You don’t know what you don’t know. Let us shed some light on the world of compliance in the dental office. Our services are designed to put you at ease and make compliance simple. Our clients call us the “sleep better at night” consulting service!

Our Compliance Programs

Foundations of Compliance in Dentistry
Medicaid and Medicare Compliance Program
Compliance Advantage Program
Record Auditing

 

Foundations of Compliance in Dentistry
(CE credit available)

Includes:

  • Mock inspection of office, office programs, credentials, record auditing using our proprietary checklists
  • In-Office Risk Management CE for dentist and all team members (6 hours that you can use to reduce your liability insurance premiums in many cases)
  • OSHA & HIPAA training (includes HB300)
  • OSHA inspection
  • HIPAA Audit & Risk Assessment (required annually)
  • Identify and correct deficiencies
  • Installation of simple, yet comprehensive, compliance program
  • Compliance Plan creation and customization
  • Radiology Inspection & Policies
  • Controlled Substance Audit (DEA Mock Audit) and systems implementation (if required)
  • Designated Agent Training and Manual
  • Infection Control Review and Policies
  • Confidential and private review of findings
  • Executive summary (treatment plan) provided with step-by-step instructions detailing how to remedy any deficiencies not corrected during the visit

Our consultants will work with you and your staff to make sure your office is in compliance with the many state and federal regulatory boards that have fingers in your practice. Our proprietary system covers rules and regulations for:

  • Dental Practice Act (and administrative Dental Board rules)
  • OSHA
  • HIPAA
  • DEA
  • State controlled substances laws & administrative rules
  • State Radiology Rules
  • Homeland Security Requirements
  • Record Keeping / Billing issues

A record audit will be performed and suggestions made for improving record keeping habits to ensure your assets are protected. Following the inspection, CE and record audit, our Compliance Officer will meet with you in private to review the confidential findings and outline the treatment plan. Throughout the visit, any issues that can be readily fixed, will be and a priority list for those that can’t be immediately repaired will be developed. This program is comprehensive and detailed and normally takes 2 days to complete. We provide invaluable risk management opportunities and training for your staff.

*Complete set of our Compliance System which includes all of our proprietary manuals is included!

 

Medicaid and Medicare Compliance Program

Dentists who provide services for government programs (including but not limited to: Medicaid, CHIP, Tricare, Medicare) expose themselves to a different set of rules and increased scrutiny and risk than their peers who do not participate in government programs. They are required to have effective compliance programs in place in order to participate. Dentists who have credentialed or re-credentialed with their state Medicaid program since 2010, have attested to the fact that they have an effective compliance program- when in fact many do not even know what they signed! Compliance Programs are more than just OSHA & HIPAA. We work with Medicaid and Medicare providers to ensure their Compliance Programs meet the government standards to minimize the impact of mistakes that expose Dentists to financial and criminal liability.

The Medicaid and Medicare Compliance Program encompasses all of the elements in our Foundations of Compliance in Dentistry Program and additionally addresses the unique needs of Medicare and Medicaid Dentists which include:

  • A program that addresses the 7 Elements of an Effective Compliance Program
  • A heavy emphasis on record keeping, billing and audit processes
  • Advertising reviews that address Anti-kickback and Stark regulations
  • Written policies and procedures
  • Fraud, Waste and Abuse Training
  • and more.

Our team has years of experience working in Medicaid Dentistry and we bring a knowledge not only of the rules and regulations, but an understanding of how those rules and regulations are enforced. We stay on top of latest trends in enforcement and rule changes.

 

Compliance Advantage Program (CAP)

Many of our clients desire ongoing support. In response to our clients requests, we developed the CAP program to be a turn-key compliance program. CAP includes everything outlined in our Foundations of Compliance in Dentistry and/or the Medicaid and Medicare Compliance Program depending on your practice needs.

In addition we provide hands on support. It also includes:

  • OSHA and HIPAA policy updates as needed
  • Periodic visits from a dedicated Compliance Officer to support you in maintaining the compliance programs/standards we install during our initial visit.
  • Ongoing support and documentation of your compliance efforts
  • Periodic checklists for your staff to complete as documentation of your internal compliance mechanisms
  • Monthly training for you and your staff on relevant issues
  • Member’s only newsletter
  • Ongoing phone and e-mail support between visits
  • Priority service to assist you with in-office emergencies, employee/patient issues, government investigations and other matters that may require assistance
  • Regular Record Audits
  • Medicaid and Medicare Compliance Program elements are supported as well

We act as a “Time Share” Compliance Officer for our client organizations. We know our clients want to focus on what they do best- Dentistry. We help them do that, by keeping the Compliance Program running and effective. Our CAP clients get Priority Access to our team and can call us day or night with their concerns and issues.


Record Audits

Maximize your collections (legally), minimize losses, ensure that your records will ACTUALLY support you when, not if, they are scrutinized by the government and third-party payers.

Our team of dentists and compliance consultants review your records and help you improve your record keeping skills. Often our consultants will find ways to increase your legitimate reimbursement. We work with clients who are proactive in updating their skills and knowledge to keep themselves out of trouble.

We also do Record Reviews for Dentists and their attorneys who find themselves in trouble with PPOs or government agencies. We have the unique perspective of being on the other side of the table. Our founder, Duane Tinker is a former Investigator for the State Board and has worked cases against Dentists for Medicaid Fraud, Standard of Care and other types of cases. He knows how the government operates and what they are looking for. Now that he is a good guy, he puts his knowledge to work for our clients.

Problem patient? Issues? Getting letters from the insurance company? Just want to improve your skills?

A record audit is a great way to start. This is a wonderful learning experience and one that will help you develop as a professional. Our consultants are professional and our risk management experts will spend time with you, review your records and

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