Healthcare providers work in a highly regulated environment, so no relationship is without risk. Even the smallest healthcare provider has obligations under applicable fraud and abuse and patient privacy laws. There is simply no way to stay on top of things clinically and deliver services every day without a separate set of eyes on ever-changing compliance requirements.
Many healthcare laws do not discriminate between a small healthcare business and a community hospital, or allow any leeway because one is a sole practitioner. The risk for all healthcare businesses is real, and being uninformed (whether purposefully or not) does not alleviate your obligations.
Moreover, as insurers uses compliance issues as a basis for denying or delaying payment, getting it right is an important feature in protecting cash flow and de-risking your business’ bottom line.
The problem in the area of healthcare regulatory compliance is this: it’s fragmented and often lacks coordination with legal counsel. This creates gaps and exposure. The HIPAA consultant does what s/he does. The CLIA consultant does what s/he does. The coding consultant…same thing. They tend not to coordinate with lawyers, which often leads to regulatory deficiencies. Consultants and lawyers see the same issue differently. Gaps and exposure.
Our tool is compatible with what clients may have in place, identifies and covers any gaps (areas no one thought to assess) and squares regulatory compliance input with any consultant input they may already be receiving.