disaster recovery, most plans fail to account for the following areas of concern: • Human issues — Plans are often inadequate for ensuring communication with, support for and mobilization...

Words: 2961 - Pages: 12

Premium Essay

Justification for Internal Control

...Justification for an Internal Control System ACC/544 The Controller is responsible for analyzing a company's performance in compliance and reporting, operations and assist management in developing its goals and budgets. They are also responsible for analyzing and managing risks companies may encounter. Performing these tasks require the controllers and financial officers to establish internal controls. The internal control system ensures that financial statements are reliable and are compliant with financial regulations; risks are reduced, and short and long time goals are identified and met. Internal controls are systematic measures (such as reviews, checks and balances, methods and procedures) instituted by an organization to (1) conduct its business in an orderly and efficient manner, (2) safeguard its assets and resources, (3) deter and detect errors, fraud, and theft, (4) ensure accuracy and completeness of its accounting data, (5) produce reliable and timely financial and management information, and (6) ensure adherence to its policies and plans (Business dictionary.com). Internal control systems are improved ways of controlling organizations with minimize risk, loss reduction, and also to achieve goals. Justifying the need for the internal control system can be done by using the insurance and political approaches. Asset allocation, security valuation, performance, and optimization are considered with the approaches. Companies acquire insurance...

Words: 530 - Pages: 3

Free Essay

Week 2 Homework

...Governance and COBIT framework Yeng Lee SEC 592 Professor Joseph Costantini May 18, 2014 What is the relationship between IT execution and IT governance? IT execution and IT governance are both related to the development of Information Technology. The differences among the two terms are their purpose and process. IT execution is a phase in IT development where IT governance is policies and rules to a project. In other word, IT governance is a whole single identity while IT execution is a step in a project. We will go further detail of the different of the two terms. But first, we will elaborate the term IT execution and IT governance. As stated above, execution is a phase in a project. IT execution usually comes after analyzing and planning phase of a project. Following the execution phase will be testing, clean up, and monitoring. In the execution or a project, it requires setting up responsibilities, time management, authorities, and control mechanism to accomplish the task. We will see later how governance does this IT execution. In the Execution phase, the project is carry out and complete. In the field of Information Technology, it can be anything from connecting a new network to upgrading an existence application or hardware to implementing security policies. As the project is being developed, executioner must refer back to the planning phase for guidance and error checking (Project Execution Phase, n.d.). Governance is the process of insure and control...

Words: 1112 - Pages: 5

Premium Essay

Riordan

...Riordan Manufacturing. Growth is a necessity to any organization, but with growth provides risks that should be assessed. The following discussion, will analyze potential areas of risk within Riordan Manufacturing. The potential risks that will be analyzed include contract, tangible and intellectual property risk, employee risk, along with tort and regulatory risk. Each of the identified potential risk areas could inhibit the ability for Riordan Manufacturing to continue growth and potentially include major decrease in business success. In addition to the potential risk areas, compliance is another factor that needs to be ensured. Sarbanes-Oxley has specific requirements that will require Riordan Manufacturing to meet for continued growth and success, but the assistance of principles from the Committee of Sponsoring Organization of the Treadway Commission will assist Riordan Manufacturing in meeting compliance. (Riordan Manufacturing, 2006) The first assessed risk area will include the intellectual and tangible property areas of Riordan Manufacturing. An area that has been identified as a potential issue with contract...

Words: 2254 - Pages: 10

Free Essay

Risk, Quality and Performance Management

... | |Linda Hyll | |8/5/2013 | | | The purpose of implementing a quality management program should focus on developing and communicating a customer-focused mission, strategies and action plans; listening and responding to the customers’ needs and expectations; encouraging employees to continuously improve and increase their overall job satisfaction, processes and environment and the gathering and analyzing key performance indicators to improve overall organizational and process results. A quality management system will help the organization to focus on prevention activities rather than the inspection or the failure of activities often driven by the regulatory process. An effective NMS provides the foundation for providers to achieve performance excellence and for the long-term care profession as a whole to achieve the core principles and outcomes set forth in “Quality First: A...

Words: 941 - Pages: 4

Premium Essay

Virtue

...In the March 2002 issue of the Harvard Business Review, Roger Martin proposed his virtue matrix as a framework for analyzing corporate social responsibility. The purpose of this paper is to discuss three recent newspaper articles that showcase acts of corporate social responsibility and to provide an evaluation of the virtue matrix in regard to its usefulness for understanding corporate social responsibility in addition to how the matrix relates to government regulation. The first article for discussion is entitled “McDonald’s to phase out pork from suppliers that cage pigs over 10 years” (York, 2012). The article reports on McDonalds’ plan to gradually eliminate the use of pig gestational crates in its U.S. supply chain over the next ten years. Gestational crates are used to confine female pigs for most of their adult life as it is reasoned by some that pregnant sows become aggressive around food. The process has been condemned by animal rights activists as unnecessary and cruel (York, 2012). The article goes on to say that McDonald’s is not the only fast food restaurant that is engaging in this act, Burger King and Wendy’s also have plans to phase out the use of these crates. McDonald’s has pledged to work with farmers to move toward other methods of confinement that will serve both of their needs. Given the widespread movement to ban gestational crates by other fast food chains this act by McDonald’s falls into the bottom left quadrant of the matrix, the choice section...

Words: 1207 - Pages: 5

Premium Essay

Ethics

...a company dumping toxic chemicals into a river and then bribing a local official to cover it up would not be an ethical practice. Most corporations in the United States have adopted some sort of ethics plan as their moral philosophy and everyone from the CEO to the mail clerk are responsible for adhering to these standards. In today's world, customers want to know that the companies they do business with are ethically sound and free from corruption. An ethics program is an essential tool for a company to have to ensure that it is in compliance with the law and acts on sociably acceptable norms and trends. It is the way to promote operational excellence throughout the company and ensure that everyone is on the same page. Ethics programs give employees a clear understanding of what is right and wrong in the organizations eyes. This leads to a higher performing workforce which improves the overall operational performance of a company. This program should be part of the company's overall culture and reflect in the core values or mission statement. An ethics plan is a critical component of an organization's risk management policy. The plan should be tailored to support business objectives, identify the boundaries of what is right and wrong, have a system to test and monitor the plan and ensure that the employees of the organization are trained and have the support to report and correct ethical issues. It is management's responsibility to ensure that they foster an environment that...

Words: 2200 - Pages: 9