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coder's personal liability

  1. Default coder's personal liability
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    we have a new person in our office who is requesting to see in writing from an "official" source a coder's personal liability when billing for services rendered. he is looking for documented rules covering the legal responsibility of a certified coder. I don't know where i can quickly locate such a document. if anyone knows where i can locate this information i would be most appreciative if you would send me that information.

  2. #2
    Location
    Columbia, MO
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    If you are able to search past Coding Edge articles I know there have been several written on this and I believe one is comming out in the upcomming August edition. You might even see if you can send a e-mail to one of the AAPC board members to see if they can help with this.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Location
    Columbia, MO
    Posts
    12,570
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    some info from my files for you:
    Coding is the medical business practice of matching the clinical documentation in a patient's record to numerical and alphanumerical codes for reimbursement of services. Medical coders deal with confidential patient information and can be liable for a breach of that information.

    Understanding Liabilities
    1. Medical coders are liable, or legally responsible, for the confidential patient information with which they work. Although medical coders do not work directly with patient care, they do provide services that affect patient information.
    Incorrect Code Assignment
    2. Coders are responsible for all codes submitted for billing, even if they are incorrect. In most cases, incorrect code assignment results in denied claims. However, circumstances exist for coders to be charged with fraud.
    Incorrect Reimbursement
    3. In some cases, incorrect code assignments can result in increased reimbursement. Submitting false billing claims can be viewed as a criminal activity and punished by law.
    Privacy
    4. A patient's health information is private and is protected against being shared in an unauthorized manner. A medical coder who shares or inadvertently releases patient information can incur civil penalties of $100 or more for each occurrence or criminal penalties, including jail time.
    Security
    5. It is the coder's responsibility to secure electronic patient information from the patients with which they work. The increased use of laptops containing patient medical information and the potential for theft create liability issues

    References

    * American Health Information Management Association (AHIMA)
    * American Academy of Professional Coders (AAPC)

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
    Location
    Columbia, MO
    Posts
    12,570
    Default
    some info from my files for you:
    Coding is the medical business practice of matching the clinical documentation in a patient's record to numerical and alphanumerical codes for reimbursement of services. Medical coders deal with confidential patient information and can be liable for a breach of that information.

    Understanding Liabilities
    1. Medical coders are liable, or legally responsible, for the confidential patient information with which they work. Although medical coders do not work directly with patient care, they do provide services that affect patient information.
    Incorrect Code Assignment
    2. Coders are responsible for all codes submitted for billing, even if they are incorrect. In most cases, incorrect code assignment results in denied claims. However, circumstances exist for coders to be charged with fraud.
    Incorrect Reimbursement
    3. In some cases, incorrect code assignments can result in increased reimbursement. Submitting false billing claims can be viewed as a criminal activity and punished by law.
    Privacy
    4. A patient's health information is private and is protected against being shared in an unauthorized manner. A medical coder who shares or inadvertently releases patient information can incur civil penalties of $100 or more for each occurrence or criminal penalties, including jail time.
    Security
    5. It is the coder's responsibility to secure electronic patient information from the patients with which they work. The increased use of laptops containing patient medical information and the potential for theft create liability issues

    References

    * American Health Information Management Association (AHIMA)
    * American Academy of Professional Coders (AAPC)

    Debra A. Mitchell, MSPH, CPC-H

  5. Smile coder's personal liability
    thanks for the information! i do have access to a few years worth of coding edge at home but he wanted the information now
    i really appreciate your response and i will be checking the old coding edge copies as soon as i can
    thanks again
    debbie

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