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Conduct all facets of business in accordance with applicable laws, rules and regulations. |
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Shall perform their duties in good faith and to the best of their ability. |
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Shall refrain from any illegal conduct. When an employee is uncertain of the meaning or application of a statute, regulation or policy, or the legality of a certain practice or activity, he or she shall seek guidance from his or her immediate supervisor, administrator, or the Compliance Officer. |
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Shall submit all claims for services to Medicare or other federally funded health care programs with accuracy and correctly identify the services ordered. |
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Shall bill payers and patients in compliance with all applicable laws, regulations and policies |
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Shall not knowingly submit for payment or reimbursement a claim we know to be false. Shall not participate in any false billing of residents, government entities, or other party; For example a simple definition of false billing would be “billing for services that were not rendered, services billed are more expensive than the services actually rendered, or services are not covered by the entity responsible for paying the claim or bill”. |
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Shall assign diagnostic, procedural and billing codes that accurately reflect the services that were provided. Also review periodically coding practices and policies, including software edits, to ensure they are consistent with all applicable Federal, state and private payer health care program requirements. |
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Shall maintain all records, whether of a medical, operational, or financial nature, in accordance with applicable laws and policies. No one may alter or falsify information on any record or document. Making any false statement in a medical record that is used to support billing of medical services may be considered criminal fraud. |
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Shall not use or disclose confidential medical or personal information, or protected health information “PHI” pertaining to Ajuba. |
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Shall not obtain any improper personal benefit by virtue of their employment with Ajuba. For example, taking money in return for awarding a vendor a contract. |
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Employees who are involved in any type of kickback scheme will receive disciplinary action, including termination and possible prosecution, if applicable. |
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Shall not engage in any business practice intended to unlawfully obtain favorable treatment or business from any government entity, physician, resident, vendor, or any other party in a position to provide such treatment or business. |
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Shall disclose to their immediate supervisor, administrator or corporate Compliance Officer, any financial interest, ownership interest, or any other relationship with a member of their immediate family. |
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Shall not use Ajuba's confidential or proprietary information for own personal benefit or for the benefit of any other person or entity, except Ajuba, during or after being employed by Ajuba. |
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Shall not consent to or participate in any agreement (including agreements based on a course of conduct) with a competitor of Ajuba to illegally fix prices. If a competitor concerning any of these issues approaches an Ajuba employee, the employee shall immediately notify their immediate supervisor, administrator, or Corporate Compliance Officer. |
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Shall participate in scheduled training regarding Ajuba's compliance program |
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Shall comply with all Ajuba's policies governing the workplace. |
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Shall promptly report all violations or suspected violations of this compliance program to the Compliance Officer through the channels of communication like compliance hotline. |
