Compliance

Compliance Consulting Services

The home care and hospice industry continues to experience a growing trend of government scrutiny for documentation compliance with regulations. Due to the government's more sophisticated fraud detection techniques and the interpretive nature of documentation, the risk potential is higher in our complex operating environment.

Simione™ Healthcare Consultants, LLC clinical, operational, and financial consulting staff's expertise is unequaled in the home care and hospice industry. Our consultants have been successful working with health care attorneys, corporate compliance and audit departments, as well as government agencies such as fiscal intermediaries and the OIG. We use our extensive industry experience to help protect your organization from civil or criminal actions and limit your compliance risk by regularly tracking regulations and legislation that impact our industry.

The overall goal of our Compliance Consulting Services is to help you minimize your risk and preserve and protect your organization's valuable assets. We will support you throughout all phases of your compliance process by:

Assessing your current state of reimbursement, clinical, and operational compliance through:

• Annual compliance audits
• Cost report audits and analyses
• Audits for Compliance with Sarbanes-Oxley Act of 2002
• Managing additional documentation requests, probe audits and focused medical review
• Conducting reviews of billing and documentation processes

Providing a clinical documentation improvement program with:

• OASIS analysis and training
• Customized audit tools
• Development of customized education programs

Working closely with your legal counsel and Compliance Officer to determine any reporting or disclosure responsibilities by:

• Conducting probe/discovery audits
• Conducting attorney privileged statistically valid disclosure audits
• Acting as an Independent Review Organization (IRO) for Corporate Integrity Agreements (CIA)

Providing you with detailed reports of findings and recommendations for needed changes.

For more information about our Compliance Consulting Service, contact us.