Sun Knowledge is stringently compliant with Medicare and Medicaid standards, HIPAA (Health Insurance Portability and Accountability Act) and other Federal Laws, Bylaws, Rules and Regulations. We make sure that our policies, including Privacy Policy as well as Fraud, Waste and Abuse Policy, abide by US Health Care laws as well as HIPAA and have procedures in place which address administrative, technical and physical safeguards.
We routinely update our staff on new guidelines, published by CMS and fulfill its reporting requirements by proactively involving the concerned departments. We consistently devise comprehensive training plans to educate our employees about HIPAA, safeguarding Protected Health Information (PHI) of our beneficiaries.
We religiously meet the reporting requirements of licensure, actively participating in the resolution of complaints of beneficiaries, as and when required.
The compliance team at Sun Knowledge is responsible for:
Development, implementation and updating of compliance policies and procedures
Monitoring the development of systems and procedures for compliance with CMS requirements
Monitoring the contracting process with business associates
Administration of audits for Part A & B, MA-PD and standalone Part D Program compliance
Monitoring the information system technology on privacy matters related to the security of Protected Health Information
Training and educating employees on compliance requirements, at every level
Advising staff on disclosures, maintenance and storage of documents containing PHI
Preparing, implementing and monitoring internal audit programs and their outcomes
Administration of disclosures of all PHI, other than routine disclosures for health care operations
Serving as the primary point of contact for privacy related complaints and litigation
Implementation of processes for receiving, documenting, tracking, investigating, and taking actions against all complaints, concerning the client’s policies and procedures, in collaboration with other similar functions and, when necessary, legal counsel
Providing support and feedback to Internal Audit Team and Audit Compliance Team
Developing and monitoring a compliance grievance process, related to employee’s complaints and subsequently, administering corrective actions
Compliance with privacy practices and consistent application of sanctions, in case of compliance failures for all individuals in client’s workforce, and for all business associates
