The Healthcare Compliance Professional's Guide to Policies and Procedures

Softcover Book + bonus CD-ROM
11" x 8.5"
ISBN 1601461720
978-1601461728
HCPro Inc
April 2008
(click button below for the very best currently available price for this important resource)

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.

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.

You will be able to customize these to your organization 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 new and pertinent legislation

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:

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
- Non-retaliation 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

Richard P. Kusserow is the founder and CEO of Strategic Management Systems, Inc. In that capacity, he leads in evaluation of difficult compliance issues and began developing, evaluating, and enhancing compliance program effective in 1992. He previously served for 11 years as the Inspector General (IG) of the Department of Health and Human Services (HHS) where he was responsible for all investigations, audits and inspections performed on behalf of the department.

With more than 17 years of experience, HCPro, Inc. is a leading provider of integrated information, education, training, and consulting products and services in the vital areas of healthcare regulation and compliance. The company's mission is to meet the specialized informational, advisory, and educational needs of the healthcare industry. As an acknowledged industry authority in healthcare regulation and compliance, HCPro focuses on providing its clients assistance and expertise in the areas of accreditation, medical staff affairs, credentialing, privileging, medical record management, regulatory compliance, nursing, quality/patient safety, infection control, and workplace safety.

(information from the publisher)

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