Compliance with quality care standards is important to us, our patients and those who depend on it. It's a central aspect of everything we do!
“In any moment of decision, the best thing you can do is the right thing.”
~Theodore Roosevelt~
Staff, officers, vendors, or patients/members of our medical group can confidentially report concerns about suspected issues of illegal, prohibited, unethical, and irresponsible acts to the Compliance Officer/Privacy Officer. These acts may impact us in several ways: Personal safety and security can be at risk; financial losses reducing the opportunity to maximize the potential at our group; and certain noncompliant activities could result in potential legal or regulatory penalties. It is everyone’s responsibility and you are required to help prevent these activities. Please care; you must and should “make a difference” by speaking up.
Employees and providers are required by law and by AHC and our codes of conduct, compliance plan, and company policies to notify the Compliance Officer/Privacy Officer about any suspected fraud, waste, abuse, and noncompliance.
In other words, you are expected to call, email, write, or fax the Compliance Officer whenever you become aware of any suspected illegal, unethical or noncompliant activities that violate the codes of conduct, policy, law or regulation. This includes any suspected HIPAA privacy or security issues.
Process: Confidential reporting system is provided by the company Compliance Officer/Privacy Officer, Lorie Santos. An individual may leave a message confidentially via phone, email, mail, or fax. If a call back number is left, the Compliance Officer will return the call within 24–72 hours.
Anonymous and Confidential: Providers, staff and patients may remain anonymous when calling the confidential line. If the individual opts to remain anonymous, no effort will be made to identify the caller. If individuals choose to provide their name, the report will still be considered confidential and privileged to the legal extent possible.
Protection: Employees cannot and will not be retaliated against for contacting the Compliance Officer or confidential line in good faith to report any suspected fraud, waste, abuse or noncompliance.
Our Promise: All calls will be taken seriously and investigated in a timely manner.
Confidential methods to report fraud, waste and abuse, noncompliance, and/or HIPAA privacy or security concerns:
Phone: (808) 909-3245
Email: Compliance@aliihealth.com
Fax: (808) 331-8682
Mail: Compliance Officer/Privacy Officer
Ali`i Health Center
78-6831 Ali`i Drive, Ste 418
Kailua-Kona, HI 96740
POLICY & PROCEDURE
Patient Non-Discrimination
Purpose: Ali`i Health Center (AHC) is committed to establishing multicultural principles and practices throughout our organizational services, and programs. We strive to reduce healthcare disparities and increase access by providing high quality, culturally competent and financially attainable healthcare. A key component of this goal is our desire to provide high quality healthcare to our community irrespective of their ethnicity, culture, religious beliefs, language, or ability to pay.
Policy: Ali`i Health Center will not discriminate in the provision of services to an individual:
1. Because the individual is unable to pay;
2. Because payment for those services would be made under Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP); or
3. Based upon the individual’s race, color, sex age, national origin, disability, religion, gender identity or sexual orientation.
Ali`i Health Center will provide to an individual:
1. A financial hardship policy when applicable;
2. Services and aids to people with disabilities to communicate effectively with us such as
a. Qualified interpreters
b. Written information in other languages and additional formats (large print, accessible electronic formats)
POLICY & PROCEDURE Patient Non-Discrimination
POLICY & PROCEDURE Filing A Grievance
I. PURPOSE To provide a means to identify and address patient grievances in a timely and efficient manner. Ali`i Health reserve the right to modify, amend, or terminate this policy at any time.
II. POLICY Ali`i Health Center is committed to supporting the right of all patients to submit expressions of satisfaction or dissatisfaction regarding health care services received from Ali`i Health physicians, non-physician providers or employees and to seek resolution and response to such concerns. To improve the delivery of healthcare services by ensuring each complaint or comment received regarding patient care is analyzed and receives a response, as appropriate, on an individual basis. Grievances will be submitted to the Peer Review Committee as applicable.
III. SCOPE This policy applies to all Ali`i Health sites where health care services are provided by physicians, midlevel providers and employees.
IV. PROCEDURE Most grievances or comments will be received at the point of service, usually at the clinic level by the Practice Manager. Unresolved grievances that require further escalation will be forwarded to Quality Improvement. Patients and staff may file a grievance at the clinic level or via phone, email or internet submission to Quality Improvement. All complaints or comments should be documented, preferably by the patient (or his/her representative) on a Grievance Form. If the patient is unwilling or unable to put his/her complaint or comment in writing, then someone within the Ali`i Health clinic should assist the patient in documenting his/her complaint. In any case where an individual filing a complaint is offensive, belligerent, or agitated, the Director of Operations, Quality & Compliance Officer or Chief Executive Officer (AHC Administration) should be contacted to deal with the individual's complaint or comment.
If the complaint or comment can be resolved or addressed at the clinic level, then the Patient Complaint Form should be completed at that level by the person handling the complaint and a copy forwarded to Quality & Compliance. If the complaint cannot be handled at the clinic level, the completed Patient Complaint Form should be forwarded to the Quality & Compliance Officer or Director of Operations. All complaints should be addressed in a timely manner (within five working days) with a documented verbal and/or written response provided to the individual submitting the complaint.
Complaints may also be sent to: HHSC Compliance Officer; HHSC Compliance Hotline.
Attached is the Ali`i Health Center Filing a Grievance form
Financial Hardship Notification
No one will be denied access to services due to inability to pay;
And
There is a discounted/sliding fee schedule based on family size and income.
It is the policy of Ali`i Health Center (AHC) that patients experiencing financial hardship may apply for a discount or waiver of the patient’s financial responsibility (i.e., copayment, coinsurance, and/or deductible). A discount or waiver shall be based on an individual assessment of the patients’ financial circumstances. The Financial Hardship Program is designed to provide free or discounted care to those who have no means, or limited means to pay for their medical care. Attached is the Ali`i Health Center Financial Hardship Application.
