Conditions of Participation (CoP).
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Get it written →Go to http://www.cms.hhs.gov and find the Conditions of Participation (CoP). Read them and discuss the standards listed.a. Why do you think each was included?”
2) Are there any specific actions or elements that you think are missing?
3)Compare and contrast Medicare’s CoP with the rules of participation for providers to join Blue Cross Blue Shield’s network and/or other private insurance carriers’ networks.
4) Locate and review the Comprehensive Error Rate Testing results in your state. Look through the list of elements that are studied by this evaluation of claims payments.a. What surprises you most?
5)Are there any additional areas that you believe should be measured?
6)Had your facility been evaluated by a CERT, what would you do to improve performance?
7) Identify the fiscal intermediary in your state and go to their website. a. What information is there that would help you with writing a compliance program?”
8) What details can you relation to : medicare claim processing, Medicaid claim processing and SCHIP claim processing.
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