Understanding and working within legal limitations is paramount for a healthcare business’s success. Be it a hospital, specialist ABA therapy center, or any other medical practice, each facet of your operations must comply with legal parameters set out by the various governing bodies. The age-old saying goes, “Ignorance of the law is still a crime.” Therefore, as a healthcare practitioner, it is your duty to understand these laws to avoid patient queries and frustration and — in extreme cases — lawsuits. This article explores how you can avoid lawsuits in your healthcare business.
Accuracy Should Be a Guiding Principle
What this means is that you must always have accurate documentation and medical records. Let us unpack why this matters. There are certain best practices for medical practitioners. One of the cornerstones of these best practices is accurate and thorough documentation. This includes detailed medical records that display the patient’s medical history, diagnosis, treatment plans, progress reports, and follow-up care details.
Accurate documentation ensures that patient care is conducted based on the patient’s required treatment and that medical practitioners have a documented defense in case of legal action. Some of the best practices include:
- Consistency: Use one template or standard for documentation across departments throughout the medical center.
- Accurate details: Include a comprehensive list of consent forms, treatments, medication, etc.
- Stick to timelines: Capture patient details as soon as possible to maintain accuracy and completeness.
- Electronic health records: Invest in an electronic health records system to enhance the accuracy and accessibility of patient records.
Implement and Maintain Accurate Billing Codes
Establishing the billing code structure in the United States of America ensures that healthcare data is captured correctly and consistently, simultaneously ensuring that health claims are processed properly for Medicare, Medicaid, and any other health program. This standardized coding system is essential for medical services, including surgery, therapy, and more. Here are some best practices to consider:
- Use the correct billing code: No matter the code type, be it an ABA billing code or another, your staff must always be familiar with these codes. They should be well-trained to know what billing code corresponds with what treatment.
- Conduct audits: The frequency depends on you; however, audits are a great way to understand where the gaps are and how you can improve.
- Know the policies: Understand the policies well to ensure you comply with federal and state regulations.
Patient Consent
The law requires medical practitioners to obtain consent from their patients before treatment can commence. Furthermore, the law requires doctors to ensure their patients understand treatments, risks, and potential outcomes before agreeing to them. Additionally, patients must be of sound mind when agreeing to treatment. Here are some guiding principles to consider:
- Obtain consent: The patient must agree to the procedure in writing before the procedure can be completed.
- Document the consent: Include the consent in the patient’s file once they have signed the consent form.
Risk Management and Quality Assurance
In the medical industry, risk management should be included in the overall management of a medical facility, its treatments, and its staff. Quality assurance should essentially be included in day-to-day operations as a form of risk management and to preempt any issues in advance so they can be addressed as quickly as possible. Some best practices include:
- Reviews: Regularly review clinical practices to ensure they meet the current standard of care.
- Incident reporting: Create an incident reporting structure that allows staff to capture, analyze, and fix errors.
- Continuous improvement: Review incident logs and use the data to drive improvements.
Staff Training
While not necessarily a legal consideration, it is vital for all staff to be as knowledgeable as possible to ensure the likelihood of mistakes is at a minimum. Staff should also be up to date on the latest billing codes, policies, and health regulations. Training programs can include the following:
- Clinical training: Where needed, conduct regular training on clinical best practices and medical updates.
- Legalities and ethics: Educate your staff on the latest legal and ethical obligations, including patient consent.
Remain Compliant
A large part of managing a medical business is complying with regulations. It is imperative to always comply with state and federal regulations since non-compliance leads to legal action, fines, and a damaged reputation. Here are some considerations:
- Stay informed: Stay up to date with regulatory updates by subscribing to newsletters and forums that provide these updates.
- Employ or outsource a compliance officer: Compliance can become a full-time job, and thus, it is crucial to have a compliance officer responsible for auditing the business.
- Regular training: Conduct regular training with staff to ensure they understand the legal parameters, what is required from them regarding their responsibilities, and more.
- Audits: While auditing is critical, compliance auditing is a separate section and should not be overlooked. Regular audits are essential, as they will show where you need to adjust your compliance.
Comply With Regulations To Remain Within the Law
Avoiding lawsuits in your healthcare business requires a multifaceted approach focused on improving patient care and remaining compliant. This can be done by accurately documenting patient information based on the standards that govern the medical industry. Another key focus area is medical billing codes; the consideration is to remain up to date on the codes and ensure they match the treatment given.
Obtain and document patient consent before procedures are conducted. Establish a thorough quality assurance system to aid in risk assessment and management. Train your staff on regulations, laws, and patient care and evaluate the training to ensure it is easy to understand. Lastly, remain compliant, as this ensures you practice patient care within the boundaries of the law.
