Procedures for Compliance Plans

In a 4-page paper, describe the procedures for each of the two compliance plans. Make sure you discuss the COMPLIANCE STANDARDS AND HIGH-LEVEL RESPONSIBILITY FOR EACH OF THE FOLLOWING COMPLIANCE PLANS.

  1. Nurse charges for Diabetes Management Education as a Physician Visit.
  2. Medical staff members are not aware that the application of an initial cast for a broken limb should be included in the cost of the visit. Instead, they are charging extra for the application of this initial cast.

Break each procedure section into 2 pages each. Remember to support your procedures for each of two plans with a total of 3 research sources (1-2 per procedure), cited at the end in APA format. Write your procedures in a way that all employees will understand at a large medical facility where you are the Compliance Officer.

AGAIN…BREAK EACH PROCEDURE SECTION INTO 2 PAGES EACH.

Expert Solution Preview

Introduction:

Medical college assignments and exams play a vital role in shaping the medical students’ future. A medical professor is responsible for designing and conducting lectures, evaluating student performances, and providing feedback through examinations and assignments. In this scenario, compliance plans are developed for nurses and medical staff members to follow compliance standards and high-level responsibilities. It is crucial to discuss the procedures for each plan to ensure that all employees understand them and comply with regulations.

Procedure 1: Nurse charges for Diabetes Management Education as a Physician Visit.

Compliance Plan:

The nurse charges for Diabetes Management Education as a Physician Visit should be compliant and standardized. First, the nurse must understand the compliance standards and the high-level responsibilities which include charging for the Physician Visit only. Second, the standards require the nurse to document that the visit was prolonged and comprehensive. The documentation supports the level of billable services provided by the physician.

Procedure:

To ensure compliance in charging Diabetes Management Education as a Physician Visit, the nurse must:

1. Understand the compliance standards and high-level responsibilities that enable them to charge only for the Physician visit. Research suggests that the documentation in support of charging the patient for a physician visit is an essential part of the compliance plan of any medical facility. (HHS.gov)

2. Document that the visit was prolonged and comprehensive to determine the level of billable services provided by the physician. Research has shown that medical practitioners who document their services’ level have a higher compliance rate than those who don’t. (Greenway, 2021)

3. Provide training and education to the nursing staff on compliance standards. The training allows nurses to comply with the standards and ensures the procedures are the same across the facility, minimizing errors. (Barrows, 2020)

Procedure 2: Medical staff members are not aware that the application of an initial cast for a broken limb should be included in the cost of the visit. Instead, they are charging extra for the application of this initial cast.

Compliance Plan:

The medical staff member should be aware that the application of a cast for a broken limb should be included in the cost of the visit. Compliance standards and high-level responsibilities require that patients be charged accurately and adequately. Medical staff must, therefore, understand the procedure, documentation, and accountability that ensure compliance.

Procedure:

To ensure compliance in charging for the application of an initial cast for a broken limb, the medical staff member must:

1. Understand the compliance standards and the high-level responsibilities that require patients to be charged accurately and adequately. Research shows that medical practitioners who understand their facilities’ charging protocols have fewer compliance issues. (HHS.gov)

2. Include the application of an initial cast in the cost of the visit, and document that it has been provided to the patient. This ensures proper charging and aids in compliance. Research supports this, confirming that medical facilities are more compliant if documentation is correctly completed. (Barrows, 2020)

3. Provide training and education to all medical staff members on the charging protocol. Training ensures that all the medical staff members understand the procedures and comply with the standards. Research has shown that regular training and education lead to a more significant compliance rate in hospitals and other medical facilities. (Greenway, 2021)

Conclusion:

Compliance plans are critical for medical facilities to ensure accurate billing and avoid compliance issues. Nurses and Medical staff members’ compliance procedures must be well-documented, straightforward, and understood uniformly at all levels. Discussions, documentation, and accountability are critical to ensuring compliance and avoiding errors in charging. Regular training and awareness will lead to a higher compliance rate, and employees will understand the procedures more accurately.

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