Self-Direct, Inc. is dedicated to delivering client driven and outcome-oriented quality services. Self-Direct, Inc. has developed and implemented a Compliance Program to assist the agency with achieving this goal. It is the policy of Self-Direct, Inc. to continually assess risk areas, and perform regular monitoring and auditing procedures, to ensure that Self-Direct, Inc. meets NYS and Federal regulations. Self-Direct, Inc. allows for confidential reporting of any compliance related concern. All individuals who are in good faith participate in the compliance program can do so without fear of intimidation or retaliation from any employee, officer or director at Self-Direct Inc. Periodic compliance audits are performed to identify compliance issues and detect any possible weaknesses. Prompt corrective action is taken to address any such issue or weakness. The audit measures Self-Direct, Inc.’s performance against its own policies, procedures and state and federal laws and regulations. This includes regulation concerning kickback arrangements, self-referrals, pricing, contracts, claims development and submission, reimbursement, sales, marketing, and supplier standards. Self-Direct, Inc. documents all formal and informal monitoring and auditing activities.
Self-Direct, Inc.’s QIC Committee is established to ensure the proper delivery of services and the maintenance and improvement in quality of care through self-review. The committee will evaluate performance that focuses on structure, process and outcomes to reduce or resolve identified problems and/or improve operations. The QIC Committee shall meet quarterly, or sooner, and perform the following function:
- Identify issues that may adversely affect quality of care and services and develop and implement plans of action to correct identified quality concerns or deficiencies
- Promote quality of care through self-review without the fear of reprisal
- Review and audit a random selection charts
- Review service utilization and determine trends
- Review annual satisfaction survey findings; determine trends, develop a report outlining the findings, and resolve issues or concerns
- Review any trainings given, or upcoming trainings and provide feedback regarding their quality; make recommendations for development of new trainings or revising current trainings
- Assess any internal procedures which are inefficient or deter the agency’s ability to provide quality services
It is at a minimum the Agency’s goal to meet or exceed the expectations of the participant. Valued outcomes measured are as follows:
- Increased independence
- Improving integration in the community
- Greater productivity
- Client selection of outcomes
- Progress towards those outcomes
- Proper support provided by service agencies
- General improved quality of life
- Client chooses where they live and with whom they live
Self-Direct, Inc. Standards of Conduct
Employer Standards
- This organization shall comply with all local, state and federal regulations that apply.
- The organization does not accept bribes, kickbacks or tips for any purpose.
- The company is not part of the ownership of any other entity that generates referrals to it.
- All employees are trained on proper business conduct.
- All employees are given instruction on the company’s Policies and Procedures.
- All information regarding our client’s medical condition are kept confidential and only released by signature from the client.
- All insurance claims reflect products or services that are actually delivered.
- Exact billing codes that match the Certificate of Medical Necessity Diagnosis will be used on all claims.
- A licensed physician must approve and complete appropriate documentation for medical equipment.
- All marketing materials and advertisements are honest, informative and non-deceptive.
- All potential employees are screened and references are checked.
Employee Standards
- No employee will knowingly engage in deceptive, misleading or fraudulent acts.
- No employee will accept any monetary remuneration from clients or referring sources.
- All employees will follow company policies and procedures that relate to their position.
- All patient information shall remain confidential.
- Patient information will not be released without the patient’s knowledge and written permission.
- All information given to potential clients will be truthful, factual and informative.
- Self-Direct, Inc. will not discriminate or retaliate against any employee who reports a suspected compliance violation. Any employees, supervisors, or other personnel who discriminate or retaliate in any way against an employee who reports a suspected compliance violation will be terminated.
- If an employee makes a report in a way that happens to reveal his or her identity, but requests anonymity, Self-Direct, Inc. will protect the employee’s anonymity to the fullest extent permissible under the circumstances. Under no circumstances will an employee be disciplined or retaliated against in any way for requesting anonymity.