Page 122 - 2020 ARE eGuide for Clinical at Nonhospital Sites

Safeguards Against Fraud, Waste, and Abuse

Even though you may not be responsible for sending out the claim to Medicare or any insurer, if
you enter information on the patient’s account or in the patient’s medical record, you are
contributing to the information submitted for payment.

Make sure that:
• Charges are entered for services and supplies
that were actually used on or for the patient you
are charging.
• Documentation entered in the medical record
supports the charges entered and that you sign,
date, and time all entries.
• Confidential information, such as patient
information and Baptist Health business
information, is protected.
• Arrangements with physicians or other referral sources do not reward them financially
based upon the number of referrals made to Baptist Health.
• Any suspected instance of fraud, waste, or abuse is immediately reported to your
supervisor or any member of management, Audit and Compliance, the Legal Department,
or the Compliance Hotline.

What are internal monitoring and auditing?

Internal monitoring activities are regular
reviews that confirm ongoing compliance and
ensure that corrective actions are in place and
effective.
Internal auditing is a formal review of
compliance with a particular set of standards
used as base measures.