CASE STUDY:

Corporate Integrity & Risk & Compliance Emergency Build-Out

SCALE was engaged by a mid-to-large size healthcare diagnostics company, whose goal was to mitigate any further risk – and build out an emergency compliance program. The client was under a Corporate Integrity Agreement (CIA) with the Federal agency of the Office of the Inspector General (OIG) that laid out key stipulations.

There was a need to rapidly develop a sustainable compliance program, maintaining high quality compliance oversight including:

Ground up creation of a risk and compliance emergency build-out
Appointment of a Chief Compliance Officer
Implementation of 7 federally required elements of the CIA within the first 90 days
Ongoing support in program deployment
Ongoing conformance with CIA requirements

Without the help of SCALE Compliance Services, ultimately, the desired outcome of further penalty risk avoidance would not have been possible:

Successful achievement of 100% compliance with CIA requirements at 90-days, 120-days and first-year implementation reports. Client passed federal requirements with flying colors in its annual review – met and/or exceeded every benchmark client was supposed to hit

Client Profile

Services Deployed

Compliance Officer

Compliance Program Development

Program Implementation

IRO Selection

Perform Mock IRO Claim Audit

Coding Audit

Privacy Management Software

Compliance Officer Role

Compliance Program Development & Ongoing Oversight

Coding Audit of Medicare Records

Privacy Program Management Software Implementation

Risk Avoidance

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Corporate Integrity & Risk & Compliance Emergency Build-Out

Situation

Without the help of SCALE Compliance Services, ultimately, the desired outcome of further penalty risk avoidance would not have been possible:

Client Profile