In this age of increased technology and business consolidation, I’m finding trust hard to come by lately. Standards that I used to take for granted when I was growing up appear to have been forever cast aside.

I’ll offer this illustrative example, since it involves a subject that’s close to my heart. The homogenization of American business has led to every town in this country having at least two fast food restaurants. Off the top of your head, can you think of an instance when you purchased the same meal from a fast food restaurant in consecutive visits and received food of the same quality (I leave out the word “good” because, let’s face it – IT’S FAST FOOD!)? In most cases, either the fries were warmer the last time you visited, or the sandwich hadn’t been sitting under the heat lamp longer than it should have after the lunch rush. Perhaps the person filling up your drink behind the counter stiffed you this time around, either by not filling your beverage cup to the top or by giving you enough ice to cryonically freeze all of your vital organs for the next millennium to accompany the few teaspoons of raspberry ice tea dancing upon the ice cubes.

My inherent lack of trust isn’t exclusive to products I buy. As a compliance officer,  part of my makeup is to trust no one. On the surface, this may seem like a cynical way to view the universe, but I feel confident that no one is going to slip anything by me. I naturally think the worst of people, which allows for few surprises when I end up being right.

Given the focus and pace of a typical medical practice, physicians have little time to consider such matters when it comes to their staff. Most doctors are in a position of being at the mercy of their non-medical employees to keep the practice moving efficiently and cost-effectively. In an economic situation of near-depression such as the one currently in effect in this country, people who find themselves in dire monetary straits seek opportunities based less on moral imperatives and more on survival and maintaining a status quo for their lifestyle. Many targets present themselves for theft, and none is more tempting than the readily available health care dollars of a medical provider.

It appears a good time for providers to take a moment and ask themselves how much they trust the ancillary staff. With the instances of identity theft stemming from access to patient medical records on the rise,  there is a risk that potentially lies within every person in the reimbursement chain. When someone does something in your name, whether you want to or not, you now have ownership of that person’s actions. While the financial impact of a nefarious employee can be minimized, the effect on your reputation, depending on the scope of the infraction, can lead to long-lasting damage to your practice.

Depending on the length of service of current staff, due diligence in the form of background and credit checks are a simple and cost-effective way of mitigating this risk. In order to feel secure, the psychological hurdle of the feeling of “prying” has to be weighed against the risks posed by the possibility of misdeeds.

We now find ourselves on the brink of a period of increased scrutiny from governmental payers. With the coming expansion of the Recovery Audit Contractor program, coupled with increased investigations from a larger and more aggressive OIG, being able to trust the work product of ancillary staff will be of paramount importance in positioning your practice for the gathering storm of hyper-analysis. Allowing yourself a few moments of skepticism before entering this new era can give you the peace of mind necessary to prepare for the coming environment.

10:59 am, August 20th, 2010 |