Should You Have a Compliance Hotline?

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Do you provide a Compliance Hotline to your employees, vendors, patients and their families?  One of the seven elements of an effective compliance plan is the development of effective lines of communication.  As a provider, your staff, patients, and family members of your patients need to feel that they have the freedom, as well as the obligation, to report compliance issues, such as potential improper coding or billing practices, vendor misconduct, harassment, bullying, or other improper conduct.  Offering a compliance hotline gives the complainant the ability to report the issues anonymously, a solution for those who are in fear of retaliation.

Having a compliance hotline is advantageous to an organization since it gives the option for complainants to report potential wrongdoing(s) internally, rather than turning to external sources, such as the Office of Inspector General (OIG).  Since statistics are showing that more than 50% of fraud tips are coming from employees within the organization, it is prudent to have a compliance hotline.  It gives you a chance to address and correct the problem quickly before it turns to something much more serious.

Experts have found that most whistleblowers are dedicated workers who wants to see their company succeed.  They are not disgruntled employees who are interested in only personal gain.  In many cases, the whistleblowers had initially reported the problem to their superiors in the hopes that the problem would be fixed.  They only turned to another entity, such as the government, when the wrongdoings did not get addressed.  It is important to note that once an employee has reported the wrongdoing(s), either internally or to the Securities and Exchange Commission (SEC), he/she is protected by retaliatory acts of the employer.  The Sarbanes-Oxley Act (SOX) protects corporate whistleblowers from retaliation from reporting fraud or other potential violations to the SEC and internally to the employer.  The Dodd-Frank Act also has an anti-retaliation provision that applies to whistleblowers who report the violations to the SEC; internal reporting to a supervisor or company management is also protected as long as the reporting was also done to the SEC.  Additionally, the Affordable Care Act (ACA) also has a provision that protects whistleblowers from retaliation.

Physician Revenue Navigators highly recommends that providers establish a compliance hotline.  It is a proactive way to handle potential problems.  Physician Revenue Navigators is happy to be a partner to Compliance Hotline, a service provided by Exclusion Screening, LLC.  Their service gives our employees, clients, vendors, patients and their families a convenient option to report potential violations of regulatory or legal matters.  The reports are confidential; the complainant may choose to identify himself/herself or remain anonymous.  Complaints can be made securely and confidentially through the following ways:

  • Online
  • Email
  • Telephone
  • Fax
  • Regular mail

Once a complaint has been submitted, the notification process begins so that we can begin the investigation and respond to the complainant.  Details of the complaints are documented and tracked.  ComplianceHotline provides an easy way for us to manage complaints that are related to compliance issues.

Physician Revenue Navigators is a premier company that provides revenue management for healthcare entities.  Compliance is important to us.  We partner with our clients to navigate them towards success within the scope of compliance.  Contact us to learn more about how we can help you.

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