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when can my certification be yanked?

  1. Default when can my certification be yanked?
    Medical Coding Books
    I have a question regarding liability. Can you please tell me what my liability is regarding entering charges from providers fee slips without reviewing documentation? I am a certified coder and was hired by this company to code as they have transitioned from paper to EMR. Because the workload is so huge and they fired their charge entry people then hired two coders, we have absorbed the charge entry positions and never have time to review documentation.

    Every time I approve charges without reviewing documentation I feel like I am committing fraud. Am I?

    Am I in danger of having my credentials revoked?

    I did get it in writing from a manager that “per the manager I am to enter charges without reviewing documentation until further notice.”

    Does this put the responsibility on them and take it off me, in other words, am I safe to continue to approve charges and drop bills for encounters when I haven't reviewed documentation and have no idea if the documentation supports the charges going thru?

    Please help me! I feel I'm being asked to do something illegal that is only going to harm me.

  2. #2
    Seacoast- Dover New Hampshire
    I have a similar situation. We code from the encounters from the MD. I feel that I should be reviewing the notes also. Look forward to responses from this.
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  3. #3
    Columbia, MO
    This is going to be hard for anyone to answer. I know I do not want to be giving out "legal" advice, as I am sure others feel the same way. The best approach here is to contact an attorney or go to the OIG and submit a question. I know how I feel about it and in general I think if YOU think it is wrong/incorrect/illegal..... then it is!

  4. Default
    thank you for your response. What is OIG?

  5. #5
    Seacoast- Dover New Hampshire
    Office of Inspector General
    Karen Barron, CPC
    Hampton New Hampshire Chapter

  6. #6
    Milwaukee WI
    Default Can't give legal advice
    I can't give you legal advice, but I would advise you to take a deep breath and calm down a bit.

    You mentioned that your practice is transitioning from paper to EMR, that you lost your charge entry staff, and that you and the other coder have been asked to pick up that function. Did the charge entry person ever check documentation to verify a code?

    It seems to me that due to circumstances your manager is asking you to serve as the charge entry clerk. Your title may be "coder" but that's not what your job responsibility is right now. AAPC is NOT going around the country checking to be sure that everyone who is certified is actually performing coding duties all the time. And, the way I see it, you are not committing fraud - you're not intentionally and knowingly submitting fraudulent claims. (For all you know they are all absolutely 100% correctly coded. You just don't know.)

    What you are doing is entering the charges as the physicians have coded them. Stop thinking of this function as "approving charges" - you're not approving anything, you're entering the charges. There is a difference.

    By all means check with an attorney or the OIG or your local Medicare office if that will help you get full understanding of your situation. But, please, for your own health, stop living in fear.

    Good luck to you.

    F Tessa Bartels, CPC, CEMC

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