Could you share with me what your thoughts are about what an operations manual consists of, other than compliance department policies?
The section in the HCCA-OIG document is Compliance Plan:
1.57 Maintain compliance plan and program
1.58 Maintain compliance department operations manualThank you as always for your guidance.
My operations manuals (not just for the compliance department) have been, depending on organization size, the how-to overview at least, the comprehensive knowledge base at most. My compliance department ops manual captures how to fulfill the compliance department's needs for reliability, is a basis for continuous improvement, and of course business continuity. Kind of the meta-P&P, in a sense. Includes processes, forms, history/justification for processes susceptible to changing course mid-stream; mine includes a rough calendar outline that helps define what "regular monitoring" means in practice and that is updated at least annually for system / process changes / work plan focus areas. I believe it needs to be maintained for accuracy to allow the team using it to shift along with changes in strategy over time with integrity. An operations manual's upkeep is a signal of the value of that activity by the leadership and which in turn drives a rules-based compliance culture.
We are writing Standard Work s for all of our processes such as, investigations, exclusion checks, conflicts of interest, etc. There are two goals in this: one is to reduce variation/improve efficiency and also to provide a very concise process steps for anyone in our department or new to our department.
Jim Bowman, CHC
Regional Compliance Manager
Office of Compliance and Integrity
80 Seymour Street
Hartford, CT 0610
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Yes. We use flow charts. One of the best that I've seen is a flow chart used to determine whether authorization is needed in order to disclose PHI upon request. Thanks.
Not to cut in on Kris, but if you decide to do this, I hope you share (as you so often do). I would definitely find it helpful!
Count me in!
I am interested! I had no idea you could do flow charts in excel. Thank you, Frank.
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I would guess...and let's see from our colleagues...that people were not aware.Question:
How many folks both knew AND have created flowcharts in Excel?If you want to post offlist...no problem...I am guessing 75% or more did not know that Excel can be used to create flowcharts.
Carly Borenkind, LCSW
I generally do mine in word. I have not done one in excel.
I would be interested in a Friday learning session.
Joseph Zielinski, JD, CHC, CHRC
Corporate Compliance Program Director
3838 North Rural Street
Indianapolis, IN 46205
720 Eskenazi Ave
Fifth Third Bank Building, Fifth Floor
Indianapolis, IN 46202
"To achieve mutual understanding you must understand what information your colleagues need from you to perform their function, and they must understand what you need from them." Peter Drucker
Had no idea and would love a video to understand how it's possible! J Mind officially blown!
Ashlee Walden, J.D., CHC
TOA – Central Billing Office
I would like to learn as well. Thanks!
I am aware that flowcharts can be created in Excel but I never have had much luck doing so. A video would be great.
Charles E. Colitre, BBA, CHC, CHPC
Compliance and Privacy Officer
Crystal Clinic Orthopaedic Center
3925 Embassy Parkway, Ste 250
Akron, OH 44333
I agree with all of the above.
Add a policy which explains the Auditing & Monitoring process; (both E&M and HIPAA Privacy)
· Define the difference between an audit & monitoring
· How you perform the audit & monitoring
· How you determine who needs to be monitoring (routine vs. focused )
· Potential Corrective Action Plans (CAP) for over-billing & under-billing (leaving money on the table).
· Potential disciplinary actions for"chronic issues", so to speak.
If you are really detail oriented; (sorry it is the nurse in me coming out, we had a P & P for everything)
· Time & Effort reports for contracted providers/Medical Directors (if applicable).
· Process for Contract review and "Auto renewals"
· What is your process in assessing Fair Market Value (FMV) & how often do you re-assess FMV.
I hope this helps you.
Patrick R. Guilfoyle BA, RN, BSN, CHPC, CFE
Office of Compliance & Corporate Integrity
42 East Laurel Road
Suite # 1300
PO Box 1011
Stratford, NJ 08084
"Right is right, even if everyone is against it, and wrong is wrong even if everyone is for it."
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