Services | EMS Compliance Solutions

The Services of EMS Compliance SolutionS

EMS Compliance Solutions has the knowledge and skills necessary to help you develop and implement an effective compliance program. The following information summarizes how EMS Compliance Solutions utilizes the recommendations from the Office of Inspector to develop compliance programs tailored to a client's specific needs:

Drafting Risk Based Policies and Procedures
Providers must perform risk assessments of their own operations in order to evaluate their compliance with federal and state regulations. Once these assessments are done and the risks are identified, the providers can then draft policies and procedures that specifically designed to address those risks. These policies and procedures may then be implemented through staff training and accountability.

Establishing an EMS Compliance Training Program
It is the job of the provider or agency that has hired the EMT or Paramedic to train them in proper patient care documentation. This is where the policies and procedures that are drafted to address the risks are implemented into the operations of the provider. This should be done at orientation upon hiring, and on a continued annual basis. This training and education will set the foundation of the ambulance provider's compliance efforts going forward by demonstrating what laws and regulations govern the ambulance industry, and establishing the expectations the provider has of the crew members regarding documentation. This training should be done by a compliance officer or consultant with knowledge of regulations regarding ambulance documentation and coding. Once a training program is in place and implemented, the provider may concentrate on the continuous monitoring and auditing of the documentation to identify what crew members will need additional training and remediation.

Creating Open Lines of Communication
If there is one thing that will stifle a compliance program, it is the lack of open lines for communication. The environment within EMS and ambulance providers has to reflect a culture of non-retaliation for good faith reporting of compliance issues. When employees feel that they will be retaliated against for reporting issues, or are being ignored by supervisors, they are often forced to report the issue to outside parties. This is where government agencies and attorneys get involved, which may lead to the filing of a whistleblower or qui tam suit. The best ways to prevent this type of scenario is to have a strict policy of non-retaliation, and institute a method of anonymous reporting (i.e., Compliance Hotline).

Continuous Monitoring and Auditing
Ambulance providers attempting to demonstrate due diligence to government agencies and contractor regarding compliance must engage in continuous monitoring and auditing of their patient care documentation. This is not something that can be omitted from the compliance program or only performed on an annual basis. This must be a constant process where internal audits or "gap analysis" of ambulance claims are performed once a month. By having these audits performed once a month you are able to properly monitor and identify risk areas, including crew members that are need of additional training.

Implementing Corrective Actions
Once a risk area or error is discovered through the monitoring and auditing processes, an ambulance provider must implement appropriate corrective actions to address the risk or correct the error. Whether it is giving a field crew member additional documentation training, putting out a billing interoffice memorandum addressing a coding issue, or returning an overpayment, all corrective actions must be done consistently and documented thoroughly. Every compliance risk or potential violation must be investigated by the compliance officer until the correction is made or it is determined that no problem exists. In either case, the investigation must be documented and kept on file in order demonstrate the ambulance provider's compliance efforts in action.

EMS Compliance Solutions, LLC
P.O. Box 14068
Fort Lauderdale, FL 33302
Phone: (352) 258-0686