decisionhealth Newsletters, Part B News - 2018 Issue 6 (June)
Check all employees monthly – and try different name spellings – to avoid exclusion hassles
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Article Overview
This article covers compliance steps for screening employees and affiliated personnel against federal exclusion resources and related state and federal lists. It discusses why exclusion checks matter, how organizations structure internal screening processes, why monthly review cadence matters, and how practices coordinate responsibilities with staffing vendors, human resources, and licensing follow-up. It is intended for practice managers, compliance staff, billing leaders, and administrators who oversee workforce due diligence and regulatory screening.
Why This Topic Matters
Missed exclusion screening can create claim denials, repayment exposure, and penalty risk for practices. Understanding the broader screening workflow helps organizations reduce compliance gaps and document that they exercised appropriate oversight.
Article Sections
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Compliance
Introduces the article’s compliance focus and frames the risk associated with missed screening procedures.
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8 things to check
Outlines practical areas practices should review as part of an exclusion-screening and credentialing process. The section covers internal workflow, outside lists, staff screening cadence, documentation, vendor coordination, reinstatement follow-up, and licensure monitoring.
What You Will Learn
- Why exclusion screening is a recurring compliance issue for practices
- Which operational areas are commonly involved in workforce screening workflows
- How organizations coordinate screening responsibilities and documentation
- Why monthly review and name-variation checks are emphasized
- How vendors and licensing status fit into broader compliance monitoring
Who Should Read This
- Practice administrators
- Compliance officers
- Billing managers
- Human resources staff
- Medical office managers
- Credentialing staff
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