How Does KMC University’s OIG Compliance Program Work?

KMC University’s online Library is renowned in the profession for the quality, scope, depth, and breadth of its curriculum and support. It is constantly updated and stays on the cutting edge of healthcare reimbursement and compliance. The OIG Compliance Program Implementation and Oversight adds more than 10 additional courses and a supercharger, the KMCU certified specialist, to the basic Library subscription.

Between your assigned, certified specialist and your appointed Compliance Officer and providers, the program is customized specifically for your practice needs. During this 12-month program, your OIG compliance needs are essentially outsourced to our compliance team. Because our compliance team is certified and trained, we will serve as your compliance officer during this time, taking the anxiety and worry off your shoulders.

Here is what we will do:

• Perform your Initial Baseline Analysis which will include the following:
  • Baseline Audit and report including error rates – Minimum of 5 charts per provider
  • Practice Performance Profile and report – includes practice fee analysis, a 3-year statistical analysis, and 6-month coding audit
  • Explanation Of Benefits audit and report – random review of 15 varied EOBs (Explanation of Benefits) with commentary
• Review any existing policy and procedure and oversee implementation of new, required, personalized policy and procedure to fill gaps as areas of correction are applied
• Implement the 8 steps of OIG compliance, as required, with your team doing the boots-on-the-ground assistance during the ongoing coaching calls, which we expect to be in live, video calls 2-4 hours per month
• Provide on-demand answers to your questions and emails as needed outside of the scheduled calls
• Perform the function of being your compliance officer during this period, while taking you under our wing to train you on what is necessary to do going forward. If you decide you would like us to continue in this role after 12 months, we are happy to do so and can discuss costs at that time.
• Oversee training of the team and physicians on the elements uncovered in the baseline audit
• Install and execute a compliance calendar for the practice, to keep up on the daily, monthly and annual requirements of fulfilment of the process
• Perform continuous monthly spot-check audits and additional audits necessary based on the error rate uncovered in the baseline audit
• Ongoing training and correction of the issues uncovered in the audits, and document the corrections
• Immediate response to detected offenses, incidents, or other concerns, while guiding you in how to correct and document them
• A slow hand-off to you as compliance officer as the one-year program ends, or a discussion about our staying on board and keeping this task

The intensive aspects of the compliance implementation are usually completed in the first six months of membership. Then, the next six months include not only the ongoing oversight, but also personalized training to ensure that issues that came up in the audits are corrected. Most practices cover the cost of compliance implementation and oversight for an entire year for about the cost of about 3 patient visits per week, assuming a Collected Visit Average of $50.

Some practices prefer a jump start to the program and baseline audit, and that is conducted in a one- or two-day onsite visit. If the practice decides to implement that, we can spread the cost of that over the months of membership, if desired.

The cost of compliance implementation pales when compared to the monetary and emotional costs of non-compliance and the subsequent fines, recoupments, and penalties. We promise to do most of the heavy lifting and make the process as smooth and trouble-free as we can. Get started now with a personal consultation to evaluate your specific needs