Why are you reviewing the documentation and billing?
If you are doing a prebill audit and they won't let you change anything, that is a huge problem in my opinion. It sounds like lip service to me, and I have been in that position before. They want to say "we are compliant everything was checked by a certified coder before it went out" then when it hits the fan they blame you and let you take the fall. Not cool. Document everything.
If you are doing retro audits for compliance and they won't let you change anything, then you need to practice major CYA. Document everything, get everything in writing. There is probably a policy that states the physician has to approve any changes, get a hold of that and keep it. Keep copies of everything you are auditing, your findings, recommendations, who you told and the outcome.
Hopefully your issues are due to a lack of understanding on the part of your employer and you will be able to change that based on the information you compile and present to them.
As I stated, I have been there, and I had to walk away. I refused to bill claims for 3 providers because they were commiting out and out fraud. I had in writing from one of them admitting she falsified her charts and I have personally witness (along with a manager and another coworker) one of the others go back and change his records so he could bill a certain code. The claims backed up about 5 months, then I was pulled in an office with 3 high level managers and told I had to push all those claims thru that day as they were. My name would have been on every single one of those and every single one was an act of fraud. I turned in my resignation less than an hour after that meeting. I do want to clarify that my issue wasn't just about E/M leveling, it wasn't my interpretation of guidelines, it was billing non-covered services in a way to get them paid by government and other payers. So everything from E/M up to MRIs were involved.
Hopefully mine is a worst case scenario you won't ever have to experience.
Good luck,
Laura, CPC
Stand for what is right, even if you have to stand alone.