For Providers

Compliance

Standards for Healthcare Compliance

We take compliance very seriously at Derma Vivere, not only for our organization but for the healthcare organizations that partner with us. Compliance is a driving force behind our patient outcomes, business operations, and employee code of conduct. Derma Vivere maintains a strong compliance program led by our Director of Compliance and supported by the Compliance committee, which is comprised of team members from legal, billing, finance, and technology, including compliance industry experts.

DV follows the voluntary standards for healthcare compliance set by the OIG (Office of the Inspector General).

N

Conduct Internal Monitoring and Auditing

N

Implement Compliance and Practice Standards

N

Designate a Compliance Officer or Contact

N

Conduct Appropriate Training and Education

N

Respond Appropriately to Detected Offenses and Develop Corrective Action

N

Develop Open Lines of Communication with Employees

N

Enforce Disciplinary Standards Through Well-publicized Guidelines

Compliance with Derma Vivere

In addition to meeting OIG standards, we developed and abide by processes tailored to address risk areas throughout our wound healing continuum of care.

Z

Regulatory Compliance

We ensure adherence to local, state, and federal regulations governing healthcare services, including specific regulations related to wound healing. This includes compliance with laws such as the Health Insurance Portability and Accountability Act (HIPAA), other relevant healthcare regulations, and the OIG voluntary compliance (identified above).

Z

Billing and Coding Compliance

Accurate and ethical billing practices, including proper coding for wound healing services. Compliance with healthcare reimbursement regulations and policies to avoid negative legal and financial consequences

Z

Data Privacy and Security

HITRUST and HIPAA security protocols to safeguard electronic health information.

Z

Patient Rights and Privacy

Respecting and protecting patient rights, including privacy and confidentiality. Compliance with HIPAA privacy laws.

Z

Monitoring and Auditing

Conducting regular internal audits and monitoring activities to assess the compliance program’s effectiveness. Training team members to identify any areas of non-compliance.
Z

Risk Assessment and Management

Conducting periodic risk assessments to identify areas of potential compliance risk within the organization, including the development of strategies to mitigate identified risks.
Z

Documentation and Record Keeping

Proper documentation of patient care, treatment plans, and outcomes is essential. Compliance involves maintaining accurate and complete records as required by regulatory bodies, insurance providers, and internal policies.
Z

Staff Training and Competency

Ensuring that healthcare professionals and staff members involved in wound healing are trained, qualified, and competent. This includes ongoing education to stay current with best practices and advancements in wound healing.
Z

Ethical Practices

Upholding ethical standards in the delivery of wound healing services, which includes transparency, honesty, and fairness in interactions with patients, families, and other stakeholders.
Z

Regulatory Training and Education

  • Regular training programs for employees to ensure they are aware of relevant laws, regulations, and organizational policies.
  • Training should cover topics like HIPAA regulations, anti-fraud measures, and any other pertinent compliance areas.
Z

Continuous Improvement

  • Regularly reviewing and updating the compliance program to adapt to changes in laws, regulations, and industry standards. Learning from past incidents to improve future compliance efforts.
  • Wound Healing corporate compliance is a multifaceted effort that requires collaboration across various departments within a healthcare organization.
  • The benefits of an effective compliance program include increasing the submission and payment of claims, reducing billing errors, avoiding the potential for fraud, waste, and abuse, promoting patient safety and quality of care, and providing protection against government enforcement action.
  • Not having a compliance program – or an ineffective one–increases the risk that the government will bring an enforcement action against the organization for failure to comply with federal healthcare laws. The government has many tools to address non-compliance, including exclusion or termination from the Medicare program, lawsuits under the US False Claims Act, Civil Monetary Penalties, disallowances and recovery of payments, and criminal prosecution.

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