The Importance of Pre-Employment Screening for Healthcare Providers

Pre-employment screening reduces the likelihood of hiring an individual who is sanctioned by the Centers for Medicare & Medicaid Services (CMS) or state agencies, as well as individuals who are not appropriately licensed. Sanctions and non-licensure limit a provider’s ability to provide patient care, as well as the entity’s ability to submit claims on the individual’s behalf. Here are four steps to ensure the providers and other employees you bring into your practice can provide and bill services, compliantly.

1. Enact a monthly process to check all potential and current employees and vendors against the the Department of Health and Human Services Office of Inspector General (DHHS OIG) List of Excluded Individuals and Entities (LEIE) and the U.S. General Service Administration (GSA) ,  (EPLS).
2. Enact a monthly process to check all potential and current employees and vendors against state sanctions and professional licensure databases.
3. Enact a policy/standard for how the organization will retain documentation of previous screenings, including whether any employee or vendor was/is under sanction or licensure is not valid.
4. Enact a policy/standard that states how the entity will respond to employees and/or vendors who are under sanction, or who do not have a valid license.

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John Verhovshek

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.

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