The Affordable Care Act requires practices to establish a compliance program as a condition of enrollment in Medicare, Medicaid and/or the Children’s Health Insurance Program (CHIP). In addition, health plans may ask your practice to attest that you have screened employees against exclusion lists, and provided them with specific CMS training modules. Eagle Associates’ OIG Compliance Program provides a complete and user-friendly compliance system to help you meet these requirements. Please review the features of the OIG Compliance Program below and feel free to contact us to discuss how this program could benefit your practice.
Program Features
Our OIG Compliance Program will help you to implement a robust compliance program to prevent fraud, waste and abuse in participation with federal healthcare programs. The following benefits and services are included:
- American Practice Advisor subscription.
- A complete review of fraud, waste and abuse statutes.
- A written policy manual to address fraud and abuse prevention methods, such as auditing and monitoring policies, reporting and investigation procedures, disciplinary actions and more.
- Specific instruction for screening employees and other entities against the OIG exclusions database.
- An Implementation & Review Guide to help you implement policies, and conduct an annual review of program elements.
- A comprehensive training module for initial and annual OIG, and CMS Fraud, Waste and Abuse and General Compliance Training.
- This training module also fulfills the training requirements of Medicare Advantage downstream entities.
- Our live support feature provides your practice access to our Compliance Consultants, who will answer any questions that you have about your compliance program.
Internal Audits
Eagle Associates has partnered with a company offering a unique and powerful tool for internal audits of patient encounters, ICD-10 code look-ups, coding guidelines and more. SpringSoft Medical offers the cloud-based program, Swiftaudit Pro, to improve revenue and compliance through objective auditing procedures. All data stored in the Swiftaudit cloud is encrypted and accessible only to your practice for statistical review and regulatory documentation purposes.
- This optional tool will be offered to all subscribers of the OIG Compliance Program at a great discount. Please visit the website: www.Swiftaudit.com for more information on Swiftaudit Pro (for practices).
External Audits
It is recommended that external audits be performed at least every three years to verify the results of your internal audits. SpringSoft Medical now also offers external auditing, using the same cloud-based platform, Swiftaudit Pro. This service may be added to your Swiftaudit Pro license, or ordered independently if you already have a method for completing internal audits. Certified, senior-level auditors can ensure that your practice is made aware of any problem areas, and that coding and documentation are correct and complete to ensure timely payments.