OIG General Compliance Program Guidance
Coronis Health Compliance operates squarely within the scope of the Health and Human Services Office of Inspector General's 2023 General Compliance Program Guidance (GCPG), released on November 6, 2023.
Billing, Regulatory and Privacy Compliance
A revenue cycle management compliance program built to the standard federal regulators hold third-party medical billing companies to, and audited to prove it.
compliance foundation
Built to a federal standard
Our team brings more than 90+ years of combined revenue cycle management compliance experience, credentialed as RHIAs, CPCs, CCPs, CCSs, and CHCs, working under the direction of our Chief Compliance & Privacy Officer.
Written Corporate Compliance Plan
Our written Corporate Compliance Plan establishes the governance, policies, and oversight that guide every aspect of our revenue cycle operations. Through ongoing education, auditing, monitoring, and risk assessment, we proactively identify and mitigate compliance risks while helping ensure services are delivered in accordance with applicable regulatory and payer requirements. The result is a transparent, continuously improving program that helps protect our clients from regulatory, financial, and operational risk.
Privacy Commitments
Protected health information, governed by policy
Protecting PHI and proprietary data form unauthorized access, use, storage, or disclosure under HIPAA is a standing pillar of our compliance program. A dedicated sub-committee owns data security and privacy risk specifically, work alongside our CISO and ISMS team on the technical controls that carry it out.
- Dedicated data security & privacy compliance sub-committee
- Incident response directed by the Chief Compliance & Privacy Officer
- Coordinated with our Chief Information Security Officer on the technical safeguards covered on our security page.
billing standards
RCM Coding and billing compliance, audited continuously
A dedicated sub-committee governs coding and billing compliance, backed by specialty-specific compliance leads and ongoing provider documentation audits.
- Clinical documentation improvement (CDI) education, delivered on-site and virtually
- Documentation errors tracked and reported back to providers
- Every payer audit and overpayment notice gets a researched response, not a form letter
regulatory oversight
Compliance that keeps pace with changing regulations
Federal statutes, state law, and private payer policy shift constantly. Our revenue cycle management compliance plan is reviewed and updated on a defined cycle, so client operations stay compliant even as the requirements underneath them change.
- Sales, Marketing & Contract Compliance Sub-Committee keeps client-facing commitments aligned with current law
- Policies & Education Compliance Sub-Committee keeps internal policy current
- Employees and vendors screened quarterly against federal and state exclusion databases
Policy enforcement practices
A culture committed to ensuring compliance
Governance & Committees
An Executive Compliance Committee oversees five sub-committees, so no compliance risk sits with a single owner.
Billing, Coding & Compliance Audits
Our annual audit and monitoring work plan identifies material risk areas in advance and tracks them systematically across the year.
Reporting & Escalation
A global anonymous hotline, available by phone and web, feeds a defined, risk-scored escalation timeline, with no retaliation for reporting.
Sanctions Screening
Employees and vendors are screened quarterly against the OIG Exclusion List, GSA's System for Award Management, U.S. Treasury OFAC sanctions lists, and applicable state Medicaid exclusion databases.
what our compliance policies mean for you
Compliance you can verify before you sign
Confirm we meet the standard, then let us show you where yours stands.
Comprehensive Compliance Assessment
We'll do a complete review of your practice document and assess for billing and coding compliance, for recommendations on how to achieve better outcomes.
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