It may start with a concern from a whistleblower, a government subpoena, an investigation of billing inaccuracies, an employee contract dispute, or even theft or fraud. Regardless of the trigger, when an investigation is called for it is best to consider a skilled investigator trained in chain of evidence, data preservation, and/or forensic accounting. Healthcare leaders must be decisive when investigative events occur and have a responsibility to protect the organization from reputational and financial risk. A clear plan of action is critical to achieving the right outcome, including knowing when and how to employ an independent investigator.
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With increasing oversight and scrutiny focused on the healthcare industry and risks on three fronts – from employees, patients, and regulators – waiting until an investigation is “needed” to develop a plan could put an organization at significant risk. An effective and efficient strategy and game plan to call upon internal and external specialists with skills in forensic accounting and data preservation can make all the difference.