Just food for thought. Most Professionals ears perk up when the bottom line ($$$) may be effected. Meaning...if they do not properly chart....you are going to have a impossible task of getting their charges through for proper payment. Then the trickle down effect kicks in. A lot of this has to do with the way the situation is presented. I've just returned for our State Bar's Convention, and if some of you have noticed MCR-Medicare payments slowly coming in---there's a major audit going on with Providers. These audits are done by MD's, RN's, CNP's, etc. The charting MUST be in line with the treatment provided to bill the proper CPT code. It is not worth being sanctioned or their license being suspended because it appeared as if fraudulent billing was taking place. There really is no excuse for a Provider not to be bothered charting properly. The Insurance Carriers won't accept any! It so happens that I do audits and this can have a profound effect on their practice. i.e.The Dr needs to know that their patients receive notification when their Dr is fined by Medicare for improper coding, billing, etc. Perhaps gently putting this into someone's ear that you are there to protect their practice and why your concerned may help the documentation situation!
Helen Strasko, RN, CLNC
Atlantic Legal Nurse Consultants