If you work for a health insurance company, you are a medical provider, or you are a healthcare professional dealing with Medicare funds, you are probably faced with supporting a high volume of language-related requests. These requests may include translating documents such as an Explanation of Benefits, Explanation Of Coverage, Summary of Benefits, denial letters, and other communications in different languages, medical or mental health appointments, or interpretations of enrollment meetings.
You are bound by rigorous legislation over privacy, demanding deadlines and volumes that can change significantly from one hour to the other. To help you manage these things, you need a Medicare Compliant Translation company that understands Medicare and Medicaid laws, funding, and compliance. They must also comply with the time frames, be auditable, and work well with you and your organization. They should scale and provide flexible adjustments to your workflow or demands.
In order for our company to be Medicare compliant, these are some of the main items that we cover:
1. Code of Conduct(“COC”) and/or Compliance Policies
Akorbi has adopted compliance policies and distributed them to all employees within 90 days of hire. These materials are redistributed annually and any time revisions are made to them.
2. CMS’ Fraud, Waste and Abuse (“FWA”) Training
Our employees have satisfied the requirements for FWA training or have been deemed to have met them. Employees are required to complete the CMS’ Combating Medicare Parts C & D Fraud, Waste, and Abuse Training model within 90 days of their hiring and every year following. In order to be deemed to have met the requirements, employees may enroll in Parts A or B of the Medicare program. They may also complete the training on the Medicare Learning Network (MLN) or as part of our internal training system.
3. CMS’ General Compliance Training
Akorbi employees complete CMS’ Medicare Parts C&D General Compliance Training module within 90 days of their being hired, and every year after. Training is completed on the MLN or as part of our internal training.
4. Office of Inspector General and General Services Administration’s System for Award Management Exclusion Screening
Akorbi screens the US Department of Health & Human Services Office of Inspector General and the General Services Administration’s System for Award Management exclusion lists prior to hiring and contracting new employees and Downstream Entities. We check these lists monthly and remove any persons/entities from work on Aetna Medicare business if they appear on these lists.
5. Reporting Mechanisms
We have communicated to all of our employees how the may report suspected or detected non-compliance or potential FWA. We have communicated their obligation to report without fear of retaliation or intimidation against reports made in good faith. Reporting mechanisms include reporting directly with Aetna or the confidential and anonymous mechanisms for internal reporting. We promptly communicate internal reports to Aetna when applicable.
6. Offshore Operations
For any work that involves receiving, processing, transferring, handling, storing or accessing Protected Health Information, Akorbi will perform in the following ways: perform the work onshore, have Downstream Entities perform the work onshore, or perform the work offshore (ourselves or through a Downstream Entity) with approval from an authorized Aetna representative.
7. Downstream Entity Oversight
Any Downstream Entity used by Akorbi will receive robust oversight to ensure their compliance with all requirements, such as FWA training and exclusion screening, laws, rules, and regulations.
8. Operational Oversight
Akorbi conducts internal oversight of all services we perform for Aetna Medicare to ensure that we maintain our compliance with all laws, rules, and regulations. We also keep a Compliance Officer on-site whose job is to help us remain in compliance with the rules of Medicare.
Akorbi: Superior Medicare-Compliant Language Services
For Medicare-Compliant language services you can trust, choose Akorbi. Akorbi has a longstanding reputation for excellent translation for businesses working in the medical field, legal field, and many more. Let us help you navigate the difficulties of compliance — contact Akorbi today.