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Rules RE: the same person entering charges and posting payments

  1. Question Rules RE: the same person entering charges and posting payments
    Medical Coding Books
    I have been told that it is illegal for the same person to enter charges and post payments but cannot find any documentation to confirm it. I know of several small practices that the entire billing department consists of one person. As long there is and EOB to prove the adjustment amount whats the problem????

  2. Default
    I have never heard of such a thing. Since I have been billing most jobs I have had I was the only one doing the billing front to end.

  3. #3
    Lauderdale Lakes
    I have worked in office's where I have done all of these. It is not illegal but it is good practice as I was told.

  4. #4
    Kansas City, MO
    Agree, it is not illegal...but it is still good practice to have some sort of checks and balances in place. I have been places where I was the one and only biller. If I started there, and there was no system in place I created one. It may be different depending on how the office is set up, but I found someone to make sure someone was counting money before or after me.
    Linda Vargas, CPC, CPCO, CPMA, CPC-I, CEMC,CCC, AAPC Fellow
    PMCC Licensed Instructor
    2018 Chapter President, Kansas City, MO

  5. #5
    Marion, OH
    It might not be illegal however, if an accountant did an audit this is one thing that he would definitaley flag you for. If you are doing all the coding/billing and payment posting/adjustments what is to stop you from taking money and adjusting the balance so the patient does not get a bill. Having seperation also protects you from the appearance of wrong doing. If there is a question of how something is done then you have no one to back you up saying that it is the correct way. Whether it is patient payments or insurance payments you don't want to be the only one handling it. You should also have someone who is not entering payments balance the bank statement each month. This is yet another checks and balance to protect the one entering the money. I hope this helps.

  6. #6
    I am like many of you and have been the only billing person, however was taught that there absolutely needs to be a separate person opening the mail and posting it, as well as reconciling the monthly bank statement, that is in the incidence that the billing office consists of one person. In my situation the office manager opened the mail, she kept a list of checks and amounts, I had to balance with her and then our lists together had to match the bank statement. I suppose it depends upon the office, but always protect yourself from the appearance of wrongdoing, I agree with the above comments. Good luck. By the way, i was never told it was illegal, it was not a good accounting practice.

  7. #7
    Mobile, Alabama
    I also have never heard of it being illegal. I do know of some offices that have several employees in the billing office and they have someone seperate to open mail, copy checks, and make the deposit. Almost all of the health insurance companies where I live don't send paper checks and EOB's, they are all electronic deposit and the EOB's are pulled from a software vender. I've been working for my company for over eight years and I am the only one who posts charges and payments. I believe it can be a trust issue with some physicians so they like to have two seperate people.

    Good Luck!

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