Compliance

 








Protocol & Compliance

The Family Workshop has established a variety of internal systems, policies, procedures, controls and safe guards to ensure a service delivery system that supports the activity of the agency. Further, we are required to be in compliance with a variety of external controls (audits) from a number of payors and licensing authorities. All of these "rules" are really the details of business and, although at times cumbersome, are designed to protect clients and our legal and ethical position. So, we agree. There are probably 1,000 things that we do, counselors do, regarding protocol and compliance, but the following list covers the highlights.

1. Our Counselors are all independent contractors, and NOT under the control and direction of the Family Workshop. This means that they have independent business certifications (CRS numbers for the state), file taxes, get outside supervision and pay other fees (liability insurance and training) as independent businesses. The primary control and direction for Counselors comes from their individual outside supervision and their licensure standards. The family Workshop simply acts as a liaison between the funding entity and the client, sort of like a leasing agent, and specifically provide client intakes, for them, and billing, for them.

2. Privacy and confidentiality - All information about clients is held in the strictest confidence. Files are locked, there is no internet information on clients and, basically, we need a release from the client to share any information. We fall under the same protection as do attorneys, doctors, and journalists.

3. Ethics - All Counselors, through their licensure standards and practices, are required to adhere to a comprehensive list of ethical standards. These include boundary, disclosure and conflict of interest issues, as well as legal, financial and personal situations.

4. Clinical Oversight - Clinical oversight is provided by each Counselor's individual supervisor. The Family Workshop provides only protocol and compliance to their "contract employee contract." This usually means the requirements of the payor, i.e. insurance companies.

5. Claims and Billing - We have established a double and triple check monitoring system to be sure that all claims are correct, that sessions were done that we have billed for and that payouts to therapists are accurate.

6. Staff and Counselor Orientations - These are written and done by the agency director, supervising office manager and the clinical director. All Counselors are "credentialed" through an outside agency to verify licensure, education and past job performance.

7. Financial Management - We operate under the requirements of Standard Practices of Accounting that include separation of duties, bank reconciliations, balance and P&L statements.

8. Taxes and Certifications - We maintain federal tax ID numbers, national provider numbers (NPI) and registration, as well as the NM State CRS systems and city business licenses in Albuquerque and Rio Rancho. We are monitored and comply with city fire codes, handicap regulations and HIPPA regulations.

9. Audits - We are audited almost annually by Insurance Companies, Medicaid, and other payors to verify compliance with logistical, fiscal and personnel practices for contractors.

10. Policies and Procedures - All Issues of protocol and compliance are written (Agency Manual, Contracts, HR, both contractors and W-2 staff, and Files) and documented for the appropriate authorities to review.

11. Coordination - With the proper releases, Counselors do a good job to collaborate, coordinate and "case manage," including coordination with all parties connected to the case.

12. We maintain a couple of Attorneys, on call, for a variety of potential business and compliance issues, custody and family disputes, and the protection of clients rights.