A Guide for Physicians
By Amy Johnson Conner
In the midst of taking care of patients every day, doctors across
Massachusetts are struggling to comply with an overwhelming number of
constantly changing state and federal regulations. Medical professionals
“don’t have the time to think, let alone deal with the 30
different [regulations] on the state and federal level,” said
Michael Manere, vice president of sales at Total Compliance Solutions in
Wellesley.
Physicians must follow federal regulations under the Health Insurance
Portability and Accountability Act, known as HIPAA; The Occupational
Safety and Health Administration, or OSHA; The Centers for Disease
Control, known as the CDC; and Medicare and Medicaid, among others.
There are also a host of other federal and state regulations
covering:
While HIPAA and other privacy concerns are of paramount importance,
experts said many physician offices don’t focus enough on the many
other high-risk regulatory areas, especially those that affect
billing.
The sure-fire way to stay out of hot water is to overcome the fear of
regulatory compliance and dedicate yourself and your staff to following
the rules. That means you must learn the regulations, follow them and
train your staff to do so as well.
While relatively expensive, third-party companies can provide
compliance plans, but if a small office can dedicate roughly 15 hours
each month of one employee’s time, it’s possible to do it
in-house. (See “Can
you do it yourself?”)
Next: Documentation
and Coding
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