Regulatory Compliance

Staying abreast of laboratory compliance and billing industry practices is a challenge for most hospitals, independent commercial laboratories, and contract billing companies. Having an ongoing relationship with a qualified industry expert results in proper regulation application and integration, and prevents organizational misinterpretations, which often leads to management team paralysis, unnecessary costs, loss of revenue and legal exposure

Our compliance and billing advisory services are designed to meet the immediate and long-term needs of each individual client. This flexibility allows our clients to focus on areas of greatest concern to improve services and profitability and maintain an effective compliance program at a reasonable cost.

Laboratory Compliance Audit Assessment

Our laboratory compliance audit assessment is a prospective review of 135 regulatory issues. Our approach is comprehensive, participative, and geared to withstand federal scrutiny.

We focus on all aspects of compliance issues, including not only coding and billing practices, but also all marketing and operational interfaces between referring physicians, contract hospitals, and pathology billing areas, which have traditionally been overlooked.

Mock Laboratory CLIA / CAP / The Joint Commission Inspection

The purpose of our mock laboratory inspection is to prepare clients for a successful outcome in their mandatory CLIA / CAP / The Joint Commission inspection (required every two years). Laboratories that are either ill-prepared or have had deficiencies in past inspections could jeopardize losing their licensure in one or more testing areas; severely hindering service and patient care. The objectives of Xmacode's mock inspection are to:

  1. Identify any areas of laboratory operation that do not meet the standards required for CAP accreditation (e.g., compliance deficiencies).
  2. Identify areas of laboratory operation that are marginal and in jeopardy of failing accreditation standards.
  3. Provide recommendations to meet CAP accreditation standards.

Our audit assessment includes interviews with selected staff, a review of selected policies and procedures, and an evaluation of CAP laboratory-related practices in the laboratory departments approved for testing. The results of our inspection and recommendations are presented to our clients in a unique 'report card' format designed to measure against levels of compliance with accreditation and regulatory standards.