CBIZ’s Compliance Protector provides a thorough examination of claims data to identify and reduce potential compliance risks. With our multi-pronged investigation of claims data, CBIZ’s Compliance Protector will give your organization an independent, third-party validation that you are accurately compiling with regulatory and payer-specific requirements.
The Compliance Defender review process encompasses the following components:
Issue Identification – CBIZ analyzes your data at the patient-level to identify the issues that should be of concern to your facility. Using our proprietary data analytics and a rules library, we identify specific cases for specific reasons.
Quantification – Once potential risks are identified, our clinical team will then review Medical Records to quantify the risk.
Education and Corrective Action Plan – CBIZ works with your team to develop action plans for the specific identified risk. We focus on achievable goals to improve compliance. We craft solutions that are specific to your facility and lead to demonstrable results. Sustainable change is the product of targeted education and process improvement. CBIZ supports your education for coding and documentation, either remotely or on-site.
Monitoring – CBIZ utilizes ongoing data analytics to monitor that identified risks have been mitigated. Our monitoring program also identifies potential new issues for coding and billing compliance as they arise.
The Compliance Protector is an annual subscription model, with quarterly reporting that provides issue identification and resolution. CBIZ’s comprehensive approach ensures that potential issues are addressed and monitored so that no backsliding occurs. Combining data analytics, benchmarking, clinical chart reviews and CBIZ’s 40 years of compliance expertise, the Compliance Protector functions as a working blueprint for the health of your billing and coding compliance.