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Compliance Program Services

The healthcare rules, regulations and guidelines that apply to documentation, coding, coverage, medical necessity and claims submission are numerous and complex, and the financial and reputational risk to providers for non-compliance is too great to measure. Our certified coding, compliance, and clinical experts have over 40 years of experience acquiring the critical skills necessary to provide your organization with invaluable assistance at every step in the coding and compliance process.

Our diverse range of experience ensures you get the expert help you need. We have provided coding, compliance, and clinical services to hospitals (both inpatient and outpatient) and physician practices including anesthesia, cardiology, dermatology, emergency medicine, family practice, gastroenterology, internal medicine, OB-GYN, pediatrics, pain management, pathology, radiology, and wound care, as well as durable medical equipment providers and third-party billing companies.

We work collaboratively with every client to ensure:

  • Individual, custom solutions that meet your needs, whether your project is brief or a large, multi-year contract.
  • Superior work, responsiveness, and the highest level of respect and appreciation.
  • Projects work with your budget and organizational needs.
  • No details are overlooked. We find ways to help you reduce risk in your compliance program while helping you identify areas of potential revenue that you may have overlooked.
  • Your organizational mission is supported by the careful work we provide as a matter of course.

Depending on your needs and budget, we work closely with you to determine how best we can support your organization. We offer monthly, quarterly and annual package services to supplement and support your internal resources and also offer a comprehensive menu of coding and compliance related services on an as-needed basis.

Our main compliance services include:

  • Customized Education and Training
  • Policy and Procedure Review and Development
  • Independent Employee Surveys
  • Statistical and Non-Statistical Sampling
  • Ongoing Consulting and Support

Customized Education and Training

Education and training is a required component for an effective compliance program. Ensuring employees are educated based on the most current regulatory guidance and industry best practices is essential for achieving financial and compliance success. We offer customized education and training to coding, billing, clinical and administrative staff based on the unique needs identified internally or the specific findings discovered through one of our review services. Every educational session is designed to be interactive and incorporates meaningful case examples. We have the capabilities to provide these sessions through telephone or web conference or in person based on your needs.

Policy and Procedure Review and Development

Well-designed policies and procedures are the foundation for building an organization’s financial and compliance success. Your policies and procedures should communicate your commitment to compliance, risk mitigation, operational efficiency, and adherence to industry best practices. Understanding the importance of well-developed policies and procedures as an essential component of an effective compliance program, our team of experts is available to work with you to review, revise, or develop policies and procedures based on the individualized needs and risks of your organization.

Independent Employee Surveys

Open lines of communication and measuring compliance effectiveness are fundamental components of a compliance program. The use of confidential employee surveys can be an invaluable tool to identify your organization’s perceived strengths, weaknesses, and risk areas. Our experts will work with you to develop and conduct web-based, anonymous, customized employee surveys. We compile the results and provide detailed, easy-to-read reports along with recommendations to improve future performance.

Statistical and Non-Statistical Sampling

We provide statistical sampling services including  identification of the relevant population, reviews of population integrity, sample size optimization and risk, and confidence and precision levels. In performing these services, we use masters-level statisticians to assist in all phases of the sampling process. HBE Advisors adheres to both industry and government protocols regarding sample selection, evaluation, and documentation.

Ongoing Consulting and Support

In addition to our project-based services, we offer access to our team of revenue cycle, coding, and compliance experts on an as-needed basis. Our support services are customized to your specific needs and may include a variety of consulting, support, and review services. We provide you with timely, reliable responses and recommendations based on the most current authoritative guidance.

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