INVESTIGATING COMPLAINTS. 3 Scenarios Review the complaint Investigative procedure Tools overview...

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Transcript of INVESTIGATING COMPLAINTS. 3 Scenarios Review the complaint Investigative procedure Tools overview...

INVESTIGATING COMPLAINTS

3 Scenarios• Review the complaint• Investigative procedure• Tools overview• Discussion

A national insurance company filed a complaint against a local chiropractor.They alleged he was using the same CPT codes for several personal injury patients.

Scenario 1

Dr. Sneaky stated on his board application that he had never had an action (including reprimands) taken against a professional license by any jurisdiction.A standard records check uncovered a reprimand in Idaho for failure to notify the board of a change in practice location and for failure to submit CE hours for renewal.

Scenario 2

A 23-year-old female naturopathic student filed a complaint alleging she and a 56-year-old chiropractor had engaged in a romantic relationship while she was attending his educational seminars and under his care.

Scenario 3

Must be submitted in writing

Creation of complaint file, review for completion, submission to Board Investigator

Board investigator acts independently

Review of report, discussion, issuance of correspondence or recommendation to AAG

Investigation Procedures

Board Action

Complaint

Submission

Investigation

Collect stories:• Complainant• Respondent• Witnesses

Subpoenas:• Production of

records• Sworn

statements• Recorded

statements• Video

surveillance

Interviews:• Complainant• Respondent• Witnesses• Families• Co-workers• Friends• Attorneys

Investigative Process

More Information?FCLB.org

Sample procedures posted online in publications library