What types of systems are most hospitals using to allow employees to report fraud? Are communications between managers the most effective, or are hospitals starting to use electronic tools to help staff report fraud or other compliance violations?
Answer 1: All methods should be made available: staff to manager (chain of command), staff directly to compliance team, and a hotline. Many staff members will use hotlines, depending on the issue. However, many issues should be and are best handled directly when staff notify their leadership. Relying on one method is not the best solution.
This question was answered by: Matt Levsen, CPA, MBA, FHFMA, former associate CFO, University of Missouri Health Care, and a member of HFMA’s Show Me State of Missouri Chapter.
Answer 2: We have a hotline that is managed by an outside company to allow for anonymity. You can call or send an e-mail message. The company gives us the reports, and the company asks the caller to check back for an answer. Many reports end up being HR issues rather than fraud or compliance, but either way, it is a good method to help people speak up. Our code of conduct includes several options to report issues or concerns, including telling your manager, contacting the compliance department, or using the hotline. I think many hospitals also post their codes of conduct.
This question was answered by: Ruth Landé, senior vice president, patient revenues, Memorial Sloan-Kettering Cancer Center, and a member of HFMA’s Metropolitan New York Chapter.
Answer 3: A compliance hotline is still one of the most used tools by employees. Employees prefer to communicate anonymously, so I don’t believe communication between managers would be effective.
This question was answered by: Caswell Samms, III, vice president and CFO, WellStar Kennestone, and a member of HFMA’s Georgia Chapter.
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