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PA Assist Documentation Requirements

  1. #21
    Default
    Exam Training Packages
    LOL! Thats funny Rebecca, yet it's not; I've always wondered how people get in positions of management when they are ignorant of what the people under them do, and what ethics they abide by?

  2. #22
    Location
    Milwaukee WI
    Posts
    4,466
    Default Bravo
    Rich,
    Bravo to you for doing the right thing and bringing the issue up. Integrity and reputation are invaluable; once lost they can virtually never be regained.

    Conduct yourself in a highly professional manner at all times. If your supervisor behaves less than professionally, speak to her about it directly, in person and in private. And, of course, make a record of it.

    If your supervisor's future actions are retaliatory, then go to HR with those concerns.

    Your employer is lucky to have you!

    F Tessa Bartels, CPC, CEMC

  3. #23
    Default
    Thanks Tessa!!

  4. #24
    Default
    Quote Originally Posted by ercoder65 View Post
    Since this facility seems to care most about the bottom line, I doubt my supervisor will give the go ahead for an outside audit (due to paying $$$). What is my next plan of attack?
    ercoder65

    Sometimes we just got to pick our battles In this situation, I think you should simply provide the information verbally as will in writing you should find some resources to share with your supervisor. I believe as coders we have a responsibility to interpet and educate to maintain compliance and sometimes as you know we have to agree to disagree. This matter although a concern, I would not view it as a need to plan an attack (lol). Make the recommendation respectfully and move on. Best Wishes!
    Mjones7

  5. #25
    Default frustrated
    Okay,

    We had a coding meeting and again, I stressed the importance of documenting what the PA did to assist the surgeon. After an hour and a half of showing her examples, she said she would implement this policy, but it would take time and we were to continue on as usual(which I didn't like to hear). Now I am told, by a friend who happens to be inside the 'circle', that my supervisor is doing everything she can to disprove me and hasn't brought this up to her boss, nor the doctors. I am also told she is documenting my passion for doing things right, as being confrontational with her. Is there an organization, or a person, I can talk to that would back me up? I feel so overwhelmed. I really believe in doing things the right way; what is so hard to make the physicians document the help the PA's perform? Also, if you explain this to the PA's, I am sure they'd make the doctors document rather then to not bill or worse, to risk an audit and open up a can of worms!! I am soooooo frustrated. I am sending my resume out becuase I can see the writing on the wall.

  6. #26
    Location
    North Carolina
    Posts
    3,126
    Default
    I don't know if these will help or if this applies to your specialty but the same concept applies for documentation....

    Assistant surgeon or assistant at surgery

    When there is an assistant surgeon or an assistant at surgery, the surgeon of record is listed as the primary surgeon. The surgeon of record is responsible for identifying the presence of the assistant surgeon or assistant at surgery and the work performed. In this situation, the assistant surgeon or assistant at surgery does not dictate an operative note. An MD or DO serving as the assistant surgeon will report the CPT codes for those procedures.

    http://www2.aaos.org/aaos/archives/b...g06/coding.asp


    If the CPT code has a “0” status indicator, the operative note will need to clearly state why the assistant was required and the extent of the work performed by the assistant to support payment. The primary surgeon is responsible for including this enhanced documentation in the operative note. Without such information, billing personnel will find appeal efforts difficult.

    http://www.aaos.org/news/bulletin/jun07/managing5.asp

    http://surgicalassistant.org/Newslet...Newsletter.pdf

  7. #27
    Location
    Long Island/New York
    Posts
    1,271
    Default
    I would get out of that situation as soon as possible. No amount of $$ is worth the stress you're going through. Good Luck!!

  8. #28
    Location
    Milwaukee WI
    Posts
    4,466
    Default Keep your cool
    Rich,
    I feel your pain and frustration, but you MUST keep your cool. One place to go is HR. They are already aware of the difficulty between you and your supervisor, and apparently have backed you up at least once. But you really need to present your case with a sort of detached professionalism. Have documentation of your position (Rebecca's links were excellent), be convincing but NOT passionate. If necessary, role-play with a trusted friend.

    Reading between the lines I'm getting the sense that your emotions (frustration, anger) might be showing through. You mention your "passion for doing things right." Messages delivered with a "confrontational" (to use your supervisor's term) attitude are rarely heard, and the perceived attitude can lead to disciplinary action (including termination). So be as careful about the way you deliver the message as you are about ensuring the accuracy of the message.

    You will always come across those people who cannot accept an idea that isn't their own. The most successful people find a way to let the other person buy into the change or even think it is their idea. If your supervisor believes you are confrontational, she will be defensive. If you can give her some slack so she can approach her supervisor with a change that is "her" idea, she may be more receptive. Try going to her with the supporting documents and just say, "Here's some additional information that you might find useful when you take this to your boss. If there's anything else I can help you with, just let me know." Deliver this message with a smile and a pleasant, helpful attitude. Then leave the room.

    Finally ... all this talking about who said what, when and to whom, and how someone looked after a meeting is distracting everyone in the department from doing their jobs. I've seen office dynamics like this, and they can turn really toxic. Do what you can to stop it; try not to let it affect your job performance.

    And keep looking for another position because I sense that in the long-term this will not be a good place for you. That will be their loss, not yours.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  9. Default
    First I would like to tell all of you how impressed I am each and every time I read / participate in forum discussions. The support here is truly unsurpassed!!
    Rich,
    I wish you the best of luck... you are on the right track. Keep your head up, keep in touch with your HR representative, & document everything. One of the best lessons I've learned from my Associate Administrator is when feeling frustrated about an issue - give it a day, sleep on it - the morning will usually bring a clear picture as to how you wish to proceed or approach someone who may be confrontational or unwilling to listen.

  10. #30
    Default Thanks!!
    I want to thank everyone for the advice and support I have received regarding my situation. Its times like these that I am truly grateful for being part of a wonderful association of people, from all different parts of this nation and different backgrounds................you are all truly the best! Thanks again.

    Sincerely,

    Richard Dinaso

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