AshleyMartin
Networker
Brief synopsis of what transpired:
On our path to meaningful use, during the process of creating a problem list for a patient in our EHR, it was noticed that an incorrect diagnosis was submitted on a claim and processed for payment by the insurance company.
More specifically, a patient was evaluated in the clinic for chest pain and palpitations. Based on the patient's symptoms, a nuclear stress test was ordered and performed. The results were negative for CAD. The charge entry clerk submitted the claim with a diagnosis of CAD 414.01. There is no mention anywhere in the chart of the patient having CAD, the patient was never diagnosed with this. It was complete and fully data entry error on the part of the employee.
Problem is, now the patient is documented by her insurace company as having CAD.
What are the proper steps to follow to ammend the patient's claim so that she is not labeled as having CAD when she indeed does not?
On our path to meaningful use, during the process of creating a problem list for a patient in our EHR, it was noticed that an incorrect diagnosis was submitted on a claim and processed for payment by the insurance company.
More specifically, a patient was evaluated in the clinic for chest pain and palpitations. Based on the patient's symptoms, a nuclear stress test was ordered and performed. The results were negative for CAD. The charge entry clerk submitted the claim with a diagnosis of CAD 414.01. There is no mention anywhere in the chart of the patient having CAD, the patient was never diagnosed with this. It was complete and fully data entry error on the part of the employee.
Problem is, now the patient is documented by her insurace company as having CAD.
What are the proper steps to follow to ammend the patient's claim so that she is not labeled as having CAD when she indeed does not?