Avoiding fraud claims

Bruce Baron
Bruce Baron

With Medicare and Medicaid costs soaring, federal and state agencies are looking at various avenues to rein in costs. Fraudulent billings from healthcare providers costs taxpayers millions of dollars each year and is an area of focus for government agencies. 

Medical providers and others in the healthcare industry are regularly required to submit statements and certifications attesting to their compliance with various federal and state health care regulations. Claims for reimbursement submitted to Medicare or Medicaid are valid only if the individual providing the treatment or service had all the licenses and certifications required. If the individual healthcare provider did not have the necessary license or certification, then the claim is considered a “false claim” under the False Claims Act. It is not a defense that the individual healthcare provider gave the patient equivalent care. 

For providers, failure to ensure their nursing staff has the proper licenses or certifications can result in penalties, loss of license and in extreme cases, jail sentences. 

To ensure licenses, certifications, in-service trainings and other mandated requirements are met, many eldercare providers use spreadsheets, notebooks or other means to track staff compliance. 

At VoiceFriend, we understand the challenges eldercare providers face in meeting stringent reporting requirements. To help ensure staff compliance, we have developed an easy-to-use solution that enables eldercare providers to automatically send staff license, certification and in-service training reminders via text message, voice message or email - 30, 60 and even 90 days in advance of compliance due dates. For management, there is a staff compliance dashboard that easily alerts you to those staff members with due dates coming soon. It even will tell you when staff are no longer eligible to work at your community. 

Fraud at eldercare providers is a tragic, but avoidable issue. Having the right tools can easily ensure that your community is in compliance with Medicare and Medicaid regulations. 

Bruce Baron is CEO of VoiceFriend. For more information, contact VoiceFriend at 781-996-3123.

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