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punkyboo

punkyboo

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I have been told by my supervisor that I do not need access to documentation to bill our doctors' hospital follow-up visits; that I should just bill what the doctor says to bill. Unfortunately, I have found that the doctors mark incorrect dates, don't document the visit at all, or the documentation is insufficient to bill. So, as far as I am concerned, if I am not allowed to check the documentation prior to billing the visits, this would be fraudulent billing.
Does anyone else have any thoughts on this?
 
i agree with you. This is fraudulent billing, and the organization you work for could be charged under the false claims act. I was a compliance auditor for over 5 years. At your organization there is a compliance hotline and you can make an anonymous call if you don't want to use your name. It is best to give as much information as you can, so I would encourage you to give the compliance department your name. I have witnessed the measures that people in the compliance department go to to keep the name of the individual who reported the issue private.
Another route would be to go to your supervisor's manager and let them know your concerns.
Something I am concerned about is that you know something wrong is going on, based on regulations, if you don't report it, that wouldn't be good for you. Your compliance department will help you.
Good luck!
 
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