Risk Management
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Assignment:
As a practice manage or CMAA in a clinic or physician practice, you are responsible for ensuring that job performance is in compliance with regulatory agency guidelines. There are many areas of compliance that a healthcare professional must be familiar with: financial risk, local and state regulations, Occupational Safety and Health Administration (OSHA), transmission and release of information, HIPAA guidelines, patient care procedures, and prevention of medical errors. For this discussion, you will research and write about the following topics:
- Identify and discuss 3 compliance risks.
- Indicate the consequences of not meeting these requirements.
- What guidelines or policies should be followed by CMAAs and all practice staff to prevent non-compliance with these requirements.
Expert Solution Preview
Introduction:
As a medical professor in charge of creating assignments and answers for medical college students, I understand the importance of compliance with regulatory agency guidelines in the healthcare industry. In this assignment, I will discuss compliance risks, consequences of not meeting requirements, and guidelines/policies that should be followed by Certified Medical Administrative Assistants (CMAAs) and practice staff to prevent non-compliance.
1. Identify and discuss 3 compliance risks.
There are various compliance risks that healthcare professionals should be familiar with. Three important compliance risks are:
a) Financial Risk: This risk involves not following accurate coding and billing procedures, resulting in incorrect and inflated claims submission. This can lead to financial loss and legal action against the healthcare practice.
b) HIPAA Guidelines: Non-compliance with HIPAA guidelines can result in a breach of patient privacy and confidentiality. This can result in legal action, hefty fines, and loss of reputation for the healthcare practice.
c) Occupational Safety and Health Administration (OSHA): OSHA compliance is crucial to ensure a safe work environment for employees and prevent work-related injuries. Non-compliance with OSHA regulations can lead to legal action and penalties.
2. Indicate the consequences of not meeting these requirements.
There are severe consequences of not meeting compliance requirements. For instance:
a) Financial Risk: Non-compliance with financial regulations can result in legal action, financial loss, and loss of reputation for the healthcare practice.
b) HIPAA Guidelines: Breach of patient privacy and confidentiality can result in legal action, hefty fines, and a tarnished reputation for the healthcare practice.
c) OSHA: Non-compliance with OSHA regulations can result in legal action, hefty fines, work-related injuries, and a tarnished reputation for the healthcare practice.
3. What guidelines or policies should be followed by CMAAs and all practice staff to prevent non-compliance with these requirements?
To prevent non-compliance with regulatory agency guidelines, CMAAs, and all practice staff should:
a) Follow correct coding and billing procedures to avoid financial risk. Regular training on the latest coding and billing procedures can help ensure compliance.
b) Ensure that patient privacy and confidentiality are maintained by following HIPAA guidelines. Periodic training sessions for staff can help reinforce the importance of HIPAA compliance.
c) Ensure that the practice is compliant with OSHA regulations. This can include providing adequate training, maintaining compliance records, and having a designated safety officer.
In conclusion, healthcare professionals must remain vigilant and up-to-date with regulatory agency guidelines to ensure compliance. CMAAs and all practice staff play a crucial role in maintaining compliance by following guidelines and policies to prevent non-compliance.
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