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Please help.. need input..

  1. #1
    Honolulu, HI
    Default Please help.. need input..
    Medical Coding Books
    I had posted this question a few days ago and got no responses. I really do need some input. I'm pretty sure I already know the answer but due to circumstances right now, my confidence is not too good. So really, any feedback I can get would be very appreciated. Sorry if this seems long winded.

    Having just moved from out of state, I was shocked to find that the majority of the jobs in the area I'm in is hired through temp agencies. Right now i'm on assignment working at a ambulatory surgical center. I have 3 years of billing experience in an asc from my previous job. The surgery center i'm working with now seems to think that it is perfectly acceptable to instead of sending in itemized invoice for implants, using an invoice for a kit instead. Here is the kicker.. the actual kit does not exist within the manufacturer. They are working out an arrangement with the manufacturer to create an invoice for the "kit".
    They are insistant in billing for the disposables and seem to believe that if they produce an invoice for a "kit" it will reduce the revenue lost on the disposables as the carrier is paying on an entire kit.

    My quandry is this.. to bill for a kit that really doesn't exist constitutes another form of fraud in my book. I have spoken to the administrators concerning this which of course turned ugly. I fear i'm probably going to loose this job. Am I right or wrong on this? Really any feed back I can get would be really appreciated!

  2. #2
    Clarksville Coders
    Default I agree
    I agree with you. In the world of coding if it isn't documented it didn't happen, so the same should apply to coding kits that don't exist. There is a huge ethical issue with that!

    In all things seek Him...

  3. Default
    I think you are right. I am not an expert in that field but I think everything has to be documented. And if the kit copies you are making has number and its always the same then yet it could be considered at fraud. If your super is getting angry over this its because they already know what they are doing is wrong. I would tread lightly with this and try to get the answer I need after all as you know if they get in trouble they you will also. Its not worth going to jail or paying a fine for the mistakes they are doing. So if I felt strongly about what you think is wrong get the answer you need. contact the company you are making the claims to and ask them Hypothetically. Its not worth tarnishing your name over it. Good luck.

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