Healthcare compliance is a complex and ever-evolving field that requires medical providers to navigate multiple state-specific laws and regulations. Compass Healthcare Consulting is well-versed in dealing with these hurdles and others in the Volunteer State.
Whether you’re in Nashville, Knoxville, or Memphis, here’s what you need to know.
What’s Unique About Tennessee Healthcare Regulations
Healthcare compliance in Tennessee features several unique aspects that set the state apart from the rest. While it shares many safety, reporting, and consumer privacy regulations with other states, Tennessee has implemented some unique requirements.
TennCare provides healthcare coverage for low-income individuals and families, including screening for non-medical needs and connecting members to community resources. Compass Healthcare Consulting is a trusted guide for healthcare providers trying to understand TennCare’s regulations.
We’re experts at spotting risks, keeping things compliant, and making operations run smoothly. We can give your organization a thorough check-up, looking for any potential issues and offering practical advice on how to meet TennCare’s rules.
This regulation demonstrates Tennessee’s commitment to balancing consumer protection and healthcare access. It helps to ensure that everyone gets the best care possible, from Memphis to Chattanooga.
Tennessee State Healthcare Agencies
Healthcare compliance in Tennessee is overseen by several key agencies, each with distinct responsibilities. For example, The Tennessee Department of Health (TDOH) is the primary agency responsible for public:
- Health initiatives
- Disease prevention
- Health promotion
The TDOH also manages various programs, including breast and cervical cancer screening, immunizations, and local health departments across Tennessee.
TennCare, Tennessee’s Medicaid program, provides healthcare coverage for eligible low-income individuals and families. It oversees benefits, services, and eligibility determinations.
The Tennessee Board of Medical Examiners regulates the practice of medicine in the state, including licensing physicians and disciplinary actions. It ensures that medical professionals meet the required standards of practice and ethics.
Operating under the Department of Mental Health and Substance Abuse Services, the Office of Licensure is responsible for licensing and monitoring behavioral health facilities and services.
Various regulatory boards under the Department of Commerce and Insurance oversee different healthcare professions, such as nursing, pharmacy, and dentistry.
Other state agencies with healthcare-related functions include:
- The Department of Human Services
- The Department of Intellectual and Developmental Disabilities
- The Department of Children’s Services
These Nashville-based agencies collaborate to create a comprehensive healthcare system in Tennessee, addressing public health, medical practice, insurance, and specialized care needs.
Get Healthcare Compliance in Tennessee with Compass
At Compass Healthcare Consulting, we support healthcare compliance in Tennessee by offering several key services that cater to organizations in the state and beyond. They include:
- Medical billing and coding reviews
- Risk assessment and compliance support
- Mergers and acquisitions
Medical billing and coding reviews
Our medical billing and coding review service provides comprehensive chart audits for multi-site physician groups, including private-equity-sponsored and health-system-affiliated practices. Our team provides detailed analysis and reporting on coding and billing practices, helping your organization identify trends that may impact reimbursement, highlight high-risk areas for payor audits, and reduce claims denials.
Risk assessment and compliance support
With risk assessment and compliance support, we help your healthcare organization navigate complex compliance requirements. We conduct thorough, site-specific assessments to identify business and regulatory risks, particularly for multi-site practices.
We then deliver:
- Tailored findings
- Actionable recommendations
- Enterprise-level summaries
These help your organization prioritize risk management that ensures regulatory compliance while improving operational efficiency
Mergers and acquisitions
We support medical practice mergers and acquisitions by providing comprehensive due diligence services. Our team performs a thorough analysis of revenue integrity and evaluates technology and regulatory risks through site visits. This allows us to deliver detailed reports with actionable insights throughout the M&A process.
At Compass Healthcare Consulting, we emphasize personalized engagement with clients across all of our services. We address specific challenges by offering:
- One-on-one consultations
- Regular communication
- Tailored solutions
This approach helps your Tennessee healthcare organization optimize its operations, improve financial performance, and maintain compliance in an ever-changing regulatory landscape. With Compass, you receive expertise that’s Knoxville-based with national reach to enhance coding accuracy, reduce compliance risks, and identify strategic growth opportunities.
