Clinical Quality & Compliance Analysis

Marwood’s expert clinical and regulatory personnel provide services designed to support the management of healthcare regulatory compliance, developing and/or implementing compliance programs, conducting clinical record reviews, billing reviews and coding accuracy assessments. Marwood ensures that CMS, OIG, as well as other state and federal rules and regulations are followed through interviews, site visits, clinical documentation review, and benchmarking similar organizations.  Marwood also assists in the development of compliance plans, quality plans, policies and procedures, HIPAA processes, and ongoing monitoring.  Sample projects include:

  • Reviewed Compliance programs to ensure that they meet the Office of Inspector General’s (OIG) Seven Required Elements, making recommendations, and assisting in the implementation of improvements
  • Conducted a review of clinical records  to evaluate  medical necessity, presence of appropriate documentation, and confirm that  records met coding and billing standards for major payors
  • Evaluated Quality Plans and made recommendations for improvements in the quality of care

 

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