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Related Experiment Videos

Process improvement program evolves into compliance program at an integrated delivery system.

R C Tyk1, P G Hylton

  • 1Holt-Krock Clinic, Fort Smith, AK, USA.

Healthcare Financial Management : Journal of the Healthcare Financial Management Association
|August 5, 1998
PubMed
Summary

A healthcare system enhanced its revenue cycle by implementing a comprehensive corporate compliance program. This initiative aimed to prevent fraud and abuse, ensuring regulatory adherence and mitigating government scrutiny.

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Area of Science:

  • Healthcare Administration
  • Corporate Compliance
  • Revenue Cycle Management

Background:

  • A healthcare system identified questionable practices during a revenue-to-cash cycle process-improvement initiative.
  • These findings highlighted the urgent need for a robust corporate compliance program.

Purpose of the Study:

  • To establish a comprehensive corporate compliance program within an integrated healthcare delivery system.
  • To proactively address and prevent fraudulent and abusive activities.

Main Methods:

  • Engaged external legal counsel to guide program development.
  • Appointed a corporate compliance officer and established a compliance committee.
  • Developed a corporate code of conduct, integrated into organizational policies.

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  • Formed cross-functional teams for compliance review and improvement.
  • Implemented mandatory compliance education for all staff.

    • Main Results:

    • Successfully established a structured corporate compliance program.
    • Integrated compliance into daily operations through policies and procedures.
    • Enhanced staff awareness and understanding of compliance requirements.

    Conclusions:

    • A systematic approach to corporate compliance positions organizations to avoid misconduct.
    • Proactive compliance measures are crucial for mitigating risks and government scrutiny.
    • The implemented program provides a strong foundation for ongoing ethical and legal operations.