# What is my liability



## ivorytofu@hotmail.com (Dec 6, 2012)

I recently started a new position in a medical office, but not specifically as the coder or biller and not sure what my exact title is. Anyway, the office uses superbills (charge sheets) and I do get those together and fax the off. Sometimes I do have to pull charts and being a coder I have noticed that a NP is going to be billed for a L4 but the documentation does not meet the requirements for that level of service. Now it is not my job to audit these charts or code these charts.  But my question is how liable would I be in a MCare or State audit? I really need to know before I push the issue or not push the issue.  Thanks in advance for all response.


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## suemt (May 13, 2013)

I would say that regardless of your liability, you could be providing an invaluable service by (tactfully!) pointing out that as a CPC you've noticed some irregularities in some of the work that's come across your desk and ask if they'd be receptive to hearing your comments.  

I don't know many places that wouldn't appreciate being alerted to potential problems.  

IMHO, the secret is in the delivery.  Find the right person to speak to, and at least in the beginning, avoid saying anything too strongly.  If they are smart they will recognize your worth and before you know it you will be helping with internal audits and training of the staff!  

Good luck.


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## AprilSueMadison (May 14, 2013)

> IMHO, the secret is in the delivery. Find the right person to speak to, and at least in the beginning, avoid saying anything too strongly. If they are smart they will recognize your worth and before you know it you will be helping with internal audits and training of the staff!



This is very important.  Any time I find an issue, which is a lot of times recently, I put my facts together, ask for help if I need it here, and then go to my office manager.  If I can make her understand my concerns, then I know she'll help me with the doctors. 

It may simply be a problem of not understanding the documentation required for each level of service.  I found that that, plus the fear of an audit, was causing my doctors to downcode.  I put together a small training class for them to explain what they should be doing for each code and it worked out well.  I'll also be doing a company wide training class on E/M codes as well in June.

I'm like you, I don't do the coding and I only see it after the fact.  I feel like because I have the want to learn more about it, the CPCD behind my name, and know so much that it *is* my responsibility to get things changed if they need to be.


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## ollielooya (May 14, 2013)

This was such a helpful thread and i couldn't agree more concerning the "delivery" mode.  If successfully implemented it's only a matter of time that your worth as an employee will be valued more..
It's something I needed to hear for the day!


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