Step-by-Step: How Emptech’s Sanction Screening Solution Works

Healthcare fraud is a serious problem that must be actively prevented by both the government and healthcare organizations. One way of doing this is by identifying excluded individuals and parties and keeping them from participating in healthcare programs that are supported by the government. In line with this effort, the Office of Inspector General (OIG) maintains the List of Excluded Individuals or Entities (LEIE), a list that contains the name of people who have a proven record of healthcare fraud. To do their part, healthcare providers must periodically check their list of employees against the LEIE and other exclusion lists.

 

The Importance of Sanction Screening

Healthcare organizations are required to perform regular sanction screening to make sure that no individual listed under the LEIE is found working for their company or receiving payments that are funded by government healthcare programs. If a match is found, it’s the responsibility of the healthcare organization to take corrective actions as soon as possible in order to minimize their losses and avoid the heavy penalties and fines. These include:

  • Immediately terminating the excluded individual
  • Disclosing information about the discovery of the exclusion to the OIG
  • Contacting patients that were involved with the excluded individual during the time the exclusion is active
  • Assessing the amount of cash reimbursed (directly or indirectly) to the excluded individual

Failure to promptly address the situation can put healthcare organizations at a serious risk. This can include paying $10,000 for each item or service from the sanctioned individual and 3 times the amount of each item or service paid to the individual. Sometimes, employing a sanctioned individual can cost a healthcare organization millions of dollars in penalties and fines.

 

Improving Sanction Screening with Emptech

While the idea of checking for sanctioned individuals might sound simple enough, carrying it out requires a lot of resources, especially for large companies that employ hundreds or thousands of people. Also, finding an excluded individual in your company has serious consequences. Aside from at least thousands of dollars in penalties, there’s also the possibility of getting listed in the LEIE. As such, it’s imperative for healthcare providers to practice due diligence when screening employees and vendors.

To help improve the sanctions screening process, Emptech offers specialized exclusion screening technology that will benefit healthcare organizations of all sizes. To come up with accurate, timely, and reliable searches, the company’s software makes use of complex algorithms, different databases for cross-referencing details, and automated updates and regular screenings. These features ensure even individuals who are actively evading sanction screening will be detected as soon as possible.

 

How Emptech Works

While there are many other sanction screening solutions offered by other brands, Emptech’s exclusion screening technology provides healthcare companies with an economical option for effortlessly complying with the OIG’s screening recommendation. Here’s a closer look at how Emptech works.

Step 1: Advanced Detection Technology – Aside from merely looking for name matches in the LEIE, Emptech uses special technology designed to identify exceptions and anomalies in the data so as not to miss any possible match. Aside from that, Emptech can also reference other exclusion lists to help healthcare organizations get more definitive results.

Step 2: Relaying Results – Once the result of the screening has been processed, Emptech can send a notification to a service team. The service team can help provide a more accurate analysis of possible exclusions. This increases the likelihood of finding out even excluded individuals who use erroneous information to avoid getting matched.

Step 3: Potential Match Evaluation – To help identify and verify a suspected excluded individual, the service team can conduct their own searches by cross-referencing the individual’s other details, such as social security numbers, with other exclusion lists. Any matches in these exclusion lists is one step closer to confirming if someone is supposed to be an excluded individual despite passing the initial screening.

Step 4: Confirmation and Notification – As soon as the identity of a sanctioned individual is confirmed, the service team will send a notification to the healthcare organization’s HR representative. Along with the notification are details regarding the employee and the reason for exclusion. This allows the healthcare organization to act faster and minimize the risks of continued healthcare fraud.

Despite automating most of the sanction screening process, Emptech still provides healthcare organizations a high degree of transparency and accessibility. With the company’s technology, it’s possible to access real-time information on exclusion lists as well as details regarding previous exclusions. This is an extremely convenient feature because the LEIE is constantly updated, and the most recent screening may yield completely different results compared to previous ones.

 

The Emptech Advantage

Aside from getting more effective sanctions screenings, healthcare organizations will also enjoy the following benefits by choosing Emptech’s exclusion screening technology:

  • Lower costs – Emptech’s automated screening is a cheaper and more convenient alternative compared to time-consuming manual screenings and expensive background checks. Using the software to conduct exclusion checks frees up precious manpower in the HR department. This, then, allows healthcare companies to divert more resources to other aspects of their operations.
  • Audit readiness – By delivering results in a timely manner and minimizing the issues caused by human error, Emptech’s exclusion screening technology allows healthcare organizations to avoid costly penalties attributed to inaccurate or delayed sanction screenings. Also, the software promotes proper documentation — a feature that will certainly come in handy in case of an audit.
  • More consistent compliance – Complying with the OIG’s recommended screening schedule has always been a big concern for healthcare organizations. But with Emptech’s real-time screening, conducting monthly searches and pre-hiring checks will no longer be a hassle. With just a few clicks, your HR can ensure that you don’t have excluded individuals, vendors, or contractors connected to your company.

Performing regular sanction screenings is more than just a matter of compliance. A healthcare organization that diligently screens out excluded individuals or entities not only looks after itself; the company also helps the nation’s healthcare industry as a whole. By terminating business with individuals that are in the LEIE and notifying the proper authorities, healthcare organizations do their part to ensure that the funds for healthcare programs are put to good and proper use.

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About Dequiana Jackson

Dequiana Jackson, Founder of Inspired Marketing, Inc., helps overachieving women entrepreneurs conquer limiting beliefs and create marketing plans that grow their businesses. This includes one-on-one marketing plan development, digital product creation, web design and content marketing. Dequiana is the author of Know Your Business: How to Attract Ideal Clients & Sell More and runs the award-winning blog, Entrepreneur-Resources.net.

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