Medforce Blog

Maximizing the ROI of Compliance Software

July 13, 2017

Category: General

In recent years there has been mounting investigation from the Centers for Medicare & Medicaid Services and state governments for potential fraud within healthcare providers across all sectors. Commercial payers are increasing their own audits and overpayment demands. The Office of Civil Rights, as the watch dog of HIPAA compliance, is increasingly on guard against security breaches. And then there are the organizations’ own stakeholders. Business metrics (such as revenue protection and reputation) are huge drivers of compliance priorities.

Compliance officers have to answer to both internal and external forces and it can be a lot to handle.


According to the 2017 Healthcare Compliance Benchmark Study by SAI Global, 59% of respondents expect compliance budgets to remain the same or shrink. Increasing demands and decreasing resources is the exact equation that should turn all providers toward technology. The right tools enable best practices, improve accuracy, strengthen cash flow, and ensure compliance. Technology that improves productivity is essential to help healthcare providers do more with less. 

The best way to ensure a return on your compliance software investment is to take advantage of tools that play dual roles: mitigate risk and also assist with day-to-day operations. While compliance-focused software has its place, your compliance technology journey should begin by taking a look at what software is available to do double duty. Look for applications that help mitigate risk and respond to denials and audits while also supporting your mission and daily activities. 

There are several advantages: 

  • Cost is shared across departments/operations. When multiple departments use the software, the costs are distributed and individual budgets take less of a hit. 
  • Improves visibility. Having documentation, process management, and communication tools (such as e-faxing or esMD) all contained within an integrated system, it is much easier to monitor everything in real time. You can ensure employees are working according to guidelines and identify issues before they become major problems.
  • Decreases response time. Another benefit of a centralized system is having everything in one spot. You don't need to go to multiple departments or individuals or search through various folders and applications. You can pull what you need to look at for audit response times quickly. 
  • Gets everyone on the same page. When the whole company is working off the same system, there is continuity across departments and a standardized way of doing things. This improves productivity and makes cross-department communication much easier. Access rights enable the necessary security and audit trails allow you to track activity for all employees. 
  • Creates platform for continuous improvement.  When you digitize your operations, it becomes much easier to enact change. Updates based on identified areas for process improvement or payer requirement changes can be quickly adjusted in the system and disseminated across the entire organization. Training becomes much easier as everyone is working off of the most up-to-date configuration possible. 

Compliance by nature can't happen in a silo. It touches and involves all departments. Getting everyone on the same technological platform to begin with not only helps to ensure compliance upfront, but it eases the process of responding to audits and denials on the back end. 

Our blog post on the Top Tools to Enable Compliance details six technologies that help improve operational productivity while contributing to securing compliance. 




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