ipl-logo

Medical Billing Memo

403 Words2 Pages

Today, a medical assistant has asked to speak privately with me, the office manager, about a matter that she is greatly concerned about. She makes an accusation of fraudulent billing that is against one of the medical doctors on staff. The medical assistant alleges that she has noticed recently in the past few months that this particular doctor has repeatedly been upcoding higher evaluation appointment code descriptions for all of his Medicare patients’ appointments. She believes that these visits should have been listed with lower medical description codes for billing purposes.
I would thank the medical assistant for coming to me with this information. I would assure her that she has done the correct thing by bringing this to my attention. I would ask her to give me any specific patient billing records that she is concerned with as being inaccurate. I would ask her to please not repeat this information to any of the other employee staff members at this time. I would assure her …show more content…

I would immediately cease filing these bills. I would then need to show these records that have inaccuracies that I have noticed to this particular doctor and ask for any explanation of his knowledge of these inaccuracies. I would then listen to him to see if he denied that there was any wrong coding on his part or if he was unaware that he had coded them inaccurately or if he disagreed that there was any incorrectness at all in the coding of them. If I believe that there are fraudulent activities or mistaken coding that has taken place, I would then contact the proper Medicaid authorities and an attorney. Yes, I would seek legal action because I would need to protect myself, the medical assistant, and both of our careers from any involvement with fraudulent

Show More
Related

Aac 117 Medical Office Procedures Research Paper

250 Words | 1 Pages

AAS MBIC 117 -Medical Office Procedures Week One Discussion Judy Potts What are some examples of the skills and education required of a medical office manager? Medical office manager also knows as healthcare office manager, someone that is in charge of the overall office and it is operations. ”In a group practice, a medical office manager” oversees the administrative staff which includes billing, medical records, medical receptionists, and technicians. They also do the hiring and training. He /she educational requirement should be as follows, basic computer and data entry skills.

Read More

E/M Coding: What Was Done In The Office

283 Words | 2 Pages

E/M codes tell what was done in the office. Everything that the doctor or physician has done is documented, and coded. If a certain thing was not done then it should not be coded, and charged for that is considered fraud. Also everything that is done in the office must be documented, and coded using the E/M codes. If the E/M coding was done incorrectly the person would get in trouble for fraud, and not only that the office would have a bad reputation, and other insurance companies wouldn 't probably want to go through that office anymore.

Read More

Critical Access Hospitals: Case Summary And Analysis

511 Words | 3 Pages

The existing law also has the ability, to give the board powers to put him or her on probation depending on the conditions. Therefore, information obtained from the MBC, in fiscal year 2015-2016, received 8,679 complaints against physicians and surgeons and unlicensed individuals alleged to be practicing medicine without a license. These complaints include allegations including excessive prescribing, gross negligence/incompetence, licensee self-abuse of drugs or alcohol, convictions of a crime and general unprofessional

Read More

Cy-Fair Team Work Case Study

310 Words | 2 Pages

She is very rude and disrespect. As you know due to the errors I have been working all day to correct the issue. As discussed with Donna I returned the paperwork to her for further verification. I stop in the office later this afternoon to check if there is more work to be done and Donna stated that she did not have the opportunity to view the information.

Read More

Summary Of The Book Of David By Richard Gelles

1325 Words | 6 Pages

Richard J. Gelles was the director of the Family Violence Research Program at the University of Rhode Island. In his research, Gelles found that in many cases Social Workers as well as other professionals fail to look at the entire picture in terms of family intervention. According to Gelles, in the case of David, preexisting family issues were overlooked which should have played a major role in determining the suitability of David’s home. In his book, Gelles addresses several issues that state families should be maintained and that children are better off with their parents than in a custody system. “The Book of David,” is a nonfiction story about the short life of David Edward.

Read More

Poad 9 Reflection

169 Words | 1 Pages

The female patient was irate, uncooperative, and exhibiting violent behavior with the nursing staff and Physician. She wanted to leave the hospital and refuse to talk to the staff. The patient throws her SCID card in the trash and I pulled it out of the trash can and place it with her paper work. The female patient received

Read More

Defendant: Case Study

373 Words | 2 Pages

That on or about August 14, 2014, and continuing then thereafter the Defendant negligently breached the Florida Confidentiality of Medical Records Act codified in Florida Code 766-102 to 766-203 of the Health General Article and psychologist patient privilege codified at Fl. Code 766-380 of the courts and Judicial Proceedings Article by disclosing and introducing confidential and privileged diagnoses and treatment records of Claimant, including text messages exchanged between the parties, email, medical records, photos, without patients authorization nor consent. Said records were disclosed in the District Court of Florida for Seminole County and were the direct and proximate cause of all of the injuries sufficed and damages that was complained of

Read More

Candace Newmaker's Arguments In The American Justice System

715 Words | 3 Pages

Candace Newmaker, a bright girl trying to find a home until she met her terrible fate of being murdered. One of the worst things you can inflict upon another human, is to steal their lives. People who take another’s life are sentenced harshly. But when it comes to doctors, they receive a free pass. Why should doctors and medical physicians not be as harshly punished compared to others?

Read More

Entry-Level Competency In Professional Nursing Practice

521 Words | 3 Pages

PT, my preceptor, and I communicated about an order issue for a patient. The PT felt uncomfortable performing PT while the patient had a Doppler order to rule out DVT. Therefore my preceptor and I called the physician to clarify if this was still an active order, since it was 4 days old. When the doctor said to cancel the order, we communicated this with the PT so she was able to work with our patient. I also communicated with the kitchen staff all throughout the shift my patients who had a hard time reading the menu and ordering their own

Read More

Denied Claim In Medical Billing

115 Words | 1 Pages

It is important to enter correct codes for patient billing because the insurance needs to know what the patient is being diagnosed with so they can charge the right amount. When incorrect codes are entered by someone, the claim that was submitted can be rejected or denied. A rejected claims means that there is an error within the claim which means that the claim has to be corrected and resubmitted. A denied claim means the claim has been determined by an insurance company to be unpayable. Both types of claims are often denied or rejected because of common billing errors or missing information, but can also be denied based on patient coverage (Medical Billing

Read More

The HIPAA Act Of 1996: Protecting Patient Confidentiality

96 Words | 1 Pages

Healthcare providers and organizations are obligated and bound to protect patient confidentiality by laws and regulations. Patient information may only be disclosed to those directly involved in the patient’s care or those the patient identifies as able to receive the information. The HIPAA Act of 1996 is the federal law mandating healthcare organizations and clinicians to safeguard patient’s medical information. This law corresponds with the Health Information Technology for Economic and Clinical Health Act to include security standards for protecting electronic health information. The healthcare organization is legally responsible for establishing procedures to prevent data

Read More

Health Reimbursement Arrangement Essay

507 Words | 3 Pages

Healthcare Options – (HRA) Health Reimbursement Accounts Health Reimbursement arrangement (HRA) is an employer-funded medical reimbursement plan for employees. Health Reimbursement accounts is designed by the Internal Revenue Service (IRS) to enable employers reimburse their employees for certain medical expenses. This helps the employee settle the cost of their medical expenses. Additionally, it also help the employer save money on taxes. Who can benefit from Health Reimbursement arrangements?

Read More

Health Care Stakeholders Analysis

1010 Words | 5 Pages

The facilities enforcing protocols and policies to secure that employees are meeting government regulations. Doctors, nursing staff and support staff I must use their best ethical and moral judge in most case to ensure patients are being retreated. Thus, sometimes causing conflict with health care administration because health care workers sometimes unknowingly break policies or protocol by putting patients first. As well as hospitals and clinics have so many departments that there can be conflict of interest with patient care that can cause inconsistency with patient care (Santilli, J. el al., 2015, Para

Read More

Medicare Billing Violations

186 Words | 1 Pages

In the text, the levels of violations are warnings, an informal disciplinary action, punitive action, and termination (Safian, 2009, pg. 218.). For a physician billing Medicare wrongfully the first time they could receive a warning. The second

Read More

Medicare Fraud Research Paper

301 Words | 2 Pages

Medicare fraud is a very common occurrence in the United States. However, there are whistleblowers who are working hard to stop Medicare fraud. The vast majority of people who report Medicare fraud are healthcare professionals. This includes people such as ambulance drivers, physicians, nursing home workers, hospice workers and nurses. There have been some changes recently to the United States whistleblower laws.

Read More

More about Medical Billing Memo

Related Topics

Open Document