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Helping health care providers stay compliant with ever-changing rules and regulations: Why outreach and education is critical

September 18, 2017

To be successful, health care providers need to be focused on their mission to provide quality care while lowering costs. Unfortunately, this can be challenging given the frequent changes in the health care industry. Federal health agencies such as The Centers for Medicare & Medicaid Services regularly issue updates to programs and regulations to stay in step with legislation and beneficiaries’ needs. Providers face another layer of complexity with the future of the Affordable Care Act in a constant state of flux.

Keeping track of these changes is even more difficult for small and rural providers, whose staffs and budgets are already stretched and who may lack the expertise to implement new programs. This ongoing sea change makes it hard for health care providers to stay compliant and efficient, and can lead to claims resubmissions, payment delays and potential overpayment.

This environment has made the need for proactive provider outreach and education paramount. The Centers for Medicare & Medicaid Services often provides helpful tools such as website resources and webinars to educate providers about current requirements and coming changes, but there is nothing quite like a one-on-one conversation tailored to a provider’s specific pain points.

Each provider is unique and has distinct challenges, concerns and local factors that effective provider education needs to address. There is an increasing reliance on Medicare administrative contractors such as National Government Services, to help the agency share timely messages with health care providers and identify gaps in education, with the ultimate goal of ensuring medical professionals stay in-step with the latest rules and regulations.

To help providers find the information they need, National Government Services has built provider-specific web portals and online educational resources in addition to offering a live customer service phone line. By melding technological resources and good old-fashioned one-on-one assistance, medical providers get the answers they need to stay compliant.

This outreach and education is instrumental in decreasing provider abrasion. With proper education and training, providers better understand not only the current health care landscape, but also what changes will be coming in the future, allowing them to prepare more effectively.

National Government Services uses data to identify and mitigate common issues, pain points and services with high error rates, helping providers realize that such issues result in unnecessary costs. Having a working knowledge of compliance rules helps providers get claims processed and paid the first time, which saves time and dollars by avoiding the appeals process and rework.

When you’re committed to education and outreach, it helps to partner with an organization that knows the health care space and is trusted by providers. National Government Services has established relationships with provider practices of all sizes as well as hospitals and labs all over the country. By serving a vast network of 400,000 providers and 25 million Medicare beneficiaries in 20 states, National Government Services has developed and tested best practices and passes that knowledge onto providers. Using sophisticated analytics data, it is possible to spot the providers that repeatedly make errors on their claims submissions. A proactive outreach and education team can offer one-on-one training and work with these providers so that they can submit error-free claims in the future.

When health care providers have questions, they need to both feel comfortable enough to ask them and know they will receive an informed answer promptly. It always helps when these answers can be tailored to the provider’s specific needs and location too, something that is hard for a national program to accomplish. With local experts in the field, technology that allows for questions to be asked and answered quickly and by putting an emphasis on being easy-to-do-business-with, National Government Services has cultivated an economy of trust with providers.

Federal contractors such as National Government Services can’t change any rules or regulations, but they can help to make the complex simple for the providers.




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