Question

(TCO G) You've just been hired as the chief operating officer (COO) for a new orthopedic physician practice. The new practice was created by two previously independent practice groups that had fines for governmental regulatory violations, as well as suspected fraudulent billing practices. You just received a subpoena to appear in court and testify as to your role in the organization and knowledge of billing practices.

All you know is that the clinic has recently purchased a new electronic billing and medical records system that is HIPAA compliant. One goal of this electronic system is to address all areas of compliance and to clean up any issues from the past. It is also intended to position the new organization as an organization with an impeccable reputation for compliance. Articulate your vision for this plan and the components that are required for its success. How will you justify the expense associated with your plan? Keep in mind that you have a newly formed organization and differing organizational cultures.

Answer 1

Articulate your vision for this plan and the components that are required for its success

The vision for the new organization is very clear, which is to develop the reputation for this organization with an impeccable reputation for compliance. Public perception and trust of the patient is critical for the functioning and community service for any healthcare organization. The previous transgressions are the part of the history and the newly found entity i.e., this new organization shall implement all the rules and regulations that are required for ethical and standard care and regulatory compliance. The plan for success shall have main focus on policy implementation, structural component, patient care, billing practices and delivery of medical care keeping in mind the HIPAA guidelines as the centerpiece to reestablish itself as the industry leader. The components that this plan shall require are:

1. Retraining of all the staff members with abolioshment of old practices and introducing the new guidelines of all the ethical practices and healthcare delivery as per HIPAA guidelines like a blanket statement in implementation

2. Hiring new skilled workforce and letting go the people with unruly compliance and faulty work ethics

3. Re-appropriating the budget to skill development and standard policy formulation and implementation

4. Engaging with the community regarding problems and suggestions for the new organization

5. Addressing the unresolved issues and ensuring a strict compliance to regulatory and medical guidelines for treatment and delivery.

6. The differing organizational cultural have to be merged by introduction of the new policies which would be same for the entire organization.

7. Adjustment period and a thorough training shall be given to acclimatize to the new policies and the practical issues faced by the staff and solutions shall be addressed to ensure smooth functioning

8. Monthly and quarterly discussions and meetings will be taken in order to address all the issues and implementing changes to deliver quality care and strict adherence to HIPAA guidelines for patient safety, treatment affordability ad protecting privacy.

How will you justify the expense associated with your plan?

The expense required for the new plan is not a requirement of leisure but a necessity for survival and revival of the new organization so as to provide industry standard medical care while developing a reputation for excellence. he new systems to be implemented would require the additional spending but this cost can be recovered when we implement the quality functional and medical care practices for quality treatment delivery to the patients. The community support and influx of the patient due to new plan shall help us recover the additional costs. It us very important to understand that the expense be seen as an investment for the future of this organization and not a purchase momentarily. Investing in quality care shall help reap the benefits from the community and support from the regulatory authorities in establishing the organization to a wider population and communities through increasing the reach through quality care and reputation.