course materials

1. Healthcare statistics: quality improvement organization (QIO)
Healthcare statistics: quality improvement organization (QIO) ON Healthcare statistics:
quality improvement organization (QIO)Your quality improvement organization (QIO) has
alerted your hospital that you are under a focused review for overutilization of healthcare
services for your Medicare population.· Explain what steps should you take to assess your
situation?· Define what structures and processes within the organization should be
examined?· If a problem is confirmed, outline what steps would you take to correct the
situation?· Distinguish how would you ensure that the situation is corrected on an ongoing
basis?1 page, approx 200 wordt172_hit_final_revenuormatted Attachment PreviewRunning
head: HIT REVENUE CYCLE MANAGEMENT HIT Revenue Cycle Management Institution
Affiliation Date 1 HIT REVENUE CYCLE MANAGEMENT 2 Introduction In the regulatory
business environment of today, it is important that all U.S businesses adopt a corporate
ethics and compliance program that would be effective. When developing a compliance
program, businesses need to adhere to the seven elements that exist in a compliance
program. These seven elements are mostly vital for organizations especially those that are
in the health industry because the elements are vital for the HIPAA compliance program as
it will ensure that health information and data of patients are protected. Therefore, when
creating a compliance program, it is important for each and every organization to make sure
that they have utilized all the seven elements of the program. The seven elements of a good
and complete compliance program A compliance program could be termed as the set of
protocols that a business develops to deter and prevent any unlawful conduct from taking
place and also encouraging a lifestyle of compliance within the organization (Chandran and
Lobo, 2016). The importance of a compliance program is that it enables businesses to
identify the legal actions which might be taken against them if they engage in some
activities. The two initiatives that will be deliberated when creating a compliance program
are potential for progressive impact and top management challenges. Hence, when creating
a compliance program, it is important that the seven elements are utilized. Establishment of
Standards. Healthcare statistics: quality improvement organization (QIO)Controls and
Procedures When creating a compliance program, the first important thing is for the
business to establish procedures and standards that will help in deterring and preventing
any criminal or unethical conduct from taking place. The management of the business also
needs to ensure that it has communicated to the employees about the rules and procedures
that have been set. There HIT REVENUE CYCLE MANAGEMENT 3 should be a program
where each and every time the employees are reminded of the standards and procedures.

2. Since the company is a healthcare company, it is important that standards and procedures
about health information of patients are set. Exercise ethics oversight and effective
compliance To guarantee that the compliance program is effective, the healthcare
organization must ensure that it has involved all the different layers of management in the
ethics and compliance process (Stucke, 2013). This will help ensure that all management of
the company will understand the procedures and standards that are relevant to the
business and also ensure that employees understand and follow all these policies and
procedures. It is important that every individual that is in charge of a department has
complete knowledge of the program. The personnel that will be involved in the oversight of
the program in the healthcare organization should be the board of directors and senior
management. Exercising due diligence The healthcare organization should avoid or deter
from delegating any authority to people who have been determined to have been engaging
in activities that are illegal or engaging in behaviors that are inconsistent with the ethics
and compliance program.This means that when the healthcare organization is engaged in
the hiring process, they should ensure that they have considered the level to which the
party’s record of misconduct is in relation to the person’s anticipated responsibilities.
Hence, the management of the healthcare organization should be alert of the type of
individuals that they are hiring. Effective training and communication HIT REVENUE CYCLE
MANAGEMENT 4 The compliance program of the healthcare institution should not only be
put in the paper form, but the management should also ensure that the program has been
effectively implemented through training and education (Weber and Wasieleski, 2013). This
is because training and education is a practical manner that enables the management to
communicate to the employees about the standards and procedures of the program. The
training and education should involve all the layers of management including both the
senior management and the board of directors of the medical institution. The topics the
education program should focus on are proper accounting, confidential information among
others. Auditing, monitoring, and disclosure It is important for the medical institution to
make sure that the workers follow the ethics and compliance programs. This means that the
management of the healthcare organization needs to audit the compliance program so that
it may ensure that the implementation of the elements is taking place to determine the
effectiveness of the program. The healthcare organization should provide the employees
with a mechanism where they will confidentially report any misconduct or inappropriate
behavior. The management should also provide employees with guidance on different
compliance issues. Discipline and Incentives The healthcare facility should make sure that it
constantly promotes the importance and values of the compliance program. This can be
done through the management rewarding the individuals that have engaged in actions that
have demonstrated adherence while punishing those individuals that have violated or not
adhered to the ethical standards of the organization. Healthcare statistics: quality
improvement organization (QIO)For the medical institution to make sure that the
credibility of the compliance has been maintained, the HIT REVENUE CYCLE MANAGEMENT
5 management should encourage employees that have adhered to ethical standards through
giving them incentives. Undertaking corrective action and detecting offenses The medical
institution should guarantee that they have taken investigative actions when responding to

3. suspected ethical and compliance violations. The management should also confirm that the
confidentiality of these investigations is protected. The healthcare facility should also
safeguard that it has developed steps and procedures that will ensure that any misconducts
and violations are prevented and do not take place in future (Williford and Small, 2013).
Hence, the management should adopt measures that will enable them to detect offenses to
the compliance program. Initiatives relating to health information The two initiatives that
relate to health information are potential for progressive impact and top management
challenges. These two initiatives largely impact the HIM department of the healthcare
institution in terms of staffing and workload because of the compliance program. This is
because, for the management to have a progressive impact, they would need to ensure that
it has adequate employees who will help the organization to adopt a good compliance
program. On the other hand, the challenges that the management has is also another
initiative.This is because the company would need employees to help it solve any challenges
it faces during the application of the compliance program and hence affecting the HIM
department. Conclusion It is significant for organizations to adopt a compliance and ethics
program to help them perform their functions effectively. A compliance program is
important especially for healthcare HIT REVENUE CYCLE MANAGEMENT 6 organizations as
it helps them avoid facing any legal actions. When developing a compliance and ethics
program, it is vital for organizations to think through all the seven elements that are present
in developing a compliance program. Through considering the elements, organizations will
have an operational obedience and ethics program. HIT REVENUE CYCLE MANAGEMENT 7
Reference Chandran, S., & Lobo, A. (2016, May). Ethics and compliance in corporations:
values based approach. In Ethics in Engineering, Science and Technology (ETHICS), 2016
IEEE International Symposium on (pp. 1-4). IEEE. Stucke, M. E. (2013). In search of effective
ethics & compliance programs. J. Corp. L., 39, 769. Weber, J., & Wasieleski, D. M. (2013).
Corporate ethics and compliance programs: A report, analysis and critique. Journal of
business ethics, 112(4), 609-626. Williford, K., & Small, D. (2013). Establishing an Effective
Compliance Program: An Overview to Protecting your Organization.