Recently I started working for a physician billing group. I found out that the billing staff is changing my coding if the bill does not pass through the software scrubber.
Evidently they are looking back through older bills that DID pass and gathering those codes, then asking the physician if they can use them. I do not see the new codes before the bill goes out. There is one biller that is familiar with coding but not technically hired as a coder and is not certified. The other employee does billing and to my knowledge no coding.
I really needs some fast and solid guidance on these issues before I speak with the manager next week.
1. What is my liability in this situation? I am not electronically signing this work nor seeing this before it goes out.
2. Is this leading the physicians to certain diagnoese that are known to 'pass' for payment? What ramifactions and inherent here and what guidelines can I quote regarding this.
3. Shouldn't these cases come back to ME for review and query of the physicians?
4. Am I correct to be concerned about this process?
Please help me right away with any commentary, suggestions and information that will help me when I present this to management. I am VERY uncomfortable with this situation and I feel they are treading on thin ice at best.
HELP and thanks in advance.
L
Evidently they are looking back through older bills that DID pass and gathering those codes, then asking the physician if they can use them. I do not see the new codes before the bill goes out. There is one biller that is familiar with coding but not technically hired as a coder and is not certified. The other employee does billing and to my knowledge no coding.
I really needs some fast and solid guidance on these issues before I speak with the manager next week.
1. What is my liability in this situation? I am not electronically signing this work nor seeing this before it goes out.
2. Is this leading the physicians to certain diagnoese that are known to 'pass' for payment? What ramifactions and inherent here and what guidelines can I quote regarding this.
3. Shouldn't these cases come back to ME for review and query of the physicians?
4. Am I correct to be concerned about this process?
Please help me right away with any commentary, suggestions and information that will help me when I present this to management. I am VERY uncomfortable with this situation and I feel they are treading on thin ice at best.
HELP and thanks in advance.
L