Health and Human Resource Center, Inc. DBA Aetna Resources for Living
Corporate
Compliance/Anti-Fraud Helpline
Language Assistance Services are available at no cost to you. To access
these
services
call 1-800-342-8111
Health and Human Resource Center, Inc. DBA Aetna Resources for Living
Corporate
Compliance/Anti-Fraud Helpline
A Corporate Compliance Helpline has been established to provide
employees,
providers
and
clients with a venue to raise
issues and concerns regarding fraud, waste and/or abuse. Health and Human Resource Center, Inc.
DBA
Aetna Resources for
Living has established this Helpline, to ensure that employees, providers and clients can report
possible wrongdoings or
unethical conduct occurring within or to Health and Human Resource Center, Inc. DBA Aetna
Resources
for
Living without
fear of retaliation. The Helpline is available seven days a week, twenty-four hours a day
excluding
designated holidays.
Helpline calls are handled by the Compliance Officer to ensure confidentiality. Calls will not
be
recorded or traced and
the caller will not be required to furnish his or her name. Calls will be investigated and the
Corporate
Compliance
Officer will ensure follow-up actions are taken. Retaliation against employees, providers and
clients
for calling the
Helpline is strictly prohibited.
Helpline: (800) 342-8111
Contact: Director, Quality Improvement
Health and Human Resource Center, Inc. DBA Aetna Resources for Living CRITICAL COMPLIANCE
INFORMATION
To provide employees, providers and clients with every avenue possible
to
raise
their
concerns and report possible
wrongdoing, Health and Human Resource Center, Inc. DBA Aetna Resources for Living has
established an
ANONYMOUS Corporate
Compliance/Anti-Fraud Helpline.
-
H:
Calls are Handled professionally
-
O:
The Operating protocols are
developed by the
Compliance
Officer
-
T:
Telephones are answered by the
Compliance
Officer
-
L:
Report potential violations of
Laws and
Regulations
-
I:
The Compliance Officer will
initiate an Inquiry
where
appropriate
-
N:
The Non-Retaliation Policy
protects employees
from
retaliation
-
E:
The Compliance Officer will Ensure
Confidentiality
If you are concerned about an ethical or legal compliance issue
at Health and
Human
Resource Center, Inc. DBA Aetna
Resources for Living , please report it immediately by using one or more of the following
options
- Speak with your Supervisor, Manager or Director
- Consult with the Corporate Compliance Officer
- Report anonymously by calling Health and Human Resource Center, Inc. DBA Aetna Resources for
Living
Compliance/Anti-Fraud Helpline (1-800-342-8111)
1-800-342-8111
Health and Human Resource Center, Inc. DBA Aetna Resources for Living
CORPORATE
COMPLIANCE/ANTI-FRAUD HELPLINE
ALWAYS
WORKING FOR YOU!
FRAUD TIPS FOR PROVIDERS
The following TIPS are provided to assist you in preventing and
deterring any allegations
of
inappropriate behavior
and/or fraud.
- Medical records should be properly documented
- Diagnosis must fit the prescription (services administered)
- Certifications and Licenses must be current
- Clients should not be solicited for payment for EAP services
- Dates of Service and/or patient services should not be altered to maximize payment
- Services must be clinically appropriate
- Under-utilization patterns will be reviewed
- Only one insurer must be billed per visit, per patient
- Only services that are rendered can be billed
- Soliciting, offering, or receiving kickbacks or bribes is illegal