5 Surefire Signs of a Second-Rate Consultant

Cross These Out Before You Count Him In

So you've hired your consultant and nosed into his background, and you've both cleared up your expectations of one another. But your facility's need for vigilance isn't over yet - it has just begun.

Stay on the lookout for these telltale marks of trouble, says Gabriel Imperato, JD, attorney at Broad & Cassel in Fort Lauderdale, Fla.:

Illegal or deceptive representations
Be wary of any consultant or firm that purports to have special approval or certification from the government or who claims that he can somehow score you inside information from CMS. On the contrary - the government specifically avoids endorsing one private consultant over another.

Basing their compensation on the revenue they save you
While this kind of arrangement may sound good to your wallet, it serves as incentive for both you and the consultant to abuse regulations - which doesn't look good to the government.

Indifference to compliance rules
Size up your consultant's attitude toward compliance before you invite him onto your staff. If a consultant nonchalantly tells you not to fret about the OIG or your intermediary's requirements, he's a bad apple. Legitimate consultants champion complete compliance, with no ifs, ands, or buts.

Setting unreasonable objectives
Your consultant shouldn't guarantee you increased revenue or any kind of special privilege with the government. Promises to get your appealed claims paid or old claims reopened signal major problems, so avoid them like the plague.

Advocating sketchy practices
This warning sign is tricky because it can take many shapes and can easily get you into trouble with consultants who have a knack for making shady billing look legitimate. A consultant's abusive strategies may be as obvious as telling you to use improper billing or to elude regulations in order to beef up your bottom line, or they may be as subtle as suggesting that you interpret a government or intermediary guideline in a way that was clearly not intended. If your consultant performs his job responsibly, he'll want you to come out squeaky-clean and won't risk your facility's reputation and finances.

- Published on 2003-08-13