Wiki What would you do?

[Goosie]

Practice Administrator pressures the coding and billing staff to bill PFT's and Sleep Studies before the Doctor has read the results.

Practice Administrator has supplied all staff with Employee Manuals and Protocols, excluding coding and billing staff.

Practice Administrator insists coding and billing staff should change diagnoses on Sleep Studies to a diagnosis that is "payable" by extracting from past Office Visits, in spite of what is on the Doctor's order.

There is no going over this Practice Administrator's head.

 

[krburke]

I don't mean to be glib, but I would begin looking for employment somewhere else.

 

[DGRAF]

I would gather documentation showing proper billing practices and go to the physicians you are billing. Show them that the Practice Administrator is opening them up to fraud. I too would look for another job.

 

[Goosie]

You are both right...

I am going to refuse formally in writing stating that I will not be a party to illegalities. I think it would be awesome if the local chapters could address how we can handle these issues. Thanks for your replies!

 

[deborah.david.ctr@us.af.mil]

Can you say Whistleblower?
Document, document, document - everything you have been asked to do, by whom, when, your responses, etc. Then.... once you have that new job lined up, contact the OIG.

 

[Rita B. Conley]

Stick to your guns...remind the PM that coding for payment is fraudulent...if you are assertive enough (in a respectful way), let him/her know that you cannot in good conscience do anything that is not supported by the documentation itself. If this PM absolutely will not follow your advice, seek out Risk Management/Compliance. Good luck