Building & Testing Your Compliance Program

The experts at Professional Provider Services can assist you in building an effective compliance program that can prevent and detect violations, withstand the scrutiny of Medicare auditors, prosecutors, and whistleblower lawyers, and teach employees to conform their billing and business practices to the ethics of your organization.

Put PPS's Experience to Work For You
Corporate compliance may seem to be the latest fad in the healthcare industry. In fact, many individuals and organizations have jumped on the bandwagon touting solutions in this area. But do they have the experience to deliver results? Have they worked on both sides of compliance investigations? Do they really know what the government will look for in your compliance program?

Your organization can benefit from our team's 100 years of collective experience in healthcare. We've seen the view from both sides of the fence - the provider's side and the government's side - and we know how the government will evaluate the effectiveness of your organization's compliance program. We know just what they'll look for - and how to identify and eliminate risk, develop and implement policies and procedures to address violations, train your employees and managers, document the program and test your corporate compliance program to ensure effectiveness. The result? Cost-effective, customized corporate compliance solutions.

Testing the Program's Effectiveness

But building a compliance program without testing its effectiveness leaves your organization vulnerable. Remember, without solid proof that your compliance program is effective, the government won't cut you any slack in the event of an investigation or prosecution.

PPS will assist your organization starting at ground zero by performing a comprehensive risk assessment of your systems. This includes reviewing documents and interviewing key corporate officers and employees for the purpose of evaluating an organization's current values and culture to determine potential areas of regulatory and administrative exposure.

We also see to it that all efforts to implement the compliance program are documented so that, if necessary, they may be reviewed by the government should there be an investigation. We keep documentation on all employees interviewed, the business areas audited, the inquiries regarding and resolution of whistleblower complaints, any disciplinary actions for dishonest or unethical behavior, and all reviews of the program.

We're There With You

But our responsibilities don't end with the written plan. As part of the program, we train personnel on all levels using a variety of teaching methods. PPS provides all employees with a corporate compliance handbook, which we thoroughly explain. And once the initial on-site training is complete, we offer ongoing toll-free support in case there are any outstanding issues to be resolved. These are crucial points, as the training of staff is one of the most important steps in any successful program.

Ongoing auditing and monitoring are also key elements of an effective corporate compliance and ethics program. Monitoring, or organizational oversight, entails looking at documents, asking questions, performing accounting procedures, investigating and helping to enhance an entity's internal controls. A thorough monitoring system not only helps make a compliance program effective; it also speaks volumes about the philosophy of management and its commitment to a program of integrity.

We will help the organization establish standard sampling protocols to identify and check on deviations from an established norm. If a deviation is identified, the facility must explain why it occurred. Once the underlying cause is ascertained, steps must be taken to immediately remedy the problem. PPS will help each organization set up a comprehensive system.

We are committed to helping clients establish, evaluate, strengthen, monitor, and assess their compliance programs in an environment of continuously changing needs and emerging risks. Our interdisciplinary team of accountants, nurses, auditors, attorneys and management personnel, coupled with our rigorous methodologies, ensure that we thoroughly address our clients' specific needs. Those needs range from enhancing or developing a provider's code of conduct, which is the bedrock of an effective compliance program, to developing roles and responsibilities, reporting, monitoring processes and detailed procedures in the areas of employment, record retention and antitrust.