We all commit to being honest in our billing and descriptions of what we do in order to respect the service definitions and what our clients have been given in their service plan. If an error is made then a correction report will be filed as soon as possible for the errors can be correced.
The Office of the Inspector General (OIG) say is fraud.
1. Services Not Rendered: ANGELS cannot bill for services not actually rendered. Billing for services not actually rendered involves submitting a claim that represents the provider performed a service that all or part of which was simply not performed at the time stated.
2 Medically Unnecessary Services: ANGELS cannot bill for medically unnecessary services. Billing for medically unnecessary services involves knowingly seeking reimbursement for a service that is not warranted by the client's current and documented medical condition.
3 Duplicate Billing: Duplicate billing occurs when the home health agency submits more than one claim for the same service; bills for multiple services at the same time; or a bill is submitted to more than one primary payer at the same time. ***Sone services are specifically designed to allow assistance during medical appointments such as mentorship and personal care.
4 Unqualified Personnel: ANGELS cannot bill for services for which the provider is unqualified or unlicensed to perform If a license or qualification lapses; then alternate, licensed personnel must perform the visit
5 Misapplying Funds Providers and clients shall not steal, embezzle or otherwise convert to the benefit of another person, or intentionally misapply any funds, money, premiums, credits or other assets of a provider of any healthcare benefit program; including Medicare, Medicaid or a private payer.
If a anyone client or provider, is found to be engaging in fraudulent documentation; ANGELS will report such actions to the proper authorities, seek financial restitution and reserves the right to discipline the employee up to termination, contract remediation or termination, and/or discharge a client
· Pay all associate fees, including but not limited to fines, court costs, etc.
· Over Payment
In case ANGELS give you more money than you should have received (calculation error, error in notes, accidental or intential fruad, data entry error, etc.) then ANGELS is may take it back.
Refunding of Payments ANGELS shall promptly refund any payments made by state or federal agencies or private payers which were made erroneously and of which ANGELS was aware. If a collaborator realizes or discovers that documentation was submitted with incorrect information that may result in an overpayment, they must immediately notify ANGELS.
BAA and HIPAA
https://www.watchingfish.com/business-associate This is a link to the business associate agreement that all collaborators are bound by. It means you are personally responsible for safeguarding all client information and are responsible for the consequences if you compromise information.
I understand that I am responsible for complying with the HIPAA policies and regulations.
I Will treat all Information received, which relates to the patients of the provider, as confidential and privileged Information.
I will not access patient information unless I have the need to know this information in order to perform my job.
I will not disclose Information regarding the Provider's patients to any person or entity other than as necessary to perform my job, and as permitted under the HIPAA Policies.
I Will not log on to any of the Provider's computer systems that currently exist or may exist in the future unless I am instructed to do so by the Privacy Officers.
I Will not use e-mail to transmit consumer information unless I am instructed to do so by the ANGELS or client's have given permission in writing.
I will not take patient Information from the premises of the Provider in paper or electronic form without first receiving permission from the ANGELS
Upon separation from ANGELS, I agree to continue to maintain the confidentiality of any information I learned while associated with ANGELS, I agree to turn over any keys; access cards, or any other device that would provide access to the provider or Its information.
· Please note, accessing confidentially information on a public Wi-Fi source is a violation of HIPPA
I understand that violation of this agreement could result in my termination, effective immediately and a report to authorities.