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coder overload!!! want opinions please....

  1. #1
    Default coder overload!!! want opinions please....
    Medical Coding Books
    I know this may sound as if I'm just being a big baby - and maybe I am which is why I would love to get a fellow coders opinion. I work for a small surgical practice with 3 surgeons and a PA. I am the only coder in the office and we have an outsourced billing company. We have recently had some staffing changes and gone from an ofc mgr who was a certified coder and former auditor to a mgr who has only ever worked in hosp medical records.
    I code and enter charges for all of the surgeries, hosp charges, office visits and each doc spends a day at the hospital's wound care center a week.
    Also we are soon to be adding another surgeon to our practice in just a few months.
    I am roughly 2 1/2 weeks behind on entering my charges!!! I have no back up or help of any kind as I am the only person in the practice who even knows how to open a claim in our billing system. Recently I have been asked to perform financial analysis of our wound care pts for the last year. I have been working on an analysis of the vascular studies we perform in our office as Cahaba has changed their guidelines and we have been receiving a ton of denials. On top of the reporting I am trying to teach myself to do, I have to answer the phones, help train the new office mgr and front desk staff, prepare the deposit from the mail each day and now figure out how to get this new doc credentialed because the mgr didnt even know that Cigna Gov Svcs was who previously handled our MCR (she thought she was calling the Cigna commercial ins) and told me that I should have told her that before she spent an hour on the phone.
    But the icing on the cake is that this morning I got a verbal repremand from the mgr and our HR rep for having an unprofessional attitude because I was upset that she didnt tell me we hadnt been receiving but only a third of the amt of money we normally get in EFTs. I was told it was unprofessional that I discussed a financial matter behind the front desk (at the end of the day w the windows shut might I add - and I apparently yelled at her) yet she continues to leave the safe unlocked at night and leaves checks laying scattered everywhere (even in the front desk area).
    I have voiced my concerns to the docs a few times and now I am so frustrated. I feel like these are her duties or the duties of a reimbursement specialist or something of the like. I also feel like it will fall back on me because I dont have the money rolling in and the claims rolling out.
    Does anyone have any advice to offer? Am I being a complainer and should just suck it up because its the life of a coder? Or is this woman out of her mind and completely unqualified to run a medical practice?
    I would appreciate any input that anyone may have.
    Thanks!!
    Mary Beth Gord, CPC

  2. #2
    Default Get a lawyer
    I think you are being unfairly targeted by these people to cover up their own inadequacies. I would get some legal advice and stand up for your rights. My fear is that these unqualified persons have an agenda and they will use it against you. No, this person is not qualified to be a manager of a surgical practice and I am very surprised that she was even hired. Do you know if she is a friend of the HR rep?

    If what you are saying is true and I have no reason to doubt what you say, I would definitely review your company policies, talk to the surgeons (if that relationship exists), and get some legal advice and defend yourself.

    You could also submit a report to the owners of the practice on all the dollars and hours of productivity they are losing because this person does not know about the billing and coding systems which causes you more undue stress and additional work which is costing the practice enormous amounts of lost productivity and lost revenue.

    Good luck and I hope it all works out for you.

    Regards,

    Debbie

  3. #3
    Default Document, Document
    Also forgot to add: document every interaction and altercation with dates, times, names of participants, and specific details of what occurred. If, in the event, you do file a formal complaint against these people or the practice, you will have a better chance of winning if you have shown that you documented every occurrence.

    Again, good luck!

    Regards,


    Debbie

  4. #4
    Default
    Also I thought it quite funny that I happened to witness another employee clocking in an employee that hadnt gotten to work one day. I thought I was making an anonymous call because I didnt really want to get them in trouble I just wanted someone to come in and evaluate the situation and a huge part of my complaint was actually regarding the ofc mgr situation. I guess they figured out who I was based on the nature of the complaint and I was approached by the ofc mgr and another HR staff member to answer questions re that incident and was assured after that conversation that the people involved would not know that I had been the one to tell on them basically.
    Two nights ago I received several text msgs from the lady who was fired over that clocking in incident talking about how upset she had been with me for telling on her but she was going to do the Christian thing and forgive etc etc...
    I was completely blindsided and I felt horrible. I called another employee and apparently when the two girls involved were questioned about the incident it was made clear that i was the one who had witnessed it!!!
    I just called HR yesterday and spoke with a person - I told him that I wanted my concern documented somewhere and I didnt really want any action taken at that point because I am pretty much already afraid that I cant trust anyone here. I certainly dont want to get her in trouble at this point because I've seen what she is capable of thus far.
    So the very next day after my phone call to HR to communicate how upset I am that my privacy wasnt kept - then I get in trouble. Does that seem odd to anyone other than me?
    Mary Beth Gord, CPC

  5. #5
    Default You are being targeted
    It sounds like retaliation in the workplace and it should be against their company policy but if not, get legal advice as to how you should proceed. I would definitely be careful as to who you talk to and what you say. But most importantly, document everything!

    It does sound like you cannot trust even your HR department or the office manager to treat you fairly and with respect.

    Where there are situations where it is your word against theirs and you go to court, the judge will always look at the documentation of events.

    Have your employment and company policies in front of you and find an employment attorney to talk to about a possible violation of your rights. Oftentimes, they will give you a free consultation. Believe me, this has the potential to get worse for you and they may be looking for reasons to fire you. For your sake, take action to defend yourself.

    The other alternative is to find a different job.

    Good luck!

    Debbie

  6. #6
    Default
    Quote Originally Posted by mgord View Post
    Also I thought it quite funny that I happened to witness another employee clocking in an employee that hadnt gotten to work one day. I thought I was making an anonymous call because I didnt really want to get them in trouble I just wanted someone to come in and evaluate the situation and a huge part of my complaint was actually regarding the ofc mgr situation. I guess they figured out who I was based on the nature of the complaint and I was approached by the ofc mgr and another HR staff member to answer questions re that incident and was assured after that conversation that the people involved would not know that I had been the one to tell on them basically.
    Two nights ago I received several text msgs from the lady who was fired over that clocking in incident talking about how upset she had been with me for telling on her but she was going to do the Christian thing and forgive etc etc...
    I was completely blindsided and I felt horrible. I called another employee and apparently when the two girls involved were questioned about the incident it was made clear that i was the one who had witnessed it!!!
    I just called HR yesterday and spoke with a person - I told him that I wanted my concern documented somewhere and I didnt really want any action taken at that point because I am pretty much already afraid that I cant trust anyone here. I certainly dont want to get her in trouble at this point because I've seen what she is capable of thus far.
    So the very next day after my phone call to HR to communicate how upset I am that my privacy wasnt kept - then I get in trouble. Does that seem odd to anyone other than me?

    I've read everything you've said and if I were in your position I too would document everything!!! I know these are hard times but I would atleast start looking for another position. I would find it very difficult to go to work everyday in a place where there is no trust. I've actually been thru a similar situation where I felt I was compromising everything I stand for, it took me a bit to find another position but I didn't want to take the first thing, I did my research finally got out of my situation and am sooooo much happier. I also worked for that company for just bout 12 years, it was hard but it was the best decision I've ever made ( career wise)....

    I wish you the best of luck in whichever route you take!
    Roxanne Thames CPC, CPC-I, CEMC
    rthamescpci@gmail.com


    "Remember the greatest gift is not found in the store but in the heart of true friends"

  7. #7
    Location
    Columbia, MO
    Posts
    12,531
    Default
    My heart goes out to you! I wish I could give you a magic wand to make it better but I cannot. I agree with Roxanne you need to get out of the situation completely. It looks to me like it has already deteriorated past the point of repair. Same sort of thing happened to me as well and I too got out and now am in a lawsuit to try to get the compensation from the employer I was due before I quit. Start applying now everywhere you can even if you have to take a position traveling it will be better. I wish you luck and will be thinking of you. Please let all of know how this goes and if we can be of any assistance in the future!

    Debra A. Mitchell, MSPH, CPC-H

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