Auditing Liability risks

cpccat

Contributor
Messages
21
Best answers
0
I work for a billing company and my account wants to send us the progress notes for each charge to make sure the Dr.'s are documenting everything they needs to in order to bill whatever procedure they are billing. Work load wise this is a lot since his company sends us over 4000 claims a month, but it will be very cut and dry. I am afraid this falls under the "coding umbrella" and we will have a liability issue. Can anyone tell me if this is a liability issue even though our contract does state we will not do any coding?
Thanks
 

mitchellde

True Blue
Messages
13,537
Location
Columbia, MO
Best answers
2
This is something for the company owner to address. The pricing is very different for one thing once you add in chart review. If you contract is strictly for claims submission then that is what you should do. It all depends on what was negotiated with the client and what is in writing. If you accept the charts and submit claims knowing the information is incorrect then yes you do become liable. But the client is also receiving a service for which they are not reimbursing. Your claims per day as the biller will decrease as well. All of these things must be taken into consideration. If the client wishes to amend the contract to include chart review then the contract must be renegotiated. You take this issue higher up the chain to be debated.
 

cpccat

Contributor
Messages
21
Best answers
0
The owner wants to do it as a service to them. He understands the work load issue. I am concerned about client getting audited and have the company I work for be liable. Just paranoid I guess.
 
Top