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AAPC Ethics Violation Complaint Form

AAPC and its Ethics Committee does not function as a judiciary body. Any complaint to AAPC should have a foundation in law (for example, someone has been found guilty of fraud or has been placed on the Medicare Exclusion List) or a foundation in AAPC administrative rules (for example, counterfeit CEUs or a member using credentials falsely).

Complainant’s Information:

Complainant’s Name:
Address:
City:
State:
Zip Code:
Phone:
Email Address:

Please provide as much information as possible:

AAPC Member's Name:
Member Number: (Optional)
Address:
City:
State:
Zip Code:
Phone:
Email Address:
I believe that he/she has acted in violation of the AAPC Code of Ethics by not adhering to the following part of the AAPC Code of Ethics:
List what specific actions you allege were violations(s) of the AAPC Code of Ethics. Copy and paste separate documents or letters as evidence:
List all documents and evidence to substantiate the listed ethical violation(s). Please copy and paste copies of any relevant documents to this form. If applicable, list names address and telephone numbers of all persons directly involved, i.e., chapter members, coworkers, employers, or payers and copies of their findings if possible. If any legal action has occurred on this matter, attach the court’s findings:
Please provide any additional information below that you feel may assist in the Executive Committee’s investigation:

To the best of my knowledge, the information provided above is true and correct. Additionally, I have been advised and understand the following:

It is my responsibility to provide the AAPC with relevant facts pertaining to my complaint.
The AAPC Ethics Committee’s only area of authority pertains to the AAPC “Code of Ethics.”
The respondent will receive a copy of the attached AAPC Ethics Violation Report Form along with any other material that I submit to the AAPC Ethics Committee or Executive Committee.
The respondent will have 30 days from receipt of the complaint to respond, in writing, to the
AAPC Executive Committee.
Either party may be asked to provide further information to the AAPC Ethics Committee or Executive Committee.
Both parties will receive a copy of the final decision when the AAPC Ethics Committee or Executive Committee has made its decision.

AAPC Ethics Violation Complaint Form

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