Wiki Fradulent Contracting?

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Jenniflower30

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Hello Members,

I need some advice. I am at an uncomfortable position with my company. I have a manager who likes to make her numbers look good at the end of the year. After a primary insurance company makes their payment, we apply the payment, our software will take out the contractual, then if a secondary is present we will bill. However, when working on an aging, if we cannot collect the remaining money My manager will ask that we contract of an additional 60% and then bad debt the 40% that's remaining. At the end of the year, I couldn't imagine that the bad debt even reached $5,000.oo.

Is this illegal? Our company is so small that I don't know what I would do or who I would turn to without getting fired. There are so many problems/issues with this manager and she is friends (guessing 20 years) with all the right people, cfo, and more.
 
From what I understand of your situation, it does not sound like an illegal practice to me since a payor is not being billed in excess. It is, however, unethical to do this if the physician/provider is not aware. The annual bad debt amount may be low, but how does she justify the increased contractual adjustment amounts? Surely, this has to raise a question or two. As you are in a small office you may not be able to say anything without fear of retribution and you may have to leave the practice if this is too troubling for you. Best of luck.
 
What she is doing was double contracting. Basically, after all insurances would pay, and the account was uncollectible, she would then contract off or have employees contract off an additional 60% (as another contractual) and then write off the difference to bad debt. I actually went to human resources awhile ago and voiced my concerns and have since had my 5 year anniversary with the company. She gave me the worst review I have ever had and has been rude and pretty much trying to force me out of my job. I have always had great reviews and raises with this manager, but after voicing my concerns she has turned into another person.
 
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