- Employees and Contractors MUST report all Compliance Concerns to the Compliance Officer, a member of the Compliance Committee, the appropriate Program Manager or a Provider Relations Manager.
- Reports may be made in person, in writing, over the phone or online via the “Consumer Report Form”
- Written Reports should be labeled “CONFIDENTIAL AND PRIVILEGED MATERIAL PREPARED FOR LEGAL COUNSEL.”
- Describe nature of concern and all parties involved (provider, child/student, parent, office staff)
- Reports can be anonymous
- No retaliation or adverse consequences for reporting in good faith – we want you to report compliance issues and concerns
- Failure to Report compliance issues will result in disciplinary action and may result in termination.
Making an Anonymous Report
You can mail an anonymous letter to:
Attn: Compliance Officer
7000 Austin St, Ste 200
Forest Hills, NY 11375
You can fill out the “Consumer Report Form” online leaving the Name, E-mail and Phone Number fields blank.
You can make an anonymous phone call to the Consumer Report Hotline
718-762-7633, ext 300
What to Report
- Billing/Payment Issues – Submission of “False Claims,” signing of inaccurate/blank session notes, etc.
- Kickbacks – situations in which gifts or gratuities are given for referrals and/or other business.
- Conflicts of Interest – where a person stands to benefit personally at the expense of Achieve Beyond.
- Breach of Confidentiality – where a person fails to maintain privacy of patient or company information.
- Discrimination – race, gender, sexual orientation, age, disability, etc.
- Immigration – individuals hired are not legally allowed to work in the United States.
- Manager/Staff Member Failing to follow company policies and/or program regulations.
- IT Issues – purposely recording inaccurate info in the database, making unauthorized modifications of information, destruction of information, theft of technology/information, etc.
- OSHA – unsafe work conditions.
- Licensing/Credentialing – providers without the proper license/certification.
- Record Retention Issues – failure of a person to maintain proper patient/program records, unauthorized destruction or modification of records.
- Unauthorized individuals in company facilities
False Claim Definition
A claim that:
- A provider knows is unwarranted
- Is submitted with reckless disregard for accuracy
- Submitted with deliberate ignorance of public guidelines
Unsure of Whether to Report
Any situation in which an Achieve Beyond employee or subcontractor feels that there might be an incident of non-compliance, that individual should report that incident to the Compliance Officer, a member of the Compliance Committee, the appropriate Program Manager or a Provider Relations Manager.
IF YOU SEE SOMETHING, SAY SOMETHING