Page 8 - Code-of-Conduct

or requests must be complete and accurate
and must reflect reasonable and necessary
7 services ordered by an appropriately
licensed medical professional.

It is a violation of the federal Civil False
Claims Act to knowingly submit, or cause
to be submitted, false or fraudulent claims
to the government.

The following are examples of illegal
activities:
• billing for supplies or services not
delivered or billing more than once for
the same service
• misrepresenting services provided
• falsely certifying that services were
medically necessary
• collecting or attempting to collect
amounts that exceed the co-payment
and deductible from a Medicare or
• Medicaid beneficiary who has assigned
benefits
• asking for, offering or receiving a
kickback, bribe, or rebate or any other
form of payment, in exchange for patient
referrals
CODING AND BILLING • offering valuable items or services to
COMPLIANCE - FRAUD Medicare or Medicaid beneficiaries to
AND ABUSE • attract their business
Providing financial incentives to limit
Genesis is committed to following all federal, services to Medicare patients
state and third-party payor requirements that If you discover inaccurate coding or an
govern billing, coding, documenting and inaccurate claim, immediately notify
submitting claims for payment and cost management or the Chief Compliance
reports. These laws are intended to prevent Officer, even if the bill or claim has already
health care fraud and false claims. been submitted for reimbursement.

Coders must be licensed or credentialed. PATIENT RIGHTS: Patients must receive
Coding must be accurate, properly reflect quality care that is delivered in a considerate,
the services provided, and consistent with respectful and cost-effective manner.
applicable coding rules and standards. Patients have the right to:
Cost reports must be accurate and properly • have or make advance directives
reflect the statistics, charges and costs for • know the names and roles of all
services provided. All bills, claims and physicians, nurses and other hospital
requests for reimbursement, and all staff members caring for them
documentation supporting those claims