‘What’s Your Tolerance Level for Fraud?’
Once I Was Asked That Question, I Couldn’t Stomach Working in US Health Care Anymore.
Author’s Note: Tomorrow I’ll return to a nice schedule of cannabis, tarot, and meditative content. But for now, allow me to indulge in a bit of navel gazing, and publish this piece I’ve been thinking about for over a decade. I’m calling this an early birthday present, as I’ve wanted this off my chest for a pretty long time!
A couple of years ago, I ran into a dilemma. My organization was committing fraud.
I knew without a doubt they were committing fraud.
They had created a mobile vasectomy program, but had failed to fully credential / contract with the physician performing the vasectomies. That did not stop them from billing the state and patient for the services under a different physician’s name (don’t worry, these patients got vasectomies and were all safe, but it’s the POTENTIAL for danger and the fraudulent billing that got to me).
Forever a fan of a good portmanteau, I declared the program “Vansectomy” and informed the clinic that “Dr. Vansectomy” needed to have a contract AND have his credentials vetted before they continued to take the state’s money for this program. Since I was also the person in charge of their EHR, I wanted confirmation that this credentialling was complete so I could enter the credentials into the EHR.My stance was considered a controversial by the non-profit clinic’s…