Compliance Plans

Churchill Consulting offers a comprehensive compliance plan for both freestanding and hospital based departments. This is the ultimate “playbook” for a department. The Compliance Plan is an integral part of the organization's comprehensive compliance program and demonstrates the commitment to honest and responsible corporate conduct by demonstrating a good faith effort and commitment to ensuring and promoting integrity. Compliance programs help to fulfill an organization's legal duty to refrain from submitting false or inaccurate claims or cost information to the Federal health care programs.

The single biggest risk area is the preparation and submission of claims or other requests for payment from the Federal health care programs. It is axiomatic that all claims and requests for reimbursement from the Federal health care programs—and all documentation supporting such claims or requests—must be complete and accurate and must reflect reasonable and necessary services ordered by an appropriately licensed medical professional who is a participating provider in the health care program from which the individual or entity is seeking reimbursement.

When submitting supporting documentation for a claim upon request, the information may not be supplemented [unless a clerical error can be demonstrated]. It is imperative that the organization/department knows the exact documentation that is required to support each service. This may include orders as well as procedure documentation. Churchill's Compliance Plan provides definitive documentation and coding guidelines to ensure compliance. Although there may be a corporate level Compliance Plan that addresses the requirements stipulated by the OIG, such as employee education, anti-kickback, reporting of false claims, etc., this unique product provides you with the actual guidelines to follow for documentation and reporting services in your department or center.

The Compliance Plan is completely customizable for the client, even down to including your logo. Content and rules are updated when industry changes are made.