This is not about health insurance fraud. There are plenty of articles about that. Healthcare compliance is compliance with law, regulations and policies of running healthcare institutions.
Compliance in healthcare has always been driven by regulation. When it concerns life, people are not too afraid of having more regulation. Unlike business professionals, who are always concerned about the happiness of their customers/clients, doctors are more concerned with health, even if the patient is not happy with the care provided. That is to say, most doctors will do what s/he can to keep a patient alive and well even at the cost of the patient’s happiness. This is where regulation does not contribute well. And the solution isn’t to add more regulation.
Corporate policies about how to handle scenarios with patients and the public is best served by taking a page from business professionals. Keeping patients happy can contribute to patients being more compliant with drug regiment, faster payment and less time in the exam room discussing not healthcare-related matters, like the annoyance of the drug regiment and dislike for paying of invoices. While the following policy suggestions mostly lack enforceability, simply having them will require a discussion of them at implementation, training and performance evaluations. That is good enough to start affecting change in the institution’s culture. After all, compliance is only effective if it is embedded to the culture.
- Eye contact when answers to questions are being provided,
- Physical touch to show connection, a handshake will do,
- Patient speaks first, do not cut off a patient mid-sentence,
- Thank the patient for something, anything,
- Apologize to the patient for even the slightest delay or interruption,
- Spend the full appointment time with the patient, if exam is completed early, complete notes in the room – patients often forget something,
- Ask about other people in their lives – sometimes the medical solution is addressing the environment, not the body,
- Always use medical terminology to explain or prescribe, but also use vernacular – use of vernacular terms sometimes cause liabilities but if used to clarify or emphasize medical terminology, the liability is gone,
- Inquire about what activities the patient enjoys for no other reason than to get an idea about the patients inclinations when given a choice,
- Share something personal so that the healthcare provider is human to them, you are human, after all.
About the Author: Marcus Maltempo is a compliance professional with more than a decade of experience helping banks, law firms and clients manage investigations and regulatory responses. He is the author of the forthcoming book History of Money Laundering: How criminals got paid and got away.