Compliance Stories

What’s The Worst That Could Happen?

It’s nearly an unspoken rule: When you’re not thinking about compliance can be the precise time that compliance is most important.

Between the countless compliance packages we’ve custom-built for our customers and our own experience in eye care practice management, we’ve seen an incredible range of situations where proper compliance saved business owners from major potential consequences. Below, you can find standout stories where compliance — and PCS — made all the difference.

Ex-traordinary Circumstances

A patient comes in for an eye exam. An employee recognizes the patient: the employee is dating the patient’s ex-spouse. Small world! The employee can’t help themselves and calls their partner to say, “Guess who’s in the office?”

The patient overhears the conversation and is, very understandably, upset. They let the office manager know, leave, and file a complaint with the Office of Civil Rights (OCR). When the doctor hears what happened, the employee is terminated with cause.

Several weeks later, officers from the Office of the Inspector General (OIG) show up at the doctor’s office. They don’t ask what happened. Instead, they ask the doctor to show them their paperwork: Notice of Privacy Practice, Acknowledgement of Notice of Privacy Practice, Privacy Manual, Security Manual, Staff Education materials, and documentation that the employee attended HIPAA training.

The doctor is able to quickly pull all of these files up through their PCS account.

After looking at all the doctor’s documentation, the OIG officers are now willing to hear the doctor’s side of the story. The investigators thank the doctor for their time, commend their compliance protocols, and ask them for contact information for the employee. They leave the office, and the doctor later receives a letter stating the investigation was closed without further issue.

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False Claims, Full Coverage

A past president of the Texas Optometry Association (TOA) fires an employee with cause. The employee is upset and vindictively files unwarranted complaints with several agencies, including the OCR and OSHA. The doctor is then contacted by the OIG asking about these potential issues.

The doctor calls PCS understandably concerned, but we assure them that, as our client, they are in compliance. We recommended that they send copies of all the protocols in their PCS binder to the OIG’s office. A few weeks later, the doctor receives a letter thanking them for their cooperation and letting them know that they were found to be in full compliance with relevant regulations.

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Closed for Compliance

An eye care practice employee falls from a stepladder. The employee continues to work that day, but after work goes to an emergency clinic. The clinic tells the employee to contact OSHA about the accident. With no intent of hurting the doctor, the employee follows their advice.

A few weeks later, OSHA inspectors show up. The doctor tells the inspectors that they are just an optometrist, so they did not have to comply with OSHA, and is generally uncooperative. The inspectors asked the staff and patients to exit the building — and then padlock the door, wrap the office in crime scene tape, and tell the doctor they can’t go back into the office until they are OSHA compliant.

The doctor had heard PCS presentations for years but ignored the message, until now. After finally contacting PCS, we are able to immediately help them. The inspectors approved PCS documents and protocols — but only after the office was unfortunately closed for over a week.

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Innocent Accomplice

A doctor in a rural area hires a new employee. Some months later, the police show up at the office to arrest the employee: the employee had been selling patient information on the black market, resulting in several identity theft problems.

The OIG arrive to investigate and find, with PCS’s help, that the doctor is in complete compliance. The doctor still has to pay significant attorney fees, provide public notification of the issue, and suffer many sleepless nights before the issue is resolved — but they aren’t found in violation of any HIPAA rule.

As it turns out, the employee had been convicted previously of selling client information. The employee ultimately ends up in prison, while the doctor continues to practice.

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Complications with Consent

A doctor’s staff in a rural town allows a patient’s partner to sign consent to treat and HIPAA acknowledgement for the patient’s children, something the partner has no authority to do. When the children’s other parent finds out, they file HIPAA privacy violations against the doctor — as well as child molestation charges — both of which end up featured in the local newspaper.

The doctor was not in compliance with HIPAA rules. PCS is brought in as a consultant and to get the office in compliance, a matter we take very seriously. As a result of our involvement, the practice is brought to full compliance, the privacy violation resolved under undisclosed terms, and the child molestation charges are ultimately dropped.

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Out-of-Compliance, Out-of-Pocket

A staff member inadvertently sends out patient invoices to a mass email list, exposing patient information to hundreds of other individuals. Unfortunately, the doctor has no compliance materials in place. Several patients file privacy violations with OCR.

The initial letter to the doctor from the OIG contains warnings that fines for the violation could start at $100,000.00. The doctor contacts PCS for assistance. With PCS’s help and assistance from legal counsel, the issue is ultimately resolved, but not without significant damage to the doctor’s reputation and finances.

The ultimate fine was not for the breach — it was for being out of compliance with HIPAA rules.

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Testimonial

"PCS gave me peace of mind that I am in complete compliance with the law, seamless for me or any practice regardless of city or state. With the PCS programs, I am prepared as a business owner for all the complexities of government regulations and employment laws."

Wes Pittman OD
Mexia Vision Services – Mexia, TX
"Practice Compliance Solution stays on top of the ever-changing rules of the compliance world, more than just HIPAA, so I can focus on patient care. Thank you, PCS for making my life easier."

David Shin OD
Gig Harbor Eye Care – Gig Harbor, WA
"It is peace of mind knowing your back is covered when it comes all the legal requirements surrounding HR, HIPAA and OSHA and have a resource when you have specific questions regarding policies and procedures. PCS has provided that comfort level to us from the very first day we interacted over 6 years ago. Don’t leave you or your office unprotected when it comes to practice compliance. PCS has you covered."

Lowell Lebovitz OD
Envision Eye Care – Pittsburg
"The team at Practice Compliance Solutions is a trustworthy, bright group of professionals who care about our practices. They are an essential and necessary part of our practice team. Working with PCS allows us to sleep easily knowing because of them, we are up to date in the crazy and complex regulatory world in which we practice."

Ron Hopping OD
Hopping Eye Associates – Friendswood, TX
“Offering the best health care possible while managing fourteen employees and all the other headaches associated with running a practice is challenging. The one aspect that I could not afford to overlook is being in compliance with all the regulatory entities that our profession falls under. Practice Compliance Solutions is THE BEST! I can't honestly imagine having a health care office without having PCS by my side.”

David Tybor OD
Oak Hill Eye Care- Oak Hill, TX
“Practice Compliance Solutions has been invaluable in our practices for over a decade. Prior to their help, we would have had significant exposure in almost any coding, HIPAA, or OSHA problem or audit. Their solutions have helped us sleep well knowing that we’ll excel in any audit.”

Glenn Ellisor OD
Vision Source Kingwood – Kingwood, TX
“No one keeps up with the ever-changing world of compliance with the myriad regulations affecting our profession like Practice Compliance Solutions. They really are THE solution! Their cloud app makes it extremely easy to remain up to date and organized, everything from employee manuals to HIPAA privacy and security regulations.”

Spencer Vidulich OD
Chicago Eye Doctors
“As a cold start practice, Practice Compliance Solutions has been an incredible resource for everything compliance. The setup was seamless and it was an absolute joy to work with Justin. The overall package of resources and documents available is extensive. Updates are made routinely providing peace of mind with the ever-changing healthcare landscape.”

James Chin OD
Thrive Eye + Optical – Dallas, TX
“From the outset, PCS has been a pleasure to work with. As a busy practitioner, there are many issues that are both worrisome and burdensome to deal with. Not having to micromanage the minefield of compliance under the care of PCS has been invaluable. PCS provides us peace of mind.”

Arnold Stokol, OD
Stokol + Fagala Optometry – Richardson, TX
“Werner Optometry has partnered with PCS for years to take care of the complex compliance requirements through a simple and user-friendly platform. As an independent private practice owner, my mission is to care for my business and staff so that we can best take care of our patients. Our association with PCS allows us to focus our energy and attention on what we do best.”

Aaron Werner, OD
Werner Optometry – San Diego, CA
“Practice Compliance Solutions has been integral in keeping my practice compliant. I use all of their products including their on-site service and their billing training audit. PCS experts are only an email or phone call away. Their knowledge, customer service and professionalism are surpassed by none.”

Lindsay Bond, OD
Bond Family Eye Care – Decatur, TX
“PCS has been invaluable to the success of my private practice in dealing with medical billing and compliance with state and federal regulations. All my billing needs are taken care of by a very knowledgeable and experienced staff. I use PCS for all three of my offices and strongly recommend them.”

Aleksandra Wianecka, OD
Vision Source - NY
“Practice Compliance Solutions has been one of the best investments we have made! The ease in which you can use their tools and how comprehensive they are, takes away all the guesswork. Knowing that I am compliant with HIPAA, OSHA, and Fraud & Abuse is priceless. I highly recommend!”

Brooke Hawley - General Manager
Maple Grove Eye Doctors at Pearle Vision
"When PCS came up with their initial products, it was packaged in a simple to understand format — I know who these folks are, I know they’re experts, I know they’re going to put something quality together, I trust them. All of those things that you want when you engage with a third party."

Dorothy Hitchmoth OD
Dr. Dorothy L. Hitchmoth, PLLC - New London, NH