Wiki Auditing liability

[nhenderson]

I am going thru the CPC course right now and I am concerned when I become certified what my liablity will be when the doctors I work for code there own claims and don't want them corrected?

Currently for non medicare claims I check that the chart note is complete to the charges coded and then submit. Sometimes I look at the cpt codes and know that the claim is over coded. Can I be held liablity and have my certification in jepordy if I submit that claim to an insurance company with out down coding it?

 

[nhenderson]

Please does anyone have an answer or were I could look for the answer?

 

[Love Coding!]

Please does anyone have an answer or were I could look for the answer?

I'll give this a shot, if there is someone acting as the compliance officer in your company my suggestion would be to report to them. A compliance officer would know what to do from there. If there is not an acting official, keep notes, times and dates of who you spoke to regarding the issue and put it away. In the future if you were ever called out on it, you have your proof in writing.

Good luck!