One thing that a private medical practice should never overlook is compliance. An integral part of a practice meeting compliance regulations is having a professional compliance officer. Below, we’ll explain what compliance officers do and why your private practice needs one.
What Is a Compliance Officer?
First, what is a compliance officer, and what do they do for private practices? A compliance officer has many duties, with their primary responsibility being to ensure the practice meets all legal compliance requirements. Compliance officers do this in various ways, with one of their main duties being to create programs to ensure the practice complies with relevant regulations.
Compliance officers are also responsible for educating practice employees on the importance of compliance and providing training to ensure everyone is familiar with regulations and policies. It’s up to the officer to address, investigate, and develop corrective action when a compliance issue arises.
Why Do I Need a Compliance Officer?
Every healthcare practice, big and small, needs a compliance officer to ensure adherence to regulations like OSHA, prevent security breaches, and ensure all paperwork regarding insurance and billing meets federal and state compliance standards. Unfortunately, private medical practices are prime opportunities for unethical conduct as they often have limited oversight, so your private practice needs to conduct its oversight by hiring a compliance officer.
Deceptive billing practices are one of the most common forms of unethical conduct in medical practices, as many will overbill, provide duplicate charges, or use other methods to scam patients and insurance providers. A compliance officer helps prevent these shady practices by identifying and correcting them.
Who Should Be the Compliance Officer?
One of the most common mistakes private medical practices make is designating the owner or an existing employee with no experience as a compliance officer. Too often, a compliance officer is seen by practice owners as a meaningless title to put on paperwork, but it’s incredibly important that the compliance officer be an educated and certified professional.
A compliance officer should have certain education and qualifications, like a Certified Compliance and Ethics Professional certification. There’s much to know to be an effective compliance officer, like the anti-kickback statute and other relevant laws and regulations regarding private practices. The designated employee or owner without compliance experience and knowledge will likely face more significant penalties if legal bodies find their practice is non-compliant.
Do yourself and your practice a favor by hiring an educated compliance professional or outsourcing compliance to a professional firm.