External investigators’ follow-up intentions when whistleblowers report healthcare fraud: The effects of report anonymity and previous confrontation

Steven E. Kaplan, Danny Lanier, Kelly R. Pope, Janet A. Samuels

Research output: Contribution to journalArticlepeer-review

Abstract

Whistleblowing reports, if properly investigated, facilitate the early detection of fraud. Although critical,  investigation-related decisions represent a relatively underexplored component of the whistleblowing process. Investigators are responsible for initially deciding whether to follow-up on reports alleging fraud. We report the results of an experimental study examining the follow-up intentions of highly experienced healthcare investigators. Participants, in the role of an insurance investigator, are asked to review a whistleblowing report alleging billing fraud occurring at a medical provider. Thus, participants are serving as external investigators. In a between-participant design, we manipulate the report type and whether the caller previously confronted the wrongdoer. We find that compared to an anonymous report, a non-anonymous report is perceived as more credible and follow-up intentions stronger. We also find that perceived credibility fully mediates the relationship between report type and follow-up intentions. Previous confrontation is not significantly associated with either perceived credibility or follow-up intentions.

Original languageEnglish (US)
Pages (from-to)91-101
Number of pages11
JournalBehavioral Research in Accounting
Volume32
Issue number2
DOIs
StatePublished - Apr 1 2020

Keywords

  • External investigators
  • Follow-up intentions
  • Healthcare fraud
  • Perceived credibility
  • Upcoding
  • Whistleblowing

ASJC Scopus subject areas

  • Accounting
  • Organizational Behavior and Human Resource Management

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