Medical Billing Coding - Should I alert admin and providers?, cpt, codes
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Thread Topic: Should I alert admin and providers?
Topic Originator: Bbill
Post Date September 30, 2017 @ 6:15 PM
Should I alert admin and providers?


Bbill
September 30, 2017 @ 6:15 PM Reply  |  Email Friend   |  |Print  |  Top

Went to work at a group practice. Saw all I needed to know and had to quit. The billing supervisor has no experience nor do the a.r. reps i understamd everyone quit and they needed warm bodies. The practice admin is new. The billing practices are so negligent. Clueless girl in charge of medicare claims refuses to sign up on spot because she doesnt want to identify herself as needed ti get on there. She also in charge of va in the community pts and insist that they can be secondary so even when the pt doesnt give other insurance info she finds it and bills them first. Pt gets bill for copay or deductible and cals in saying we billed wrong payer. Its supposed tobe v.a. she then removes the pt charges and bills out to va ofcourse they pay in full so npw two have paid. No attempt to refund either payer and neither knows about the other. Super "abandons" overpays in the system to zero out. This is hundreds of claims. Also no pro coder on staff and modifier 59 used every claim to bypass edits. Claims partially denied for total incompetence of billers, supervisor will have them appealed. When denied she voids the charge from claim in the system instead of adjusting and having to explain the error to mgmt that caused the denial in the first place. She also had her car repoed from the parking lot at work and didnt have the sense to keep it private frim a.r. reps. Am sure she would like to keep it from admin but that epitomizes her competence with money. Theres no way these drs know how bad the billing os or hpw much trouble they are being exposed to nor does the admin. Should I warn the admin? I think they have a right to know but on the ither hand being so out of touch with whats going on and wool over her eyes by super is their fault.

Anonymous
October 5, 2017 @ 9:58 AM Reply  |  Email Friend   |  |Print  |  Top

Since there may be billing fraud, you have an obligation to report your concerns to the organization's compliance officer.



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