Compliance Effectiveness and Support Services
Healthcare (Provider) Compliance Services
In a climate where the national focus on the quality of healthcare and the outcomes, both financial and clinical, is markedly increasing, Huron’s Compliance service offerings are customized and widely available to academic medical centers, hospitals, health care systems, ambulatory care centers, law firms and others who contribute to the health and welfare of patients. Our familiarity with the regulatory landscape and the demands of organizational oversight and operations make us ideally suited to offer customized support to institutions faced with compliance issues and compliance oversight.
Organizational assessment and monitoring plans, to be effective, must now integrate compliance risks associated with quality, regulatory, peer review and risk management. Huron, in keeping with recent trends in the healthcare arena, views compliance as an integrative process. We are sensitive to the many challenges institutions face when initiating an integrative approach to compliance. Every institution invariably requires a structured, customized organizational approach. The compliance program should be proactive in its approach, content and enforcement, but must also be responsive to existing issues identified by clinicians, staff and government authorities.
At Huron, our professionals combine or focus our service offerings to mirror client institutions’ needs and priorities. The following list provides some insight into the myriad services we offer clients. Any of these services can be performed independently or coordinated as part of a broader intervention.
- Strategic and Operational (development and implementation of comprehensive compliance programs)
- Compliance Effectiveness Assessments
- Compliance Training
- Independent Compliance Investigations
- Compliance Monitoring and Auditing (concurrent and retrospective) /or comprehensive compliance program
- IRO Services
- Assistance with negotiation of CIAs and CCAs
- Regulatory Consultation
Huron’s committed energies and expertise afford our clients the support and skills necessary to manage the compliance risks inevitable in healthcare settings. Our assistance will help your institution structure, adopt and implement integrative compliance and risk management strategies and, ultimately, better navigate today’s challenging healthcare regulatory environment.
Billing and Coding Compliance
Due to the continual changes related to hospital billing and coding, providers face the challenge of staying current with and fully understanding new regulations and coding changes. Even overlooking just one coding change or not applying it properly can result in hundreds of thousands of dollars in lost revenues and/or compliance concerns over the course of a year.
Huron’s billing and coding professionals can provide consulting services in the following areas:
- Inpatient DRG reviews
- Outpatient APC reviews
- Chargemaster reviews
- Evaluation and Management Documentation, coding and billing reviews
- And much more….
Our team of certified coding professionals is available to help manage risks, improve processes and provide specific training to your organization.
Investigations & Expert Testimony
Huron Consulting Group provides investigatory support to law firms and target institutions that are under investigation by the government. With deep expertise in healthcare compliance, coding and billing, and research, we offer the necessary detailed support to assist in bringing the matter to closure. Additionally, we provide Independent Review Organization (IRO) services to those in the industry that are operating under a Corporate Integrity Agreement (CIA). Our experience with investigations coupled with our IRO experience provides a level of knowledge and expertise to assist the targeted entity in demonstrating the fulfillment of its CIA obligations while maintaining a compliant organization. We also provide expert testimony in healthcare compliance and clinical research related issues to support the legal team in advocating based on regulatory requirements and industry best practices.