Customer Service

How to Build a Whistleblower

July 18, 2016

When I was a kid, I built models, usually of airplanes and of cars.

Some hospitals and medical groups build whistleblowers.

I’m not kidding you.

These healthcare entities ignore employees or partners who come to the business or group with complaints related to billing irregularities, upcoding, lack of medical necessity, and so on. In doing so, they squander an opportunity to investigate and correct, and morph an early warning into an ignored insider who becomes determined to alert a “higher” authority.

Take the situation of Robert Kane:

Mr. Kane was assigned by his employer, Continuum Health Partners Inc., which operates the Healthfirst hospital network in New York, to investigate the amount of improper billings resulting from a computer glitch.

Kane completed his investigation and delivered a rough report indicating more than $1 million improperly billed. He informed his employer that further analysis was needed to confirm his initial findings.

Instead, he was fired. Then he blew the whistle by filing a False Claims Act lawsuit against Continuum.

View all compliance-related complaints as potentially valid. Investigate them. And make sure to let the person complaining know that you are taking the complaint seriously.

Will this completely prevent the employee or partner from becoming a whistleblower or from calling the feds? No. But it won’t be feeding upset until it turns into anger. And, it won’t be creating pretty good evidence that your group or business doesn’t care about compliance, magnifying the downside when the you-know-what hits the fan.

Building toy planes and cars was fun.

Building whistleblowers? Now so much fun at all.

Yet I can guaranty you that someone, somewhere is building one right now.

It’s not your group or facility, right?

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