How to prevent NEMT fraud
Any business has the potential to experience fraudulent activity. Banks are constantly on the lookout for fraudulent transactions; the government is susceptible to fraud due to its size; and healthcare operations, including NEMT, are specifically vulnerable to billing schemes. If you’re considering starting your own non-emergency medical transportation operation, you probably aren’t attempting to build a fraudulent business or expecting to encounter fraud at your company—however, it’s important to be aware of the possibility and know how to react if the situation does arise.
Fraud in NEMT
There are a few different ways fraud can occur in the non-emergency medical transportation industry. One of the most common examples involves the NEMT provider charging for trips that weren’t ever actually taken. For instance, a perfectly legitimate NEMT company might exist, and the company may have completed a number of real NEMT trips over the years, but they also may have billed for trips that didn’t actually take place. If this is the case, the company is committing an illegal act and will be charged with fraud if found guilty. This isn’t a common occurrence, per se, but like anything, it can happen and you should be prepared to act if it does.
How to prevent NEMT fraud
No one wants to deal with fraud at their business, so if you’re just starting your NEMT journey, there are a few things you can do to prevent the possibility. For starters, take the time to conduct in-depth interviews and background checks of all potential candidates. As a new business owner, it can be tempting to hire the first group of people who apply for the job, but it’s important to ensure they’re qualified and trustworthy—this goes for every position. At your company, you’ll need to hire drivers, billers, dispatchers, and anyone else who might help create schedules and ensure that everything is running smoothly in the day-to-day operation. When you hire reliable, credible workers, you reduce the likelihood that you’ll run into a fraudulent situation.
How to report NEMT fraud
Whether you’re a passenger, a business owner, or an employee at a NEMT business, if you see or know of fraud happening, it’s important to do the right thing and report it. State Medicaid agencies make this easy to do and even allow anonymous reports—however, they prefer to have a phone number or email address to reach the reporter for follow-up questions. Anyone can report a fraud concern through the Centers for Medicare and Medicaid Services (CMS) website, or by contacting the Office of Inspector General at the U.S. Department of Health and Human Services.
How to hire a top-notch team
When it comes down to it, there’s no way to know for sure whether someone at your company will commit fraud or not—but that’s not a good attitude to have as a business owner. Instead, it’s important to recognize the qualities you should search for in prospective employees. Depending on your specific business needs, you might be looking for people with varying levels of experience. Here, we’re specifically looking at drivers and what qualities you should look for when hiring drivers. The following are some of the most important qualities NEMT drivers should have.
NEMT drivers often work with elderly and/or disabled passengers, so it’s crucial that they are compassionate, understanding, and patient people. Hiring a driver with a short fuse or the inability to understand a passenger’s needs is going to be a bad idea. In the end, they won’t stick around long, and you’ll face a tarnished reputation once your passengers are unsatisfied.
A safe driver
If there’s one thing you want to know for sure, it’s that you’re hiring drivers who are safe on the road. It’s important to check prospective drivers’ records to make sure they’re clean of any accidents. When a passenger gets into one of your vehicles, their life is in your driver’s hands. Be serious about who you’re hiring to drive to avoid any incidents down the line.
A people person
Your drivers spend their days with a number of different passengers, so having good social skills and being a friendly person is definitely a good quality to look for in drivers. While some passengers may prefer a quiet ride, others might feel more comfortable having a conversation while they ride. It’s great to have a driver who understands both preferences and can adjust as necessary.
Run the best business possible with non-emergency medical transportation software
You can’t control everything that happens at your business, but you can do your best to set yourself up for success. Investing in NEMT software is one of the smartest things you can do—it automates your whole trip process, is protected by top-notch security measures, and saves you time and money. If you’re looking to prevent fraud and improve operations, get in touch with the team at iSi Technology to learn about our family of software products!