Compliance Services

All Sleep Centers are required to implement a compliance program to remain compliant with State and Federal regulations, thus reducing the risk with audits and potential for assessment of penalties.

Regulatory compliance affects all areas of a sleep center or sleep DME service, from the receptionist to the provider.

To conform with the Federal and State requirements, regular education and training of all staff members about the Compliance plan is required, with ongoing monitoring for sustained integration of the regulatory standards.

It is important to follow the compliance guidelines to protect your reputation and credibility within the community.

Compliance in the health care industry is the process of meeting regulations, recommendations, and expectations of federal and state agencies that pay for health care services and regulate the industry.

These include integrating standards and practices to promote operating a sleep center in accordance with federal and state regulatory requirements.

The outcome of the integration provides privacy, health information security and appropriate insurance claims processing to reduce fraud and abuse.

The use of standardized performance improvement processes to improve the delivery and quality of health care.

SCMI provides:

· Tools to Manage Your Compliance Plan

· Strategies and Tactics to Implement Your Compliance Program

· Auditing of Your Compliance Management

· Training and Education for your Staff and Providers

· Compliance Officer Contract Service

In collaboration with your sleep center leadership SCMI’s compliance consultants will guide you t0 create and maintain your customized Compliance Program.

Services

SCMI offers a full menu of compliance program services:

· Compliance Program Audits using latest 2011 compliance standards

· Implementation of financial policies and procedures

· Staff Training for Compliance Management

· Coding and billing procedures

· Pre-employment screening criteria

· Standards to reconcile the Explanation of Benefits and Remittance Advices

· Offsite Compliance Officer Services

Compliance Audits

To perform this step the SCMI team will be on site to complete:

· Audits of Coding and billing information of 25 patient charts at each facility

· Relevant Explanation of Benefits and Remittance Advices for respective billing cycles,

· Review of all denied claims in a six (6) month period of time,

· Review of HR Policies and Procedures to include Role Descriptions

· Review of IT Policies and Procedures to assess Security Risks

· Review of all third party payer contracts

· Interviews with key sleep team members.

Call 1-888-556-2203 or email info@sleepcmi.com for more information on how SCMI's team may assist your sleep management team with your required compliance programs.