Auditing Help Needed!

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4
Location
Indialantic, FL
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Good afternoon,

I'm a CPC auditor and work for a health plan. I need some advice on an issue. I've come across a company that has made agreements with providers to supply them with vaccines to reduce their overhead and, in turn, this company will bill for the vaccine AND for the administration of said vaccines. However, they do not perform the administration. They never come in contact with the patient, the staff at the physician's office perform the administration. The providers have different TIDs and are separate entities. I don't believe this is legal, much less ethical. Can someone tell me where I can find resources to support this? Or is there some loop hole that allows this company to bill this way?

I appreciate any feedback and assistance!
Thank you,
Diane Barco, CPC
352-337-8501
 
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7
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Administration of vaccine

Hi Diane,
Did you ever get some info on your question?
Irene Quast-Beck, CPC, CPCO, CPMA, CRC, CPPM, CEMC
 
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