Wiki Altering Paper Medical Orders??

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khartoum1900nile@aol.com

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Is it okay to alter paper medical orders for a DME company? My billing supervisor erased something that the doctor wrote on the order and replaced it with something else before the paperwork was submitted to Medicaid. I just don't know what is right and wrong in this situation. Another thing, this is not the first time that this has happened. I was even asked to step out of her office and then she gave the paperwork back to me after it was altered. I even had a previous supervisor say that was an okay practice and not a big deal.
 
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khartoum1900nile@aol.com said:
Is it okay to alter paper medical orders for a DME company? My billing supervisor erased something that the doctor wrote on the order and replaced it with something else before the paperwork was submitted to Medicaid. I just don't know what is right and wrong in this situation. Another thing, this is not the first time that this has happened. I was even asked to step out of her office and then she gave the paperwork back to me after it was altered. I even had a previous supervisor say that was an okay practice and not a big deal.
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Absolutely not. That's fraud.

If the order need corrected, they need to get a corrected order from the provider's office.
 
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Here's an excerpt from the Medicare Program Integrity Manual (p 12):


The DME MACs and UPICs have the authority to request to verify the information on a CMN or DIF at any time. If the information contained either in the supplier’s records or in the patient’s medical record maintained by the ordering physician fails to substantiate the CMN or DIF, or if it appears that the CMN or DIF has been altered, the DME MACs and UPICs should deny the service and initiate the appropriate administrative or corrective actions.

I know you mentioned these were Medicaid claims - I'm sure you could find similar verbiage for your state's Medicaid program as well.
 
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I don't know even what to say about that. No, just no.
"The prescriber is responsible for ordering the items in connection with his or her plan of treatment. The prescriber must be a licensed, active, Alabama Medicaid provider. The provider is responsible for delivering and setting up the equipment as well as educating the recipient in the use of the DME."

Some food for thought:
 
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