Healthcare Compliance Excellence
Better Call Solutions maintains the highest standards of healthcare compliance, ensuring your practice meets all regulatory requirements while protecting patient data and maximizing reimbursement opportunities.
Our Compliance Framework
Comprehensive compliance services that protect your practice and ensure regulatory adherence
HIPAA Compliance
Full adherence to Health Insurance Portability and Accountability Act requirements, including Privacy Rule, Security Rule, and Breach Notification Rule implementation.
- Administrative safeguards
- Physical security measures
- Technical protections
- Employee training programs
- Business Associate Agreements
Coding Compliance
Accurate medical coding following ICD-10, CPT, and HCPCS guidelines to ensure proper claim submission and prevent fraud and abuse.
- Regular coding audits
- Documentation reviews
- Modifier usage verification
- Upcoding/downcoding prevention
- Annual code update training
Data Security
Advanced security protocols to protect sensitive patient information from unauthorized access, breaches, and cyber threats.
- 256-bit encryption
- Multi-factor authentication
- Regular security assessments
- Incident response planning
- Secure data backup systems
Fraud Prevention
Proactive monitoring and detection systems to prevent billing fraud, abuse, and waste in accordance with federal and state regulations.
- Claims pattern analysis
- Outlier detection
- OIG compliance programs
- False Claims Act adherence
- Anti-Kickback Statute compliance
Documentation Standards
Comprehensive documentation practices that support medical necessity, justify services rendered, and withstand audit scrutiny.
- Medical necessity verification
- Proper documentation training
- E/M documentation guidelines
- Progress note requirements
- Signature and authentication
Audit Support
Expert assistance during payer audits, Medicare/Medicaid reviews, and compliance investigations to protect your practice.
- Pre-audit preparation
- Response coordination
- Documentation compilation
- Appeal support
- Post-audit remediation
Regulatory Standards We Follow
Adherence to federal, state, and industry regulations ensures your practice remains compliant
Federal Regulations
HIPAA Privacy Rule
Protects patient health information privacy rights
HIPAA Security Rule
Safeguards electronic protected health information
False Claims Act
Prevents fraudulent billing to government programs
Anti-Kickback Statute
Prohibits improper referral arrangements
Stark Law
Restricts physician self-referral practices
HITECH Act
Strengthens HIPAA enforcement and breach notification
Industry Standards
CMS Guidelines
Medicare and Medicaid billing and documentation rules
OIG Compliance Program
Office of Inspector General best practices
AMA Coding Guidelines
American Medical Association CPT coding standards
NCCI Edits
National Correct Coding Initiative bundling rules
LCD/NCD Policies
Local and National Coverage Determination compliance
Payer-Specific Policies
Individual insurance company requirements
Our Compliance Process
A systematic approach to maintaining compliance throughout your revenue cycle
Assessment
Comprehensive review of current practices, policies, and procedures to identify compliance gaps and risk areas.
Implementation
Deploy compliance protocols, security measures, training programs, and documentation standards across all operations.
Monitoring
Continuous surveillance of billing activities, coding accuracy, and data security to detect issues early.
Improvement
Regular audits, staff training updates, and process refinement to maintain the highest compliance standards.
Compliance Risk Mitigation
Proactive strategies to minimize compliance violations and protect your practice
Billing Errors & Fraud
Implement dual-review coding processes, automated claim scrubbing, regular pattern analysis, and comprehensive staff training on fraud prevention.
Reduces claim rejection rates by 40% and eliminates fraudulent billing practices.
Data Breaches
Deploy enterprise-grade encryption, multi-factor authentication, intrusion detection systems, and regular security vulnerability assessments.
Protects patient PHI and prevents costly HIPAA violation penalties averaging $50,000 per breach.
Documentation Deficiencies
Establish clear documentation standards, conduct quarterly chart audits, provide targeted provider feedback, and use coding compliance checklists.
Ensures medical necessity justification and reduces audit risk by 60%.
Employee Non-Compliance
Require annual HIPAA training, implement compliance attestation protocols, conduct random audits, and establish clear disciplinary procedures.
Creates culture of compliance and reduces internal violations by 75%.
Compliance Resources & Training
Ongoing education and support to keep your team compliant and informed
Policy Templates
- HIPAA Privacy Policy templates
- Security Incident Response Plans
- Business Associate Agreements
- Employee confidentiality forms
- Compliance manual templates
- Sanction policy guidelines
Training Programs
- Annual HIPAA compliance training
- Coding accuracy workshops
- Fraud and abuse prevention
- Documentation best practices
- Privacy and security awareness
- Regulatory update seminars
Compliance Tools
- Self-audit checklists
- Risk assessment forms
- Breach notification protocols
- Compliance calendars
- Regulatory update alerts
- Documentation scorecards
Our Compliance Track Record
Proven results in maintaining compliance and protecting healthcare practices