Proprietors Must Step-Up to Prevent Medicare Fraud

PIC - WILLIAMS E GRAND BLVD 001Small-scale assisted living and adult day care providers must have in place a specific plan to guard resident and program participant information. Situations where this becomes a larger challenge include occasions when you have to share Medicare and other info with visiting professionals. These includes dentists, medical doctors including psychiatrists, home health agencies and medical equipment companies.

PIC - VISITING PHYSICIANWe have experienced no shortage of practitioners billing for services within group living and adult day care programs. Our residents and others need these services. However, we also have an obligation to ensure that what has been billed reflects actual services rendered. If you pay attention to the following suggestions you will heighten your own role in protecting your business from the shadow of fraud:

1. Ensure all visiting professionals and their staffs sign-in at arrival and out at departure. Be sure there is a space on the sign-in sheet for them to note everyone they officially saw during that visit.
2. Obtain permission from residents or their designated representatives to open all mail from Medicare in order that you can cross-check billing statements against actual visit dates
3. Do not provide information to any company ahead of the date that services are rendered. Some may say, “well I will be treating everyone here so let me gather dates of birth, social security numbers and Medicare numbers now to open the charts.” Do not do it, but insist that on the date they arrive for services you will provide info needed.

Working together as an internal team and developing a collaborative policy that adheres to the foregoing, adult day care and small-scale assisted living providers can protect themselves.

PIC - LINKEDIN IMAGEFor more on our commitment to the best in adult day care and small-scale assisted living join the groups: Adult Day Care Innovation & Growth and Small Scale Assisted Living Success Strategies.