JNC Healthcare Compliance Group

JNC Healthcare Compliance Group JNC Healthcare Compliance Group provides healthcare advisory services to small and medium-sized medical, dental, and behavioral health practices nationwide.
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JNC Healthcare Compliance Group provides healthcare advisory services to small and medium-sized medical, dental, and behavioral practices. Our services include implementation of billing/coding audits, compliance and practice standards, education, and training for all staff. Collectively, the team has over 20 years experience working for reputable healthcare organizations. Our advisors and auditors

JNC Healthcare Compliance Group provides healthcare advisory services to small and medium-sized medical, dental, and behavioral practices. Our services include implementation of billing/coding audits, compliance and practice standards, education, and training for all staff. Collectively, the team has over 20 years experience working for reputable healthcare organizations. Our advisors and auditors

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JNC Healthcare Compliance Group
07/03/2020

JNC Healthcare Compliance Group

JNC Healthcare Compliance Group's cover photo
05/03/2020

JNC Healthcare Compliance Group's cover photo

Tip: Evaluate CMS’s new enforcement authorities to reduce fraudulent behavior.On Sept 5, 2019, CMS announced new enforce...
09/16/2019

Tip: Evaluate CMS’s new enforcement authorities to reduce fraudulent behavior.

On Sept 5, 2019, CMS announced new enforcement authorities to reduce fraud within Medicare, Medicaid, and CHIP.

The new authorities and restrictions will be effective by November 4, 2019, in which CMS can revoke or deny the enrollment application due to the following:

• A provider or supplier circumvents program rules by coming back into the program, or attempting to come back in, under a different name (e.g., the provider attempts to “reinvent” itself);
• A provider or supplier bills for services/items from non-compliant locations.

To review the other two restrictions and tip, click “Compliance Tips & Resources” in the bio/about link!

P.S. Don’t forget to hit the save button, tag a colleague, book a free appointment, or grab our compliance kit (see bio/about)! Our 2019 motto: It’s time to enact!

Tip: Enforce disciplinary standards through well-publicized guidelines.In element six, we discussed promoting open lines...
08/12/2019

Tip: Enforce disciplinary standards through well-publicized guidelines.

In element six, we discussed promoting open lines of communication, which is part of the 7 Elements of an Effective Compliance Program. However, we end this series by advising you to enforce disciplinary standards and well-publicized guidelines within your practice.

Every practice must promote credibility and integrity within their compliance program, which should come in the form of a written statement that is visible and explained thoroughly to your staff.

To review the rest of the tip, click “Compliance Tips & Resources” in the bio/about link!

P.S. Don’t forget to hit the save button, tag a colleague, book a free appointment, or grab our compliance kit (see bio/about)! Our 2019 motto: It’s time to enact!

Tip: Develop open lines of communication. Open communication between staff, patients, and patients’ family is essential ...
08/07/2019

Tip: Develop open lines of communication.

Open communication between staff, patients, and patients’ family is essential when building an effective compliance program.

Did you know communication failures account for 30% of the malpractice cases? Per CRICO Strategies, this is equivalent to nearly 2,000 patient deaths that can be avoided if medical staff improved their communication.

As management, you can avoid this by enacting the sixth element of the 7 Elements of an Effective Compliance Program, which is developing open lines of communication.

This includes publicizing your “open door” policy through meetings, email, bulletin boards, brochures, etc. Also, you must assign specialized staff to investigate reported issues, and to talk to your team, without retaliation.

To see various reporting mechanisms, click “Compliance Tips & Resources” in the bio/about link!

P.S. Don’t forget to hit the save button, tag a colleague, book a free appointment, or grab our compliance kit (see bio/about)! Our 2019 motto: It’s time to enact!

Tip: Respond appropriately to detected offenses and develop corrective action plans within your practice.As discussed in...
08/05/2019

Tip: Respond appropriately to detected offenses and develop corrective action plans within your practice.

As discussed in our previous tip, we shared the 7 Elements of an Effective Compliance Program. Our focus has shifted to the fifth element, which is responding appropriately to detected offenses and developing corrective action plans are critical.

When a compliance incident occurs, the first step is to ensure the compliance officer or designated employee(s) review the allegation to determine whether it is a violation and/or if corrective action can be pursued.

Always proceed with caution and investigate thoroughly before making any final decisions because it may be a misunderstanding due to unclear rules or guidelines.

To review how to handle internal vs. external warnings, click “Compliance Tips & Resources” in the bio/about link!

P.S. Don’t forget to hit the save button, tag a colleague, book a free appointment, or grab our compliance kit (see bio/about)! Our 2019 motto: It’s time to enact!

Tip: Conduct appropriate training and educate your entire practice regarding compliance regulations.In our last tip, we ...
07/19/2019

Tip: Conduct appropriate training and educate your entire practice regarding compliance regulations.

In our last tip, we discussed the 7 Elements of an Effective Compliance Program, in which we would like to add the importance of conducting appropriate compliance training and education for all staff.

As shared in our blog, just like you have protective measures in place to prevent malpractice suits, the same goes within the non-clinical setting (e.g., coding policies, waiting room policies).

You can no longer tell the government “we didn’t know” because they provide numerous resources to assist you.

Since compliance is comprehensive, the first step is treating it like a class, just like your medical studies.

Remember, all educational programs are tailored to your practice risk areas, and training is specific to specialty and size. The OIG suggests three steps to set up educational objectives….

To review the educational objectives, click “Compliance Tips & Resources” in the bio/about link!

P.S. Don’t forget to hit the save button, tag a colleague, book a free appointment, or grab our compliance kit (see bio/about)! Our 2019 motto: It’s time to enact!

Tip: Designate a compliance officer or contact that will assist you with building an effective compliance program. In th...
07/16/2019

Tip: Designate a compliance officer or contact that will assist you with building an effective compliance program.

In the last few tips, discussed the 7 Elements of an Effective Compliance Program, in which designating a compliance officer or contact is another element that should be considered.

As recommended by the OIG, each healthcare entity should:

•Hire a compliance officer;
•Split tasks among employees;
•Designate one person from the practice to correspond with an outsourced compliance officer or consultant.

The OIG acknowledges that practices may not have the funds to hire a compliance officer or consultant, which is why they suggest utilizing current employees to build an effective program.

As you are designating a compliance officer or an employee, make sure they are knowledgeable in several areas, such as business administration, clinical practices, coding, billing, reimbursement, and more.

To learn more about designating compliance officer’s/contact, click “Compliance Tips & Resources” in the bio/about link!

P.S. Don’t forget to hit the save button, tag a colleague, book a free appointment, or grab our compliance kit (see bio/about)! Our 2019 motto: It’s time to enact!

Tip: Implement compliance and practice standards.As shared in our previous tip, all practices should follow the 7 Elemen...
07/15/2019

Tip: Implement compliance and practice standards.

As shared in our previous tip, all practices should follow the 7 Elements of an Effective Compliance Program, in which implementation of compliance and practice standards is a necessity after the internal audit is performed.

An OIG best practice is to ensure that every healthcare entity has a compliance manual in place so that employees are aware of the expectations.

One of our rules is making sure that this manual or electronic file is available. And, as the OIG puts it “doesn’t sit on the shelf to collect dust.” Always continue to update the manual to ensure new and old staff, are aware of the changes and expectations to uphold compliance standards.

The OIG also has suggestions of the type of risks that should be communicated within the compliance manual. A good example of risk factors are....

To learn more about the risk factors, click “Compliance Tips & Resources” in the bio/about link!

P.S. Don’t forget to hit the save button, tag a colleague, book a free appointment, or grab our compliance kit (see bio/about)! Our 2019 motto: It’s time to enact!

Tip: Ensure that your practice is conducting internal monitoring and auditing regularly. As stated in our previous tip, ...
06/24/2019

Tip: Ensure that your practice is conducting internal monitoring and auditing regularly.

As stated in our previous tip, it is important that all practices follow the 7 Elements of an Effective Compliance Program, in which conducting internal monitoring and auditing is critical.

There are two types of audits that the OIG suggest be performed by each practice, called:

Standard and Procedures

The OIG recommends physician practices review standards and procedures to determine if they are current and complete. The best way to do this is to review the OIG website, work plan, or any other compliance guidance’s to assist with identifying any risk areas the practice will encounter.

Insurance companies and healthcare associations are also good resources for updated information, especially for CPT and ICD-10 changes. Keep in mind a well-publicized audit plan will also let staff know how serious practice management is about complying with federal and state regulations.

To learn more about the second type of audit, click “Compliance Tips & Resources” in the bio/about link!

P.S. Don’t forget to hit the save button, comment, tag a colleague, or grab our free kit (see bio/about)! Our 2019 motto: It’s time to enact!

If you have been following us for a while, we are a big fan of surveying employees and patients regularly.  The informat...
06/11/2019

If you have been following us for a while, we are a big fan of surveying employees and patients regularly. The information gained from these surveys will assist you with building or improving your compliance programs.

SAI Global also states for credible and useful results consider using an independent source to ensure the confidentiality of participants. They observed:

• There are two general types of surveys that can be employed to evidence compliance program effectiveness: compliance culture surveys and compliance knowledge surveys. However, respondents clearly favor developing and administering surveys internally. This is not a best practice.

Do you plan to enact surveys in 2019? If so, will you consider using independent survey sources?

-Joi Sherrod, MPH, CPC, CPCO (Owner/Advisor)

SAI Global 2018 Healthcare Compliance Benchmark Report:https://compliance.com/wp-content/uploads/2018/05/SAI-Global-2018_Healthcare_Compliance_Benchmark_Report.pdf

P.S. Don’t forget to hit the save button, comment, tag a colleague, or grab our free kit (see bio/about)! Our 2019 motto: It’s time to enact!

Tip: Interpret and apply the “7 Elements of an Effective Compliance Program” for individual and small group physician pr...
06/11/2019

Tip: Interpret and apply the “7 Elements of an Effective Compliance Program” for individual and small group physician practices.

The goal of the OIG compliance guidance is to make sure the patient is priority. And, in our previous tip we highlighted the Compliance Program Guidance for Individual and Small Group Physician Practices.

In their documents, the OIG expresses the importance of a well-designed plan which will be integral to reducing medical errors, better medical record documentation, enhanced patient outcomes, and much more.

They believe that a great majority of physicians are honest and want to protect the integrity of government healthcare programs. However, creating a good compliance plan lets the OIG see that you are putting a “good faith effort” to submit claims appropriately, which in turn can reduce extensive investigations or even fines.

Also, an effective compliance plan allows the community to see that you care about making sure you are compliant and effectively protecting their information……

To learn more about the “7 Elements of an Effective Compliance Program,” click “Compliance Tips & Resources” in the bio/about link!

P.S. Don’t forget to hit the save button, comment, tag a colleague, or grab our free kit (see bio/about)! Our 2019 motto: It’s time to enact!

Tip: Discuss the Exclusion Statute with your management team.  And, check the exclusion list (LEIE) at least monthly. Wh...
06/10/2019

Tip: Discuss the Exclusion Statute with your management team. And, check the exclusion list (LEIE) at least monthly.

What is the Exclusion Statute?

Per the OIG, under the Exclusion Statute, they have the authority to exclude individuals and entities from Federally funded health care programs.

When the individual or entity is excluded, this means they can no longer receive payments from any federal government programs for any items or services they furnish, order, or prescribe.

What are mandatory exclusions?

The following are considered mandatory exclusions under this statute:

• Medicare or Medicaid fraud, as well as any other offenses related to the delivery of items or services under Medicare or Medicaid.

• Patient abuse or neglect.

• Felony convictions for other health care-related fraud, theft, or other financial misconduct

• Felony convictions for unlawful manufacture, distribution, prescription, or dispensing controlled substances

To learn more about the Exclusion Statute, click “Compliance Tips & Resources” in the bio/about link!

P.S. Don’t forget to hit the save button, comment, tag a colleague, or grab our free kit (see bio/about)! Our 2019 motto: It’s time to enact!

As shared in our previous tip, a survey by Insider Data Breach asked more than 4,000 employees their thoughts on data br...
06/04/2019

As shared in our previous tip, a survey by Insider Data Breach asked more than 4,000 employees their thoughts on data breaches and acceptable behaviors when sharing data.

To reduce this percentage, teach employees to give their full attention to security awareness and ask that they double-check who they are sending information too.

If you want to assist, create a security checklist. Checklists are a great tool to protect patient data.

-Joi Sherrod, MPH, CPC, CPCO (Owner/Advisor)

SAI Global 2018 Healthcare Compliance Benchmark Report:https://compliance.com/wp-content/uploads/2018/05/SAI-Global-2018_Healthcare_Compliance_Benchmark_Report.pdf

P.S. Don’t forget to hit the save button, comment, tag a colleague, or grab our free kit (see bio/about)! Our 2019 motto: It’s time to enact!

Tip: Review the Stark Law and examine your referral relationships with designated health entities. In our previous tip, ...
06/04/2019

Tip: Review the Stark Law and examine your referral relationships with designated health entities.

In our previous tip, we discussed the importance of understanding the Anti-Kickback Statute (AKS), which is slightly like the Stark Law.

However, let’s dive in on what this law entails:

What is the Stark Law?

Under this law, it prohibits a physician from making a referral for certain designated health services payable by Medicare or Medicaid to an entity in which the physician or an immediate family member, has an ownership/investment interest or with which he or she has a compensation arrangement, unless an exception applies.

What is the difference between the Stark Law and Anti-Kickback Statute (AKS)?

• Difference #1: The Stark Law is a civil enforcement statute, unlike AKS.

• Difference #2: The Stark Law only applies to Medicare and Medicaid. AKS applies to all Federal health care programs.

To see the additional differences, examples, penalties, and exceptions, click “Compliance Tips & Resources” in the bio/about link!

P.S. Don’t forget to hit the save button, comment, tag a colleague, or grab our free kit (see bio/about)! Our 2019 motto: It’s time to enact!

Tip: Examine the Anti-Kickback Statute (AKS) and determine whether your practice is in violation. The Anti-Kickback Stat...
06/03/2019

Tip: Examine the Anti-Kickback Statute (AKS) and determine whether your practice is in violation.

The Anti-Kickback Statute can be difficult for practices to understand if one doesn’t know the exact definition or requirements.

Therefore, allow us to break it down and explain the following:

What is the Ant-Kickback Statute?

Under this law, it is a crime to knowingly and willfully offer, pay, solicit, or receive any remuneration directly or indirectly to induce or reward referrals of items or services reimbursable by a Federal health care program.

Per CMS, remuneration includes anything of value, such as:

• Cash
• Free rent
• Expensive hotel stays
• Free meals
• Excessive compensation for medical directorships or consultancies

Also, don’t forget to review your state regulations regarding AKS.

How does AKS affect healthcare?

As shared by the OIG, kickbacks in healthcare can lead to:

• Overutilization
• Increased program costs
• Corruption of medical decision-making
• Patient steering
• Unfair competition

To see more about this statute with examples, click “Compliance Tips & Resources” in the bio/about link!

P.S. Don’t forget to hit the save button, comment, tag a colleague, or grab our free kit (see bio/about)! Our 2019 motto: It’s time to enact!

As shared in our previous tip, the OIG is big on auditing and monitoring your compliance program.  In fact, they suggest...
05/30/2019

As shared in our previous tip, the OIG is big on auditing and monitoring your compliance program. In fact, they suggest that baseline audits/assessments are performed annually to ensure you have an effective compliance program.

Sadly, these results show that we have a long way to go and it’s time to shift our mindset when it comes to auditing and monitoring compliance programs.

I agree with the SAI Global survey when they state management can’t audit their own program for effectiveness, in which I suggest hiring consultants in 2019.

What are your thoughts about hiring consultants to assist?

-Joi Sherrod, MPH, CPC, CPCO (Owner/Advisor)

SAI Global 2018 Healthcare Compliance Benchmark Report:https://compliance.com/wp-content/uploads/2018/05/SAI-Global-2018_Healthcare_Compliance_Benchmark_Report.pdf

P.S. Don’t forget to hit the save button, comment, tag a colleague, or grab our free kit (see bio/about)! Our 2019 motto: It’s time to enact!

Today is my mother’s birthday.  As I celebrate her life and accomplishments, I am reminded of how important it is to kee...
05/29/2019

Today is my mother’s birthday.

As I celebrate her life and accomplishments, I am reminded of how important it is to keep going even when faced with adversity.

My mom battled lupus most of my life as she worked in the healthcare field.

But, even when living with her illness was tough, she was still determined to connect with her patients and co-workers to fulfill her calling and purpose.

I want to encourage you and say: “You didn’t come this far to only come this far.”

I always say healthcare professionals are one of the most selfless people I know who truly want to help people.

I know you may get tired of the compliance changes, documentation requirements, employee troubles, personal issues, etc.

And, I know, including myself, we hope for a perfect road with no setbacks.

But, sometimes our breakthrough moments are hidden in our tribulations.

Friends, if you are frustrated with your work life, don’t forget to use this time to get in your quiet place and self-reflect on why you chose this field, and what changes you can make to continue in your purpose.

And, to my mother, I thank God for you every single day. Thank you for instilling in me what it truly means to love healthcare and how to keep going when faced with adversity.

I love you and Happy Birthday.

-Joi Sherrod, MPH, CPC, CPCO (Owner/Advisor)

P.S. Don’t forget to hit the save button, comment, tag a colleague, or grab our free kit (see bio/about)! Our 2019 motto: It’s time to enact!

Address

3355 Lenox Road, Suite 1000
Atlanta, GA
30326

Opening Hours

Monday 9am - 5pm
Tuesday 9am - 5pm
Wednesday 9am - 5pm
Thursday 9am - 5pm
Friday 9am - 5pm

Telephone

(888) 691-0440

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JNC Healthcare Compliance Group provides healthcare advisory services to small and medium-sized medical and dental practices nationwide. Our services include implementation of billing/coding audits, compliance and practice standards, education, and training for all staff. Collectively, the team has over 20 years experience working for reputable healthcare organizations. Our advisors and auditors are skilled in a wide array of specialties with an in-depth understanding of the private and hospital sector. We have extensive knowledge in front-desk operations, billing/coding, accounts receivables follow-up, and revenue cycle management to ensure compliance from front to back office. The healthcare field is continuously changing. Let us embrace the changes by monitoring current trends and introduce improved training materials to educate your entire office. Our goal is to keep your practice in the loop and provide peace of mind, so your main focus is on patient care.

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