Healthcare compliance

Keep your compliance program moving forward.

Inspired Compliance gives healthcare organizations one place to manage policies, training, risks and corrective actions. Run it with your own compliance staff, or work alongside the consultants at Healthcare Inspired.

The guided demo takes about ten minutes and uses a fictional sample organization.

HHS-OIG GCPG 2023Program structure and training aligned
14-module annual trainingWith knowledge checks and certificates
Practices, ASCs, hospitalsConfigured to your setting
Fully remoteNothing to install
Two ways to work

Your team can run it, or we can run it with you.

Many organizations already have a compliance officer and simply need better structure and tools. Others need experienced people to help carry the work. Inspired Compliance supports both.

Self-service

For internal compliance teams

Your compliance officer and staff manage the program directly in the workspace. No consultant is required.

  • Track risks and corrective actions with owners and due dates
  • Maintain your policy library and record staff acknowledgments
  • Assign the 14 training modules and issue certificates
  • Review evidence internally with a complete audit trail
  • Offer staff an anonymous way to report concerns
  • Produce reports for leadership and your compliance committee
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Supported by Healthcare Inspired

For teams that want experienced help

The same workspace, with a Healthcare Inspired consultant handling reviews, follow-up and reporting alongside your staff.

  • An initial assessment and agreed priorities with your leadership
  • Evidence reviewed by HCI, with clear written feedback
  • Policy gap analysis and draft policy language
  • Coding, billing and credentialing audits by specialists
  • Leadership reports prepared at each review cycle
  • Regular meetings with your assigned consultant
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You can start on your own and add support later, or the other way around. Your records stay in the same workspace either way.

The workspace

Everything the program needs, in one place.

Whether your own staff are doing the work or HCI is involved, everyone works from the same records.

Risk and action tracking

Each identified risk is tied to an action, an owner, a due date and a current status.

Policy library

Draft, approve, version and distribute policies, and see who has acknowledged them.

Evidence review

Documentation is submitted, reviewed and accepted or returned, with a full history.

Staff training

Assign modules by person or role, follow up on overdue learners and keep certificates on file.

Leadership reporting

Clear summaries of progress, open items and decisions needed for your board or committee.

Concern reporting

A confidential intake form, with an anonymous option and a follow-up code for the reporter.

OIG alignment

Work is organized around the General Compliance Program Guidance and the seven elements.

Review cadence

A defined review cycle keeps the program active between major milestones.

Consulting services

Experienced consultants, when you need them.

Healthcare Inspired's independent consultants bring backgrounds in coding, billing, auditing, credentialing and compliance. Services are available on their own or as part of a supported engagement.

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Coding and auditing

Pre- and post-payment claim audits, specialty reviews for E/M, surgical and facility coding, and coder education.

Billing compliance

Gap analysis, OIG Work Plan risk review, charge capture and denial patterns, and billing policy development.

Compliance program support

Program assessment and design, GCPG 2023 alignment review, and compliance committee support.

Provider credentialing

Initial and re-credentialing, payer enrollment coordination, CAQH maintenance and credentialing audits.

Revenue cycle review

Workflow review from front end to back end, denial management strategy and KPI reporting.

Education and training

The 14-module online program, live virtual workshops for coders and billers, and provider documentation education.

Supported engagements

We handle the structure. You make the decisions.

When HCI is involved, responsibilities are agreed in writing at the start. Every engagement is scoped to your organization.

What Healthcare Inspired handles

  1. Assess and prioritizeReview the starting information, identify gaps and document a work plan.
  2. Set up the actionsConnect each risk to an owner, a due date and the evidence needed to close it.
  3. Review and follow upAssess what is submitted, explain what is missing and keep work moving.
  4. Report to leadershipSummarize progress, open items and the decisions that need to be made.
  5. Repeat the cycleReturn at the agreed interval with an updated plan.

What your organization provides

  1. Name your teamA compliance sponsor, a coordinator and owners for each task.
  2. Share accurate informationComplete intake and submit requested documentation on time.
  3. Make the decisionsReview the issues raised and decide on the ones only leadership can.
  4. Put changes into practiceCarry out approved actions and apply revised policies.
  5. Stay involvedAttend review meetings and raise blocked work early.
Who we work with

Built for the organizations we serve.

Organizations that need compliance work completed, not just documented.

Medical practices

Physician groups, specialty clinics and multi-site practices managing billing, documentation and coding accuracy.

Hospitals and health systems

Facilities working through OIG risk areas, corrective action tracking and committee reporting.

Ambulatory surgery centers

ASCs managing accreditation, surgical coding and implant billing accuracy.

Rural health clinics

RHCs and FQHCs balancing limited staff with cost report accuracy and audit readiness.

Behavioral health providers

Mental health and substance use programs focused on documentation and credentialing.

Multi-site organizations

Consistent oversight, shared policies and combined reporting across locations.

See the workspace for yourself.

Follow a compliance concern from identification through evidence review to a leadership summary. About ten minutes, using a fictional organization.