Our medical billing and revenue cycle management industry is evolving continually. Our companies must be adding expertise, implementing more technology, generating new ideas, and finding operational efficiencies to keep up with competition, pricing pressure, and ever growing client needs and demands. In such an intense environment, it is easy to lose track of the details. It is also often difficult to distinguish our services from those.

However, one significant factor that can set our companies apart and show we have moved beyond “billing” into our new world of RCM and more is the level of compliance and security that we have solidified in our daily processes, as well as our overall corporate philosophy and approach. Recognizing this, I engaged with our HMBA vendor partner, the Healthcare Compliance Pros, to embark on the journey to achieve the HBMA Compliance Accreditation. My initial evaluation showed the per FTE model to be a cost-effective way to move into full compliance while keeping my budget tight and internal team focused on daily billing responsibilities for our clients.

To this point, in my own company’s compliance efforts, we had developed and implemented a comprehensive compliance plan as well as maintained an active compliance committee for monitoring internal activities and keeping updated on official requirements. However, with the speed of business these days, my concern was not with the strength of our efforts but rather in the information overload that was occurring trying to stay abreast of current regulations or what exposure we may have to risks that we were not even aware existed. As a small- to mid-size RCM company, I was also concerned that regularly scheduled committee meetings, formal minutes, and follow-up tasks could get overlooked in light of prioritizing everyday revenue- generating work. Compliance is not a place where today’s RCM company can afford to relax their standards.

Working through the accreditation process has been simple and effective. It is a self-paced, staged, gradual, and customized process. I was relieved to learn that all our existing compliance information could be incorporated into the HCP platform, so all our efforts to this point were not in vain and all our prior records were retained. We have continued to progress through the list of requirements with the assistance of helpful HCP representatives for training, questions and answers, and periodic check-ins to keep us moving forward. Regular reminders are emailed as needed monthly and/or quarterly to keep compliance information up to date and recurring events on the schedule. As we progress with completing each accreditation standard, we receive additional reminders to keep them on track so the program builds on itself and you can continue to meet HIPAA and OIG essentials to maintain the proper level of compliance.

In a recent HBMA Snap Survey, we found that 64 percent of members who responded provide compliance training for clients. The HBMA Compliance Accreditation program is a great way to add credibility and validity to these services, as well as provide clients with more comprehensive assistance. Additionally, 71 percent of respondents provide coding compliance to clients. Included in the HCP package is the ability to ask questions and get advice and consulting to avoid other outside costs, legal fees, etc. while providing these expanded business services to clients.  And without surveying, it is fair to say that 100 percent of our companies cannot afford the risks associated with a compliance violation, both financially or to our corporate reputations. I encourage all of you to explore the HBMA Compliance Accreditation program, a great member value. Several members are already completing and being awarded the accreditation seal and certificate and, as a result, are achieving a higher level within the RCM community.

How well does your compliance program measure up? Begin the HBMA Compliance Accreditation process and find out. Already involved? What stories do you have to share about the accreditation process? HBMA wants your feedback.

– Mick Polo, CHBME, HBMA President