6 Elements of Private Medical Practice Compliance

Owning a private medical practice requires a lot of focus and dedication if you’re going to run it successfully. You are responsible for everything that goes on in your practice, ranging from the quality of the medical care provided to the well-being of your business. Among the most important areas, you should be focused on as a private medical practice owner is regulatory compliance. Compliance is necessary to ensure quality care for your patients and adherence to government laws and regulations. To ensure that your private medical practice stays on track and delivers on its promises, here are six key elements of regulatory compliance for you.

1. Kickback and Referral Compliance

To ensure physicians’integrity and their medical work, laws have been put in place to prevent kickbacks and referrals. The federal anti-kickback law mandates that healthcare professionals cannot accept any kind of reward in exchange for referrals. The federal Stark self-referral law mandates that a healthcare professional cannot refer a patient to a third party providing medical goods or services with which they have a financial relationship. Extending beyond the integrity of your practice, violation of these laws can be punished by hefty fines or even prison. A violation could also mean losing your license to practice, which is why compliance with these laws is vital for the continuation of your practice.

2. Billing & Health Insurance Compliance

Billing can get pretty hectic as your private practice grows, but that does not mean you can start getting sloppy. If you are not careful, you could find yourself, or staff members of your practice, engaging in billing fraud and abuse, particularly where health insurance is concerned. Failing to comply with health insurance regulations, such as Medicare and Medi-cal, could at least mean exclusion from participation in the program, if not legally implicate you. Because a lot of your patients will most likely be covered by health insurance, compliance is very important to ensure you get reimbursed for your work.

3. Staff Training & Supervision Compliance

You will find that a multitude of laws and regulations exist concerning the training and supervision of your staff. It is essential that you comply with all of them to ensure the continued safety of your business, as well as your staff. Taking on the HIPAA Exams Bloodborne training course is crucial to protect your team from potential exposure to bloodborne pathogens. Partnering with healthcare staffing solutions can further support this compliance by ensuring that trained professionals are not only knowledgeable but consistently follow established protocols The supervision of your staff, setting aside a compliance point of view, means that their work is revised for any faults and improves the quality of healthcare your practice provides.

4. Electronic Information Compliance

Safeguarding your patients’ health information should be one of your top priorities to ensure their privacy and the integrity of their records. More so, from a compliance point of view, multiple acts mandate industry-wide standards to protect your patients’ data from unauthorized access, including the Healthcare Information Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH). Your liability towards these acts extends to third-parties with whom you might need to share patient data, so make sure you obtain contractual assurances of their compliance as well. Furthermore, when selecting a secure communication method for your healthcare practice, carefully compare pricing for e-fax plans to find the best value. Reviewing the pricing and services provided can help you choose a cost-effective solution that meets compliance standards.

5. Accessible Healthcare Compliance

Part of what makes a quality healthcare system is its accessibility. The Emergency Medical Treatment and Labor Act (EMTALA) ensures this by providing patients with access to emergency services without the need to prove health insurance coverage or an ability to pay. Not only is compliance important for your practice, but it also protects the interests of patients in high-risk emergency situations. After all, if a person’s life is in danger the last thing you’d want to do is ask for insurance details. A number of other acts enabling accessibility and affordability also exist, for which compliance is important, such as the Americans with Disabilities Act, which protects the interests of patients with disabilities.

6. Publicizing & Monitoring Compliance

For medical practices, federal compliance mandates that clear policies and standards be publicized and monitored. What this means is that how you comply with all the different rules and regulations should be clearly communicated to both your staff and your patients. As you move forward, and to ensure that compliance is actually happening, you should audit, monitor, and report on the happenings of your private practice.

Having your own private medical practice can be rewarding, as you make a name for yourself, forward your career, and work to help others medically. However, it is equally a huge responsibility and proportionally requires compliance with a large number of laws and regulations. By delivering on these six elements of compliance, you can be sure that your private medical practice is on its way to success.