Compliance Program

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Compliance Program

Five things providers need to know about the VNSNY CHOICE Compliance Program

At VNSNY CHOICE, we are committed to preventing and detecting any fraud, or abuse in the organization related to federal and state health care programs. Here are five things that you, as a provider, should know about our Compliance Program.

1. What is a Compliance Program?
A Compliance Program is a series of internal controls and measures that have been established to ensure that we are following all applicable laws and regulations that govern the programs in which we participate.

At VNSNY CHOICE, we have a system in place to receive, record and respond to compliance questions, or reports of potential or actual non-compliance from employees, contractors, agents and directors, while maintaining confidentiality and ensuring non-retaliation against callers. 

2. What are the rules you must follow?
The standards set forth in the Code of Conduct provide an overview of the laws and rules our employees and providers are expected to follow. A copy of the Code of Conduct is provided to all of our employees upon hire, as well as to providers when they join the network, and is available on our intranet and website or upon request from the Compliance Officer. In short, we expect everyone, VNSNY CHOICE and providers alike, to conduct themselves pursuant to the highest ethical, business and legal standards. As a provider for or a member of VNSNY CHOICE, if you suspect anything that you think might be illegal or unethical, please report it. 

3. What kind of things should be reported?

  • Questionable billing, coding or medical record documentation
  • Giving or accepting something of value in exchange for patient referrals or other business
  • Quality of care issues
  • Altering medical or business records
  • Assisting or ignoring fraud, waste or abuse concerns and/or any activity or business practice that could possibly be interpreted as unethical or illegal

4. What should you do if you suspect compliance violation? 

If you suspect that insurance fraud, abuse or suspicious activity – such as it is described above – has occurred, is occurring or will occur, please report it immediately though any of the following channels:

Anonymous Reporting

Other Ways to Contact Compliance

VNSNY CHOICE
Attn: Compliance Department
1250 Broadway, 11th Floor
New York, NY 10001

5) Can you raise the issue anonymously?
Yes. You can report anonymously through the VNSNY CHOICE Compliance Hotline or through our web reporting system.

All reported compliance issues will be investigated. Be assured, there will be no intimidation of, or retaliation against, anyone who in good faith reports a compliance issue.

Learn more on our Compliance Program page.

Suspect Something, Say Something!

Last updated 10/1/2016

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