Fraud, Waste and Abuse | ArchCare
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A Message to Our Community from Scott, LaRue, President and CEO: I invite you to join me again on Wednesday, August 5th at 7:30PM for a live session. Please register for Q & A Session with Scott LaRue.


Based on the Health Advisory on Skilled Nursing Facility Visitation from the NYS Department of Health

Issued on July 10, 2020

The Nursing Home must meet all of the criteria as outlined in the NYS Health Advisory (see below) to begin to allow limited visitation.

1. There have been no new, nursing home onset COVID-19 cases in the nursing home for 28 days (through phases one and two)

NURSING HOME NAME LAST COVID-19 POSITIVE CASE CONSECUTIVE DAYS OF NO COVID-19 POSITIVE CASE OF EMPLOYEES AND RESIDENTS ANTICIPATED LIMITED VISITATION DATE
ArchCare at Ferncliff July 4, 2020 7 days August 1, 2020
ArchCare at SVdP June 25, 2020 16 days July 23, 2020
ArchCare at SVdP (ALP) May 13, 2020 59 days June 10, 2020
ArchCare at Carmel Richmond July 3, 2020 8 days July 31, 2020
ArchCare at TCC July 8, 2020 3 days August 5, 2020
ArchCare at MMW July 6, 2020 5 days  August 3, 2020

Criteria Met for ArchCare at Ferncliff Nursing Home, ArchCare at SVdP, ArchCare at Carmel Richmond, ArchCare at Terence Cardinal Cooke Health Care Center, ArchCare at Mary Manning Walsh Home

2. The nursing home is not experiencing staff shortages

3. The nursing home has adequate supplies of personal protective equipment and essential cleaning and disinfection supplies to care for residents

4. The nursing home has adequate access to testing for COVID-19 5. Referral hospital(s) have bed capacity on wards and intensive care units


Keeping our community safe, together. 

Our team is here to answer any questions that you may have. Call our dedicated COVID-19 hotline: 877-239-1998.

Available 24/7 or email info@archcare.org.


 

Fraud, Waste and Abuse

ArchCare is committed to detecting and preventing healthcare fraud and abuse. Fraud and abuse in the healthcare system result in higher insurance costs for everyone, including the Medicare and Medicaid programs, individual health plan members, group plans, and business partners, as well as state and federal governments that are funded by taxpayers. ArchCare takes all allegations of fraud and abuse or other compliance issues very seriously.

 

  • Review your monthly Explanation of Benefits (EOB) to ensure you received all services stated on the document. The EOB is a listing of medications you received, the co-payment you paid and the amount billed to your insurance for the previous month. Look for incorrect dates of service or services you did not receive.
  • Review your Medicare Summary Notice (MSN) and ensure you received all services stated on the document. The MSN shows what Medicare was billed for, what Medicare paid and what you owe.
  • Be sure to protect your membership card, as it contains information regarding your benefits.
  • Beware of providers who use pressure tactics to convince you to accept a certain product or service.
  • Only allow appropriate medical professionals to review medical records or recommend services.
  • Stay informed about your Medicare/Medicaid and/or other insurance benefits.
  • Always keep proof of any payments you make to a healthcare provider.

 

Reporting Healthcare Fraud‚ Waste and Abuse

If you have a reason to believe a healthcare provider is performing unnecessary or inappropriate services or is billing for services not given to you, you should report this immediately. Your report may be made confidentially.

To report any fraud, waste or abuse, please contact ArchCare by filling out our online reporting form or calling the Fraud, Waste and Abuse Hotline toll-free at 800-443-0463.

 

Medicare Fraud

Protecting Medicare and You From Fraud

 


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