| Course | HCP 516 Auditing, Monitoring and Corrective Action in Compliance (HCP/516) |
|---|---|
| Week | 6 |
| Paper type | Compliance committee presentation |
| Length | about 789 words, 3 double-spaced pages plus title page and references |
| Format | APA 7 student paper |
| School | University of Phoenix |
| Program | MHA |
| Updated | September 2026 |
Free sample paper for HCP 516 Week 6
What We Found, Why It Happened, What We Repaid and How We Know It Is Fixed: A Twelve-Slide Report to the Board's Compliance Committee on Therapy Unit Billing
[Student Name]
University of Phoenix
HCP/516: Auditing, Monitoring and Corrective Action in Compliance
Week 6 Assignment
[Instructor Name]
[Date]
The therapy company, its committee, findings and figures are composites written for a model presentation; guidance and research come from the sources listed.
Slide 1: The Bottom Line
We found a billing problem in therapy units.
We measured it, repaid it and fixed it.
Verification shows errors down from 21.7% to 3.3%.
Speaker notes
Thank you. My message tonight is short: our first compliance audit found that we billed Medicare for more therapy units than our documentation supported on about one in five visits. We measured the problem with a valid sample, returned the estimated overpayment on counsel's advice, changed our systems and verified the fix. I will ask the committee for continued oversight at the end. Each slide carries one message, and the detailed audit report is in your packet.
Slide 2: Why We Looked
Federal auditors found 61% of sampled therapy claims failed rules.
Mismatched timed units were a leading cause.
Our own data showed one clinic at 71% maximum-unit billing.
Speaker notes
This risk is industry-wide. In a federal audit of Medicare outpatient physical therapy claims, 184 of 300 sampled claims did not meet requirements, and timed units that did not match documentation were among the most common problems (Office of Inspector General, 2018). Our data pointed us to the same risk.
Slide 3: How We Tested
Probe: 30 random visits, 9 errors.
Valid sample: 120 random visits from 17,000.
Standard: Medicare's rule for counting timed minutes.
Speaker notes
The probe told us a problem existed. The larger random sample let us estimate its size across six months of visits. A certified coder reviewed each visit, and therapists had the chance to show documentation we missed.
Slide 4: What We Found
26 of 120 visits overbilled: 21.7%.
4.3% of sampled dollars paid in error.
Most errors were one unit per visit.
Speaker notes
The visit error rate is high, but the dollar impact per visit is small, because most errors were one extra unit. The focused review at our outlier clinic found 40% of visits with errors.
Slide 5: Why It Happened
A template that did not total minutes.
New staff trained on a different rule.
No billing check; oversight looked elsewhere; units on display boards.
Speaker notes
Our root cause team, which included therapists, found five contributing causes. Most were in our systems, not in individuals' honesty. We deliberately avoided looking for a single root cause, a known weakness of the method in health care (Peerally et al., 2017).
Slide 6: What We Repaid
$52,300 returned to our Medicare contractor.
Lower limit of the 90% confidence interval.
Counsel advised a contractor refund, not self-disclosure.
Speaker notes
The point estimate was about $69,700. On counsel's advice, and because nothing suggested intent, only mistakes, we used the contractor's voluntary refund process within the required time frame.
Slide 7: What We Changed
Template now counts minutes and shows supported units.
Billing edit holds mismatched claims.
One template for all clinics; training for new hires.
Speaker notes
We ranked actions by strength and put design changes first. Training supports them but does not replace them.
Slide 8: Did It Work?
90-day audit, same method: 3.3% errors.
Outlier clinic: 1 error in 30 visits.
Billing edit caught all but one.
Speaker notes
Using the same method lets us compare before and after fairly. A fix is only a fix once the same test that found the problem says it is gone.
Slide 9: What It Cost
$18,000 for template and billing changes.
Existing staff time for training and feedback.
Compared with continued overpayments and audit risk.
Speaker notes
The investment was modest relative to the exposure, which would have grown every month. Without the audit, a contractor review could have found the same errors and extrapolated a demand across a longer period, possibly with interest.
Slide 10: Your Oversight Role
Guidance for boards: ask about risks, resources and results.
Are we finding problems before regulators do?
Are fixes verified?
Speaker notes
Guidance developed for health care boards encourages directors to ask whether the compliance program identifies risks, is adequately resourced and follows up on findings (Office of Inspector General et al., 2015). Tonight's report is an example of that cycle working.
Slide 11: What Comes Next
Weekly monitoring of held claims continues.
Area stays in next year's audit plan.
Two more audits this year: plan of care and threshold services.
Speaker notes
We will report monitoring results quarterly and bring the next audit findings in the spring.
Slide 12: Our Request
Accept the report and the closed corrective action plan.
Continue quarterly monitoring reports.
Speaker notes
I ask the committee to accept this report and to continue receiving quarterly monitoring results. I welcome your questions.
References
Office of Inspector General. (2018). Many Medicare claims for outpatient physical therapy services did not comply with Medicare requirements (A-05-14-00041). U.S. Department of Health and Human Services. https://oig.hhs.gov/oas/reports/region5/51400041.pdf
Office of Inspector General, American Health Lawyers Association, Association of Healthcare Internal Auditors, & Health Care Compliance Association. (2015). Practical guidance for health care governing boards on compliance oversight. https://oig.hhs.gov/compliance/compliance-guidance/docs/Practical-Guidance-for-Health-Care-Boards-on-Compliance-Oversight.pdf
Peerally, M. F., Carr, S., Waring, J., & Dixon-Woods, M. (2017). The problem with root cause analysis. BMJ Quality & Safety, 26(5), 417-422. https://doi.org/10.1136/bmjqs-2016-005511
What the HCP 516 Week 6 instructions ask
The final HCP 516 assignment usually asks students to present audit findings, root cause analysis and a corrective action plan to a compliance committee or board, often as slides with speaker notes. Prompts may ask students to summarize the audit's purpose and method, present findings and financial impact, explain causes, describe corrective actions and verification and state what the committee needs to decide or monitor. Some versions set a slide limit or require narration. Strong presentations lead with the conclusion, use a few clear numbers on each slide, explain method briefly but credibly, separate facts from judgments, address repayment and disclosure decisions, connect the issue to industry risk and ask the committee for specific oversight.
How this HCP 516 Week 6 example is built
The deck opens by telling the committee that a billing problem was found, measured, repaid and fixed. Slides show the 30-visit probe and the 120-visit sample, the 21.7% visit error rate and 4.3% dollar error rate, and the five causes, led by a template that did not total minutes. A slide explains the repayment of $52,300 to the Medicare contractor on counsel's advice. Actions are ranked from design changes to training. The verification audit shows errors at 3.3%. Board guidance on compliance oversight frames the questions directors should ask, the cost of the fix is set against the exposure and the final slide requests continued quarterly monitoring.
HCP 516 Week 6 grading rubric: where the points go
The committee presentation is generally graded on clarity, accuracy and fitness for a governing body. Instructors look for a clear summary of findings, method, financial impact, causes, corrective actions and verification, with the committee's role made explicit. Slides should be concise, with explanation in speaker notes, and numbers must match the underlying audit. Addressing repayment and disclosure accurately and linking the issue to industry-wide risk earn credit. Using guidance written for health care boards shows awareness of governance expectations. Visual organization and APA citations complete the rubric. Decks that read like the audit report pasted onto slides, or never state what the committee should do, usually score lower.
HCP 516 Week 6 help: mistakes to avoid
The most frequent weakness in the HCP 516 final presentation is burying the conclusion. Start with the bottom line: what was found, how serious it is and whether it is fixed. Then support it: method in one slide, findings with a few key numbers, causes, money, actions and verification. Keep each slide to a few lines, put the explanation in the notes and check every figure against the audit workpapers. Explain repayment and disclosure decisions and who made them. Show that the risk is known in the industry. Finally, tell the committee exactly what oversight you are asking for, such as continued monitoring reports, and rehearse answers to likely questions.
Related HCP 516 sample papers
Other HCP 516 week samples
- HCP 516 Week 1: Auditing Versus Monitoring
- HCP 516 Week 2: Risk-Based Audit Planning
- HCP 516 Week 3: Conducting the Audit
- HCP 516 Week 4: Root Cause Analysis
- HCP 516 Week 5: Corrective Action Plan
More MHA sample papers
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- HCS 504 Week 1: Career Alignment and SMART Goals
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HCP 516 Week 6 questions, answered
What does HCP/516 Week 6 usually ask for?
Final assignments usually ask students to present audit findings, root causes and a corrective action plan to a compliance committee or board, typically as slides with speaker notes.
Where can I find a free HCP 516 Week 6 sample paper?
The twelve-slide committee report above costs nothing to read and includes speaker notes for every slide. Send your own audit results, and we build your first presentation at no charge.
What should a board compliance committee receive?
Clear summaries of significant findings, their causes, financial impact, corrective actions, verification results and trends, enough to exercise oversight and ask informed questions.
Should a compliance presentation include the audit method?
Briefly: committees need enough about sampling and standards to trust the findings, but detailed methods belong in the report or speaker notes rather than on slides.
How should a presentation explain repayment decisions?
State the amount, how it was calculated, who advised on it, to whom it was returned and why that route was chosen, such as a contractor refund rather than self-disclosure.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official University of Phoenix document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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