Why Regular OIG Checks Are Vital for Your Healthcare Business

There is no easy way to run a healthcare business; it's a tremendous amount of effort! You have to provide care to patients, manage your employees and pay the bills. In the midst of all this, there is a ton of administrative work that is generally considered "invisible"; one of the most important types of invisible administrative work is compliance, which means ensuring that individuals you hire as well as vendors with whom you do business are eligible to participate in federal healthcare programs .As such, we need to discuss the OIG Exclusion.

What is an OIG Exclusion?

Simply put, the Office of Inspector General (OIG) can prevent an entity or individual from participating in any federally funded health care program (such as Medicare and Medicaid) when the entity or individual has committed fraud, engaged in patient abuse, or has been convicted of a felony in connection with the provision of health care.

When you employ an individual or contract with a vendor who is on the OIG Exclusion List, your organization could be subject to large penalties. These penalties could be thousands of dollars per item or service billed while the excluded individual was employed by the organization, not just a slap on the wrist.

The Importance of the OIG Check

How do you stay secure? There is a checklist to follow. An OIG Check seems simple to everyone and will be performed via the OIG database. You enter a name and look to see if it is returned in the OIG database for OIG Excluded Individuals and Entities. However, this is much more difficult in practice than it seems in theory.

Suppose you are searching for a "John Smith." When you type in "John Smith" into the database, you may receive several hundred results. Which one of these individuals is your employee? Is there a middle initial? Is there a date of birth? If you assume there is a match and you are wrong, then you would be terminating a potentially innocent employee. If you assume there is not a match and you are incorrect, then you would be subject to fines.

That’s why Venops makes this easy! Instead of having your HR spend hours guessing from other data sources through cross-referencing, smart software will reliably confirm for you that you are not wasting your time on false positives/false negatives.

Mastering OIG Screening

It is Important to Perform Effective Screening for OIG at the Time of Hire and Monthly Thereafter. You Cannot Conduct a Screening of a Nurse at Their Date of Hire in 2015 and Never Conduct Another Screening. As of April 2016, OIG Updates the List on a Monthly Basis, So it Will be Possible for an Individual Who Had Been Cleared Yesterday to Have a Legal Exclusion Effectively Tomorrow.

In Order to Be Compliant, You Must Complete Screens at a Minimum on a Monthly Basis for All Employees and Vendors. If You Are a Small Clinic, That is an Inconvenience, but if You Are a Very Large Healthcare Organization, then It Becomes Nearly Impossible to Conduct This Process Manually Without Errors.

Thus, Automation Is the Answer. Using an OIG Screening Provider Who Offers a Dedicated Service, You Can Identify and Monitor Each and Every Employee/Vendor Name on a Monthly Basis Against the Most Current Database of Names. Venops Provides This Type of Continuous Monitoring Service to Assist You in Addressing Any Compliance Issues Promptly—Before What May Be a Minor Compliance Issue Becomes a Significant Legal Issue.

Simplifying the Process

Compliance doesn't need to add more paper, rather, it needs to provide safety and security. When you have an OIG Screening system you can trust, you will sleep better at night knowing you will get instant notice if someone on the bad list is entered into your database. 

In addition to safety and security, compliance can also save you money! If your HR department spends all day reviewing spreadsheets to determine if a database match is valid or false, they are wasting their time that could be spent in establishing company culture, hiring solid employees, and supporting existing employees. Venops utilizes advanced algorithms to eliminate the noise/bad matches, so your HR employees only deal with real matches.

Ultimately, by being compliant with OIG Check regulations, you are protecting the image and profitability of your organization. Achieving compliant OIG Screening does not have to be challenging; it does need to be completed appropriately. With the help of high-quality vendors and tools, you can make compliance the easiest part of your month. 

Venops is committed to supporting you in your journey through compliance and your focus always remains exactly where it should be: Providing the best possible care to your patients.