Efficient and safe services in the healthcare sector require regular exclusions screening of people and entities that organizations hire or work with. These screenings identify banned entities that the federal government has banned from participating in Medicaid and Medicare facilities. With the help of this list, any healthcare facility can prevent working with or paying a blacklisted individual. As we know, healthcare is a critical sector that requires the finest equipment and medications, along with trusted employees, to provide patient care effectively. All this can only be ensured by an employee with a right-stated position and no history of fraud, abuse, or a harmful background.
Accurate screening services are essential to partner with vendors that are reliable and provide the right drugs and medicines. Moreover, in this guide, we will explore the exclusions screening, its steps, benefits, and how it benefits the organization, and why it is especially essential in the healthcare sector.
What Is Exclusion Screening & Its Execution Steps
The process of verifying that individuals, vendors, and entities are not listed in the federal and state exclusion databases is called exclusion screening. These checks are essential to ensure that no organizations unknowingly partner with banned entities, which can result in heavy fines. Sometimes it even leads to program reimbursement. Otherwise, the organization faces financial risks, legal penalties, and reputational damage. Here are the steps involved in this screening process. Healthcare organizations usually follow these steps to stay compliant:
- Identify who needs screening – employees, contractors, physicians, and sometimes volunteers.
- Check official databases – like the OIG’s List of Excluded Individuals and Entities (LEIE), GSA’s System for Award Management (SAM), and state Medicaid exclusion lists.
- Verify regularly – screenings aren’t one-time. They must be repeated monthly or quarterly because lists are updated.
- Document results – keep records of checks for audits and compliance reviews.
- Take action if someone is excluded – immediately stop hiring, contracting, or paying them to avoid fines or losing eligibility for Medicare/Medicaid.
This compliance process that verifies whether the employees, contractors, or vendors are listed on the state or federal exclusion database. These include three databases:
- OIG’s List of Excluded Individuals and Entities (LEIE)
- State Medicaid exclusion lists
- GSA’s System for Award Management (SAM)
Why this Screening for Exclusion Matters?
The importance of screening for exclusion lies in its ability to prevent fraud, abuse, and unsafe care in healthcare organizations. These are the basic features that healthcare facilities provide to their patients, and even a small mistake can harm the patient’s health. This lightens the topic that hiring OIG excluded individual can lead to:
1. Financial Penalties
Violating these rules and paying or working with individuals on the excluded list can result in a violation charge of thousands of dollars. Even when the partnership is formed unknowingly, without information about their history or background, the chegres still supply. These charges even extend to every service taken from the excluded entity.
2. Legal Consequences
The connection to the exclusion entity further leads to legal consequences, such as a long-term and thorough investigation of your organization and the services it provides. Additionally, a lawsuit and even a loss of program eligibility.
3. Reputational Damage
Once the organization goes through fines and legal consequences, the public loses the healthcare organization and its provided facilities. Years of reputational building were wiped out by a single lawsuit arising from a silly mistake of failing to run proper screening. Stakeholders lose trust in a non-compliant organization. Therefore, it is essential to run a screening process that is automated and prone to human error.
Why Venops is The Best Safety Net?
Venops is one of the most trusted screening partners, providing automated exclusion screening. This yields fast and accurate results with a 90-minute turnaround time and without error. The automation system performs screening using updated lists, such as LEIE, OIG, or SAM. Therefore, it ensures that screening is thorough and nothing is left out that could result in legal penalties and consequences.
Venops uses advanced automation to manage a living roster and update it anytime as needed. Automated re-screeing using the Venops autopilot is easy and possible, whether for an individual or a group. All the advanced and fast services are priced in line with Venops’ compliance programs and resources.
Wrapping It up!
The safeguarding of patients and providers, along with the protection of organisational reputation, can be ensured through exclusions screening. Through regular checks, the organization keeps itself shielded from entities that could pose a threat to it. It’s unique and more essential to run this screening, as it focuses on compliance with federal healthcare rules. Additionally, it prevents any excluded entity from slipping through cracks. Nowadays, automation plays a significant role in these screenings. They streamlined the process by including lists, such as OIG, LEIE, and other states, to conduct thorough checks.
These OIG check are prone to human error but yield accurate, reliable results within a few minutes with automated software applications. Therefore, you don’t have to worry about working with excluded results. The automation monthly checks also add a layer of safety. It runs through checks on all and quickly informs if any potential matches are found. For further investigation, a thorough investigation is also provided.
Contact Venops for fast screening and reliable results, with effective, thorough checks.
FAQs
Ques 1: What is exclusions screening?
Ans: It is the process of verifying that healthcare staff, contractors, or vendors are not listed on the federal or state list of excluded entities.
Ques 2: Why is this screening for exclusion important?
Ans: It is crucial because it prevents organizations from hiring or paying OIG Excluded individuals. This could lead to heavy fines and loss of program eligibility, thereby protecting the healthcare facilities.
Ques 3: How often should an OIG Check be done?
Ans: The best practice for this check is to perform it monthly, since exclusion lists are updated frequently. So, doing it on a regular basis keeps you up to date on any improvements of entities or vendors’ steps.
Ques 4. Who needs these screenings?
Ans: Every individual involved in healthcare, whether as an employee, vendor, or service provider. Each entity, such as employees, physicians, contractors, and even vendors, must perform this to ensure compliance.
Ques 5: How is exclusions screening different from other checks?
Ans: Unlike general background checks, screening for exclusion specifically focuses on the OIG list of Excluded Individuals and requires consistent OIG Check procedures.
