Compliance Support Services (CSS) CSS Functions:
Fraud & Abuse Compliance Plan Development Assist the Practice in developing a plan for complying with applicable federal and state statutes, regulations, policies and procedures governing Medicare and Medicaid billing and reimbursement matters. Assiste the Practice in keeping their Fraud & Abuse Compliance Plan current and updated.
Compliance Plan ImplementationAssist the Practice in developing processes, procedures and business practices to effectively implement the Plan and adhere to Government Regulations.
Compliance Hot-Line Voice MailEstablish and maintain a dedicated telephone line to receive compliance related reports of potential fraud & abuse or HIPAA issues. Implement a process to protect the anonymity of complainants.
Training ServicesProvide annual training sessions for the Practice on issues such as the fraud and abuse laws for claim development and submission process; a review of Medicare requirements relating to documentation, charge entry and coding; and the consequences for failing to comply with applicable laws. Conduct all new employee training on a monthly basis.
Auditing Yearly audit of Medicare and Medicaid claims regarding coding practices, claim submission and reimbursement.
Employee/Vendor ScreeningConduct a screening of employees and vendors by reviewing the DHHS/OIG Cumulative Sanction Report and a source for state or local background check.
ConsultingQuestion and Answer service for all compliance issues. Will provide documentation to support TSMG's response.
NewsletterPrepare and distribute a monthly newsletter to update and educate CSS Compliance Member Groups. Information in the newsletter will include a summary of newly released Compliance Information and Health Care Fraud Alerts issued by the Office of the Inspector General.
Joyce Kyle, CCP
Director of Compliance
(260) 422-7524
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