Conflicts of Interest Disclosure Form
1 - Duties of Compliance Personnel
2 - Charitable Contributions
3 - Reporting Potential Issues or Areas of Non-Compliance
4 - Compliance Committee
5 - Excluded or Debarred Persons or Entities
6 - Non-Retaliation
7 - Overview of Relevant Laws
8 - Preventing Fraud, Waste, and Abuse
9 - Exit Interviews
10 - Responding to Government Investigations
11 - Document Retention
12 - Monitoring and Auditing
13 - Compliance Investigations
14 - Overpayments and Refunds
15 - Risk Assessments
16 - Education and Training
17 - Policy and Procedure Development
18 - Business Courtesies to Potential Referral Sources
114 - Focus Arrangements Review and Approval Process
116 - Management Certifications
201 - Relationships with Billing Entities
303 - Professional Courtesies and Patient Discounts
304 - Correspondence with Medicare and Medicaid Carriers
305 - Suspension of The Medical Record
307 - EMTALA: Anti-Dumping and Anti-Exclusion
308 - Critical Care
309 - Physician Services at Teaching Hospitals
310 - Billing for Services Provided by an APP
311 - Medical Necessity
313 - Use of Scribes
314 - General Coding and Billing for Hospital Based Services
HIPAA Policies & Procedures
Notice of Privacy Practices*
*Note – Facility based Providers will use and abide by the Facility’s Notice of Privacy Practices.
For questions regarding HIPAA related matters, please contact the Privacy Officer, Jillian Marcus, at complianceconcerns@envisionhealth.com or 615.787.2160.