Do You Trust Your Employees?
“Skepticism, the Professional Suicide”
by Sean Weiss, Partner & VP of Compliance
Camillo Benso DI Cavour said, “The man who trusts men will make fewer mistakes than he who distrusts them.” What do you think about that? Do you trust your employees and/or coworkers? Why or why not? I have been both employee and employer over my 25-years of working in health care and have found myself at times struggling with that word “Trust”. I struggled both with whether or not my employees and/or coworkers were able to be trusted with the finances and the forward-facing work that was being done with clients. The work we do significantly impacts the lives of so many in health care; from the patients, providers, government, payors, the organizations we work for, and so many more. So, I had a mentality of if it is going to get done correctly, I have to do it myself. Or worse, when I was an employer the first time around, I spent as much time scouring the books and inventory as I did the work that was being performed, which to be honest caused heartburn for my partners and our employees and painted me as someone I wasn’t but, as they say, “Perception is reality” and that was the reality of the world I created. It took me a long time to get to the point I am at now, which is of the mindset that I can only worry about the things I can control and those that I cannot do not deserve my energy because it is what it is. Now, I know some of you reading this are thinking that’s really a bad way to think about things and to be candid, for you that very well may be true but for me and maybe for others, it works.
The purpose of this blog is to get you to take a moment out of your day and reflect on the type of leader/coworker you are and how you think you are viewed by others around you in the workplace. Now, for some of you, you’re going to stop right here and say “Everyone loves me” and that very well may be true, but do they respect you? Eric Hoffer said, “People who bite the hand that feeds them often lick the boot that kicks them.”
In health care especially where we are so regulated and work on a “Honor” system, trust across the spectrum is critical. Trust begins at the start of an encounter that a provider is going to use their best judgement in providing care for the patient and base decisions on standards of medical care and medical necessity versus what is best for the organization financially. Coders and Billers are going to ensure the claims being submitted only contain complete and accurate information. Insurance carriers are going to process the claims in good-faith that services were rendered as claimed and that, should the need for clinical documentation review be required, information is contained within the progress note to substantiate things. While I am simplifying the steps in the previous statement, I believe my point is clear.
Beyond the documentation and coding aspects of running a medical practice, we have the administrative and financial requirements placed on individuals such as handling cash and other financial transactions with patients and vendors. Maintaining protected health information (PHI) and protected financial information (PFI) is of utmost importance. One of the biggest issues hanging around these days with regard to financial problems is identity theft. In the past 4-months, I have dealt with no less than 6 matters at multiple practices of all sizes around the country on this issue. Talk about something that will call into question how much trust should be placed on individuals handling this type of information. The simple solution is to put processes in place to validate what people are doing or should be doing. But then I get folks saying “What about respecting them as professionals?” and I typically respond with something along the lines of “It is not about respect, it is about preserving the integrity of the information and upholding the trust patients placed in your organization to safe-guard their most sensitive information.” The old saying goes “If you load responsibility on a man unworthy of it, he will always betray himself.” August Heckscher
Some things you can do to ensure compliance:
- Establish policies and procedures for high-risk areas within your practice;
- Monitor employee performance and spot check their work with little to no notice to ensure honesty;
- At a minimum, review current polices or processes to ensure they’re working and that measures are put in place to safe-guard that employees are doing what they are supposed to;
- Utilize an Exclusion Screening program to ensure employees are clear each month of sanctions or exclusions;
- Prior to hiring someone do a complete background check (Criminal, Employment, Financial, etc.), verify all references, and make sure to ask the right questions;
- Have an open-door policy with your staff that should they see something, they should say something and not fear retaliation (Because you have a non-retaliatory policy);
- Listen to what other employees are saying about suspicious behavior of an employee who is showing signs of erratic behavior or withdrawing from the company they usually keep;
- If an accusation is made, begin the investigation as soon as possible and maintain independence and objectiveness (If you cannot, hire a third-party) and make sure to consult with legal counsel to determine if it needs to be under privilege;
- Complete investigations in a timely manner and take proper corrective action to demonstrate a good-faith effort; and
- Never, under any circumstance, let your guard down; you are paid to do a job and not be peoples’ friend. You are in the position you are in because you have a skill set that others don’t have and they rely on you to ensure things are right!
At the end of the day, it falls onto the leaders of organizations to ensure that we are not simply operating on “Blind Trust” and that policy and processes are in place to demonstrate compliance and not just telling people when something goes wrong when we are called to carpet that we did it the way we did because that is how we always have done it. That will not fly! While I like to believe in the inherent goodness of humans unfortunately, when temptations become more than one can bear, weakness consumes them and bad judgment ensues. When I handle investigations for groups concerned with acts of reckless behavior or outright fraud and the potential culprit says, “This was my first time,” I remind them that the first time is always the hardest.
What to do next…
- If you need help with an audit appeal or regulatory compliance concern, contact us at (800) 635-4040 or via email at email@example.com.
- Read more about our: Total Compliance Solution
Why do thousands of providers trust DoctorsManagement to help improve their compliance programs and the health of their business?
Experienced compliance professionals. Our compliance services are structured by a chief compliance officer and supported by a team that includes physicians, attorneys and a team of experienced auditors. The team has many decades of combined experience helping protect the interests of physicians and the organizations they serve.
Quality of coders and auditors. Our US-based auditors receive ongoing training and support from our education division, NAMAS (National Alliance of Medical Auditing Specialists). All team members possess over 15 years of experience and hold both the Certified Professional Coder (CPC®) as well as the Certified Professional Medical Auditor (CPMA®) credentials.
Proprietary risk-assessment technology – our auditing team uses ComplianceRiskAnalyzer(CRA)®, a sophisticated analytics solution that assesses critical risk areas. It enables our auditors to precisely select encounters that pose the greatest risk of triggering an audit so that they can be reviewed and the risk can be mitigated.
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