Accreditation: Go beyond documentation

A. One of the accreditation requirements is to have and maintain a performance management plan. Although providers provide this documentation at the initial accreditation survey, many fail to implement it after the survey. This is an important factor and requirement to maintain your accreditation. This is also a valuable tool to help your company correct issues and make you shine above the competition.

Your performance management plan should measure billing practices, adverse events and consumer services. In doing so you need to follow the Medicare Quality Standards and their guidelines. Here are some of the areas that Medicare wants you to review:

Frequency of billing and coding errors: Make sure you review the number of claims denied as well as billing and coding errors. Make sure you have your staff maintain your billing error log. Not only will this allow you to find areas of weakness, but it will also help improve your cash flow and accuracy.

Patient, referral source, and employee evaluations and surveys: All feedback is helpful in determining how you are doing as an organization. This will allow you to find any deficiencies within the structure of your organization. Make sure your staff is recording complaints in the complaint log. Medicare requires that this log contain the HIC number and proof that you are responding to the patient with the results of your investigation within 14 days.

Adverse effects for malfunctioning equipment: Make sure you record any incidents or injuries that occur as a result of your services. Hopefully you are not in that boat but if you find yourself in that situation maintain detailed documentation. This could include manufacturer, attorney and insurance paperwork.  Keep in mind that you have a limited timeframe to research and report.