HEALTHCARE COMPLIANCE AUDITS
Healthcare Compliance and Audits
The Advis Group has extensive experience in conducting audits of hospitals, and other healthcare providers, operations, and practices. In addition to targeted compliance audits addressing billing compliance, HIPAA, 340B, and Provider-based Status, Advis conducts annual compliance audits helping organizations assess the current state of their compliance program. Advis assists hospitals and health care systems in the following ways:
Advis assists hospitals and healthcare systems in the following ways:
- Manage and respond to government investigations, including the development of Plans of Correction (CMS-2567)
- Medical necessity audits
- RAC/MAC audits
- Third-party input and investigation to assist providers in developing compliant responses to government actions
- Challenging unfounded allegations
To prepare your facility for an upcoming accreditation or federal/state survey, Advis can assist your facility by conducting an on-site survey to determine documentation and clinical compliance to determine readiness. To avoid costly delays in initial certification or arduous Plans of Correction, Advis will provide a multi-disciplinary team of on-site surveyors, which can review and perform:
- Organizing and governing documentation
- Governance structure
- Medical staff credentialing and HR files
- Key policies and procedures
- Environment of Care and Life Safety documentation
- Patient tracer activities
- Patient medical records and charting documentation
- Director-level and staff interviews
- Patient interviews
In addition to providing a comprehensive written evaluation of opportunities for improvement, Advis will also work closely with administration and clinical leadership to counsel and resolve identified deficiencies on-site by providing daily updates and following the written evaluation to assist with implementation of recommendations.
For more information on how our team of experienced regulatory experts can help your facility prepare for an upcoming accreditation, CMS, or state survey, please contact The Advis Group.
PLAN OF CORRECTIONS
Following an on-site survey, state, regional, and accreditation agencies issue a Statement of Deficiencies report identifying findings. This document contains a listing of deficiencies cited by the surveying State Agency or Regional Office as requiring correction. The Statement of Deficiencies is based on the surveyors’ knowledge and interpretation of applicable regulations.
Following issuance of the Statement of Deficiencies, the healthcare organization must prepare a Plan of Corrections (POC) within a designated timeframe identifying how the facility will correct the deficiencies. The POC is the organization’s opportunity to demonstrate how substantial compliance will be attained.
The POC must include the statements reflecting the facility’s plan for corrective action and the anticipated time of correction. Effective completion of a POC often requires communication with the surveying agency and comprehensive assessments of facility operations.
Assisting you to provide a POC.
Advis assists healthcare organizations to prepare and implement an effective POC through offering the following services:
- Survey exit conference participation
- Initial POC strategy coordination
- Communication with survey staff
- Timely follow up with regulatory agencies
- Verification of POC due dates
- Interpretation of cited regulations and deficiencies
- Methods of Correction identification
- Strategy implementation
Find out about our areas of expertise to see how our skilled staff members can ensure that your POC is carried out effectively and efficiently and meets all standards.