SC Data and Compliance 2014. What Works Today?. Presenters. Michelle Sipple, Familylinks Mary Jane Fletcher, Lenape Valley Foundation Dan Sausman, CMU Joel Goldberg, Quality Progressions. Is this YOU?. What do we mean by Compliance?.
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What Works Today?
Balancing act between fiscal viability, quality and compliance
• Standards and expectations are trained upon hire.
• All staff members are re-trained on an annual basis.
• By all managers with different parts of orientation.
• Training is focused on integrity and compliance.
• Integrity is also discussed at all monthly staff meetings.
• Agency reputation is at stake!
• ISP Compliance
• Service Notes/ Units
• Monitoring Compliance
• Eligibility (Physicals, Recertifications, Redeterminations)
• Quality - Documenting service delivery and issues
• Outcome progression and issue resolution
• Compliance - Acting as a Medicaid claim
• Productivity – Oversight and assurance of TSM productivity
standards and billing integrity
• Timeline Compliance/ weekly reconciliation of work time
• Be accurate
• Be honest
• Make a difference in the lives of consumers