Healthcare working using compliance software.
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June 14, 2018
    Article highlights
  • What is healthcare compliance software, really?
  • Benefits of healthcare compliance software.
  • Categories of healthcare compliance software.

Laws and regulations in the healthcare industry are not only extremely complex, but they are also constantly changing.

Between ever-changing industry standards, accreditation requirements, and federal, state, and local laws and regulations, it can be difficult to maintain compliance in healthcare.

And there are so many different aspects of compliance in healthcare. Everything from policies to training to billing practices must line up with regulations. It’s hard to know where to start.

Maintaining compliance helps healthcare organizations provide better patient care, improve patient safety and care, and avoid costly lawsuits.

Staying in compliance can lower insurance premiums and improve the organization’s reputation.

Healthcare compliance describes the state where operations follow all the required laws, regulations, and internal policies and procedures.

Organizations can only achieve compliance when every employee understands and follows the guidelines.

However, healthcare compliance software can help organizations achieve, track, and maintain compliance.

Healthcare compliance software can track changing regulations and let administrators see how policies and procedures match up. Compliance software tools make it easier to distribute documents and training to employees, run risk assessments, and set automatic alerts to maintain licenses.

Healthcare compliance software also makes it easier to maintain records to prove what the organization is doing to stay in compliance.

What Is Healthcare Compliance Software, Really

Because healthcare compliance is such a broad topic, what is meant by healthcare compliance software can mean a number of things. Ultimately, it is any piece of software that helps healthcare facilities get or stay in compliance with regulations.

There are many different types of healthcare compliance software.

Some include policy and procedure management – helping organizations develop, deliver, and track policies and procedures. Some help manage employee training. Others cover medical billing and coding.

All of these are important aspects of healthcare compliance. Since healthcare compliance is so complex and vast, organizations may employ a few different softwares to help maintain compliance in different areas.

In any case, healthcare compliance software can help simplify and streamline compliance efforts.

Organizations can sometimes find software that serves a few different functions.

For example, PowerDMS can help with policy management, training, accreditation, tracking licenses, and more.

Benefits of Healthcare Compliance Software

In a recent survey, respondents named limited staffing and a lack of resources as the biggest challenges for healthcare compliance.

Healthcare compliance software lets organizations do more with less.

With the right software tools, organizations can achieve and maintain compliance with fewer dedicated compliance staff, fewer hours, and less energy.

Team members use healthcare compliance software to increase compliance.

Healthcare compliance software may require an up-front investment, but it can save organizations thousands of dollars in the long run.

Software can increase operational efficiency, reducing things like overtime costs and the need for extra administrative staff. It can help healthcare facilities spot problems ahead of time, preventing regulatory fines.

Good healthcare compliance software also increases accountability and fosters proactive risk management.

It gives healthcare administrators and leaders peace of mind that everything is up-to-date and in compliance. This allows healthcare organizations to put the focus on high-quality patient care, not just on maintaining compliance.

Categories of Healthcare Compliance Software

As mentioned before, healthcare compliance is extremely complex. Regulations are complicated and change often. Laws governing everything from billing requirements to the security of patient records are constantly updated.

That’s not to mention the day-to-day operations of a healthcare facility, which naturally include risks.

It’s incredibly important to make sure that all staff members follow proper policies and procedures to maintain compliance and safety.

Healthcare compliance software can help organizations govern compliance. However, most software focuses in on one or two aspects of compliance.

Some software cover multiple areas of compliance, but healthcare organizations may need to employ several different healthcare compliance software to effectively manage all areas of compliance.

Here are some of the categories of healthcare compliance software:

Policy and procedure management

Policies and procedures are essential for both internal and external compliance.

Overall compliance – whether to laws, industry standards, or facility-specific practices – can only be achieved when each employee understands the expectations and follows the rules.

Policy management software helps with this by making sure employees know how to do their jobs well.

Good policy management fosters accountability and responsibility. Employees understand expectations and guidelines. They have the most up-to-date procedures that comply with regulations. And if they’re unclear on a policy, they can quickly find the information they need.

Healthcare compliance software such as PowerDMS makes it easy to distribute policies to all employees.

PowerDMS houses all documents in a secure, centralized location. Employees can find the policy they need with just a simple keyword search.

Since healthcare laws and regulations are always changing, policies and procedures also have to be regularly updated.

Policy management software makes it easy to review and update important documents.

With PowerDMS, administrators can track policies to new requirements, collaborate on policy updates, and create workflows to get approvals on policy updates.

PowerDMS gives administrators full version control. This means employees only see the most up to date policy, and supervisors can track signatures to make sure every employee read and acknowledged the policy.

This not only helps ensure that the organization is in compliance, but it also helps prove compliance.

If an organization is ever accused of violating regulations, a healthcare compliance software can show that the organization took every possible step to ensure compliance.

Policy and Procedure Management Software

See for yourself how you can improve compliance through better policy and procedure management.

Auditing tools

Auditing and monitoring are some of the most critical elements of healthcare compliance.

Monitoring compliance should be the ongoing function of managers and supervisors. But audits should be done by someone who is outside of day-to-day operations – often the compliance officer or members of the compliance department.

Audits provide a bigger-picture view of compliance operations – evaluating whether internal controls are adequate and effective.

Healthcare compliance software that includes auditing tools simplifies the auditing process.

By housing all the data all in one central location, auditing software makes it easy to spot trends and high-risk areas. Organizations can run risk assessments, spot gaps in compliance, and address potential risks before they get out of hand.

Healthcare compliance software helps keep organizations on track with audits. Compliance officers can schedule audits, target specific cases or charges to audit, and customize audit reports.

Good auditing software integrates with billing systems to make it easy to conduct financial reviews.

Training management and tracking

Distributing policies and procedures is the first step in making sure employees know how to stay in compliance. The next step is training.

Compliance training teaches employees how regulations apply to their day to day work.

The U.S. Department of Occupational Safety and Health Administration (OSHA) requires healthcare organizations to train employees on many different hazards and safety measures in the workplace.

Compliance training should also cover things such HIPAA requirements, Medicare and Medicaid, and internal policies and procedures.

Doctor uses healthcare compliance software on a tablet.

While some of this training will be hands-on, some recurring training can be done online.

With a training management software, employees can complete recurring training on their own time. This cuts training costs by eliminating the need for classroom space and overtime pay for training.

A training management software makes it easy to conduct and track employee training. PowerDMS’s training software automatically logs online training hours.

Employees and supervisors can also log in-person training and continuing education hours.

Housing all training records in one place makes it easy to ensure compliance with training requirements.

Administrators can view overall training hours and trends, and also view complete training records for every individual employee.

Medical billing and coding

Billing and coding regulations are among some of the complex aspects of healthcare compliance. Noncompliant billing practices cost healthcare organizations billions every year.

As we mentioned in our post on avoiding qui tam lawsuits, the government recovered $4.7 billion from false claims cases in 2016. More than half of that came from healthcare organizations.

Healthcare compliance software reduces the risk of human error in medical billing and coding.

It helps keep sensitive information secure. Billing software can help healthcare organizations prevent fraud and comply with HIPAA requirements.

It can identify coding errors, reduce lost revenue, and make the payment process simpler for both organizations and patients.

License, certificate, and contract tracking

Between employees, vendors, third-party providers, and more, healthcare organizations juggle many different credentials, licenses, and contracts. An expired license can put a healthcare organization in danger of getting fined or sued.

Healthcare compliance software can help organizations keep track of all these critical documents and licenses.

It can help automate processes and track due dates. With software such as PowerDMS, administrators can set automatic reminders to renew licenses and review contracts well before they expire.

Incident management

OSHA requires all employers to keep records of work-related illnesses and injuries.

However in healthcare, incidents go far beyond employee injuries, and mistakes can cause serious harm to patients. Things like misdiagnoses, prescription mix-ups, or accidents can put patient lives at risk.

Incident management software can help healthcare organizations identify and address incidents.

Healthcare compliance software also collects data on incidents so organizations can see what went wrong and how to prevent such incidents in the future.

Accreditation management

Healthcare accreditation is a great way to boost compliance.

Accrediting bodies hold healthcare facilities to a rigorous set of external standards and best practices. Often, accreditation surveyors will provide valuable advice and insights on how to improve operations and compliance.

With PowerDMS’s accreditation management tools, healthcare organizations can identify gaps in compliance, track changes in regulations, and easily prove compliance.

Healthcare compliance software makes it easier for healthcare organizations to achieve and maintain regulatory compliance.

Software such as PowerDMS can help organizations maintain compliant policies, conduct training, manage licenses, and more.

With compliance software, healthcare organizations can focus more of their resources on providing high-quality care

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