| Course | HI545 Health Care Compliance |
|---|---|
| Unit | Unit 6 |
| Paper type | Corrective action plan |
| Length | About 1,010 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | MS in Health Informatics |
| Updated | October 2026 |
Free sample paper for HI545 Unit 6
The Field That Stamped the Clock: A Unit 6 Corrective Action Plan for Time-Based Office Visit Levels a Template Inflated
[Student Name]
Purdue University Global
HI545: Health Care Compliance
Unit 6 Corrective Action Plan
[Instructor Name]
[Date]
Esterline Health, the physician, the dates and every count are composite; the statutes and sources cited are real.
Finding
The quarterly audit sample under the Unit 4 plan found four of ten office visits overcoded for one pulmonologist, here called Physician C. Under the plan's thresholds, that triggered an expanded review of thirty further visits from the same quarter, drawn with a recorded seed. Fourteen of the thirty were billed at a higher level than the documentation supports, past the threshold of eight that refers a matter for corrective action. Twelve of the fourteen were billed as level 4 or level 5 on the basis of total time.
Root Cause
The reviewers noticed that the time statements in the twelve time-based visits were oddly exact and oddly large: 41, 44, 47 minutes, for notes describing short follow-up visits. The clinical informatics team traced the cause to the office visit template the practice used before acquisition. A field labeled total time was filled automatically with the minutes between the chart being opened and the note being signed. Physician C opened charts at the start of clinic and signed them after the last patient left, so the field often showed long stretches that had nothing to do with the patient. Under the guidelines in force since 2021, a clinician may set the office visit level on decision making or on the minutes she personally devotes to that patient across the calendar day of the visit (American Medical Association, 2020). Time spent with the chart open while seeing other patients is not time on this patient. The template therefore produced statements that the record could not support. The physician chose levels the template's numbers allowed, and the template's numbers measured how long a chart stayed open, not how long anyone spent on the patient. Two of the fourteen overcoded visits were level 4 claims chosen on decision making, where the reviewers found the documented problems and data supported level 3. Those are treated as ordinary coding errors, addressed by education.
Scope Check
Because the template served all six physicians and two nurse practitioners, the cause may reach beyond Physician C. Every time-based office visit billed with the template since the 2021 guideline change is in scope for the lookback in step 4. Automated text and copy-forward features are known sources of inaccurate documentation (Tsou et al., 2017), and the template review in step 2 also looks for other auto-filled fields.
Corrective Actions
1. November 3, 2026. Owner: clinical informatics director. Remove the automatic total-time field from the office visit template in production; replace it with a blank field the clinician must complete.
2. November 13, 2026. Owner: clinical informatics director. Review every field in the practice's templates for other automatic entries that could support a billing level, and report findings to the compliance officer.
3. November 6, 2026. Owner: practice manager. Place a hold on billing time-based level 4 and level 5 visits until the new field is in use and the clinician has completed step 6.
4. December 4, 2026. Owner: coding audit manager. Identify every time-based office visit billed with the old template within the six-year lookback, and draw a statistically valid sample designed with counsel to estimate the overpayment.
5. January 15, 2027. Owner: coding audit manager. Complete review of the sample and calculate the estimated overpayment by payer.
6. November 20, 2026. Owner: practice coding educator. One-on-one education for Physician C on time-based and decision-based level selection, with documentation examples from the reviewed visits.
7. December 11, 2026. Owner: practice coding educator. A forty-minute session for all six physicians and two nurse practitioners on time statements, followed by a ten-question check that each must pass.
8. January 29, 2027. Owner: chief compliance officer, with counsel. Decide the repayment route: a voluntary refund to the Medicare contractor and other payers, or, if facts suggesting knowing conduct appear, the OIG self-disclosure protocol.
9. Within sixty days of the overpayment being quantified. Owner: revenue cycle director. Report and return the overpayment, as federal law requires once an overpayment is identified (42 U.S.C. § 1320a-7k, 2024), with the time allowed for a diligent investigation documented under the implementing rule (81 Fed. Reg. 7654, 2016).
10. Ongoing from November 2026. Owner: practice manager. Monthly report of level 4 and level 5 time-based visits by clinician, reviewed by the medical director, to show whether the distribution shifts after the fix.
11. March 31, 2027. Owner: coding audit manager. Closing re-audit of thirty visits by Physician C from the first full quarter after step 6, drawn by the same method.
12. April 15, 2027. Owner: chief compliance officer. Report to the compliance committee on all steps, the re-audit result and the repayment, with a recommendation to close or extend the plan.
Closing Criteria
The plan closes when all of the following are true: the template fix is in production and verified; the repayment has been made; all clinicians have passed the education check; and the closing re-audit finds three or fewer of thirty visits overcoded or unsupported. If the re-audit finds more, Physician C remains under a monthly ten-visit prospective review for two further quarters, and the plan stays open.
Communication
Physician C receives the finding, the root cause and this plan in a meeting with the medical director and the compliance officer before step 3 begins. The finding is described as a template failure and a documentation gap, not as misconduct, because nothing in the record suggests intent. The other clinicians are told that a template field was wrong and has been fixed, and why their own time-based visits are in the lookback. The general compliance guidance places prompt response and correction among a program's essential parts (Office of Inspector General, 2023), and documenting the response this way is also the record that the program works.
References
American Medical Association. (2020). CPT evaluation and management (E/M) office or other outpatient services and prolonged services code and guideline changes. American Medical Association.
81 Fed. Reg. 7654 (2016). Medicare program; reporting and returning of overpayments (final rule).
Office of Inspector General. (2023). General compliance program guidance. U.S. Department of Health and Human Services.
Tsou, A. Y., Lehmann, C. U., Michel, J., Solomon, R., Possanza, L., & Gandhi, T. (2017). Safe practices for copy and paste in the EHR: Systematic review, recommendations, and novel model for health IT collaboration. Applied Clinical Informatics, 8(1), 12-34. https://doi.org/10.4338/ACI-2016-09-R-0150
42 U.S.C. § 1320a-7k (2024). https://www.law.cornell.edu/uscode/text/42/1320a-7k
What the HI545 Unit 6 assignment asks for
The sixth unit usually asks for a corrective action plan in response to an audit or investigation finding. Expect to state the finding, identify the root cause, list actions with owners and target dates, address any repayment, and say how you will know the problem is fixed. Many instructors want containment steps that stop further errors while the investigation continues. Distinguish system causes from individual ones, because the response differs. Closing criteria, written before the plan starts, are often required. Cite the coding guidelines involved, the overpayment rule and the compliance guidance on response. A numbered list of actions works better than paragraphs. Four to six pages is usual. Check that every action has a single owner who can actually perform it, and that dates follow a sensible order, with containment first and the re-audit last.
Inside the HI545 Unit 6 example
The finding opens the plan with the numbers from the audit and the expanded review. A root cause section explains how the reviewers noticed suspiciously exact time statements and how clinical informatics traced them to an automatic field. The highlighted sentence separates the physician's choice from the template's false numbers, and a margin note explains why two ordinary coding errors are handled apart. A scope check widens the lookback to every clinician who used the template. Twelve actions follow, each with a date and owner, from removing the field to the compliance officer's closing report. Closing criteria list four conditions and what happens if the re-audit fails. A communication section explains how the physician and colleagues are told, describing the finding as a template failure. Three margin notes in all point to cause, proportion and accountability.
Reading the HI545 Unit 6 grading rubric
Corrective action plans are generally scored on root cause, actions and verification. A considerable portion of the points goes to a root cause supported by evidence rather than a guess. Actions are judged on whether they address that cause, contain further harm, and carry owners and dates. Repayment and disclosure steps earn their own credit when they follow the rules and assign the decision to the right people. Verification, a re-audit or monitoring with defined closing criteria, often separates strong plans from adequate ones. Communication with affected staff, organization and APA citation share the rest. Students lose points by blaming an individual without examining the system, by omitting repayment, or by ending the plan after education without any test of whether it worked.
HI545 Unit 6 help from the desk
The usual reason this plan comes back is a root cause that stops at the person: the physician overcoded. Graders want to know why. Another frequent gap is no containment, so errors continue while the plan is written. Many drafts list education as the only action. Some forget that other clinicians may share the same cause. Repayment is sometimes promised without a route or a deadline. Dates appear out of order, with the re-audit before the fix is in place. If your finding is different, bring the audit result, the case and your instructor's template, and a plan can be written with a cause traced through the system and closing criteria set before the work begins.
Get an HI545 Unit 6 example written to your instructions
A corrective action prompt typically hands over one finding, occasionally a full audit report. Either will do as a start; include the rubric and any plan template the course issues. Containment, cause, correction and verification will each name an owner and a deadline. It arrives in 24-48h, and there is no charge for a first request. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
More HI545 papers and MS in Health Informatics samples
- HI545 Unit 1: Discussion Case Post
- HI545 Unit 2: Fraud and Abuse Analysis
- HI545 Unit 3: Compliance Policy Draft
- HI545 Unit 4: Audit Sampling Plan
- HI545 Unit 5: Billing Risk Assessment
- HI545 Unit 7: Compliance Training Outline
- HI545 Unit 8: Seminar Reflection
- HI545 Unit 9: Investigation Memo
- HI545 Unit 10: Program Effectiveness Review
- HI540 Unit 6: Resource and Budget Plan
- HI530 Unit 6: Data Dictionary Excerpt
- HI520 Unit 6: Multi-Table Join Query
- HI510 Unit 6: Registry Submission Analysis
HI545 Unit 6 questions, answered
Why does containment come before root cause?
Because claims keep going out while the investigation runs. If the pattern continues for the six weeks a root cause takes, the organization adds six weeks of claims to the problem it is trying to fix. The sample starts pre-bill review for the affected physician immediately and lifts it only under a stated release rule.
Does every corrective action plan need repayment?
Only where the finding produced an overpayment. A policy gap with no claims attached may need correction without any refund. Where claims were paid on unsupported documentation, as in this case, the plan identifies them, quantifies the amount and returns it, and it files the calculation so a later reviewer can see how the figure was reached.
Should a physician be disciplined for this finding?
It depends on the system's standards and the facts. The sample treats the template as the primary cause and the reliance as a training matter, so it proposes education and monitoring rather than sanction. It also states that any discipline would follow the same written standard applied to coders and other staff, since uneven enforcement is itself a program failure.
Where can I find a free HI545 Unit 6 sample paper?
You can read the full Unit 6 plan here, from the finding and root cause through twelve dated steps and the closing re-audit.
How does the plan decide when it is finished?
It closes when the template fix is verified, repayment is made, every clinician passes the check and a re-audit finds three or fewer of thirty visits wrong.