Whistleblowing In Health Care

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Reporting fraud or illegal activity in a healthcare setting can sometimes be known as whistle blowing. Whistle blowing can be referred to as someone alerting authorities when another person is engaging in illegal or prohibited activities in the workplace. Some illegal activities that would be associated with whistleblowing is a violation of a rule, law or regulation. There are different ways of reporting prohibited activities in the healthcare setting, it just depends on what the activity is that you are reporting. For example, how people report medicaid fraud. Medicaid is a government program that provides health insurance to low income families that do not have sufficient medical insurance or no medical insurance at all. There are different types of fraud that can be committed involving medicaid. For example, billing for services not provided, billing for unnecessary medical services, double billing, and false cost and price reports. Although, there are all different ways of committing these frauds, billing for services not rendered is the most common type of fraud committed. When you believe someone is committing any of these activities there is a set way or protocol that you follow.…show more content…
For the state of Georgia the contact would be the Georgia Department of Community Health. You could contact them by email, or phone. When reporting the activity it is best to have as much information as possible in order for the investigation process to happen in as timely a fashion as possible. Having the name of the client, the client’s card number, name of health care provider, and the amount of money Medicaid approved or paid, can help speed along the process. After you have provided the necessary information to the proper authorities you have completed the process of reporting the illegal
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