Wiki Department of labor billing

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maryk328

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I work for an ASC. We only do same day out patient surgeries. Our hours are from 6:15am-4pm. We have an open claim for the Department of Labor. The patient checked in & had surgery on 8/24/21, after post op he was released on 8/24/21. Box 24A has the date of surgery as 8/24/21-8/24/21. The Department of Labor wants us to change it to 8/24/21-8/25/21. I have refused to change it. My supervisor said its legal to change. I disagree. Please help us settle this.
 
It's hard to take sides on something like this without knowing the whole story. Why does the DOL 'want' you to change the date? That makes no sense. Have they instructed you to do this in writing or given you an explanation for why this needs to be done?
 
The denial says there is a missing diagnosis indicator missing or is invalid. When we called we were told the date can't be the same in both places. My supervisor said its because of the auth stating from 8/24/21-8/25/21. I said the auth can say anything. The patient was seen & release on the same day. So we can't have the following day on the claim.
 

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  • DOL denial.pdf
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maryk328 said:
The denial says there is a missing diagnosis indicator missing or is invalid. When we called we were told the date can't be the same in both places. My supervisor said its because of the auth stating from 8/24/21-8/25/21. I said the auth can say anything. The patient was seen & release on the same day. So we can't have the following day on the claim.
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I don't see anything on your attachment that says they want you to change a date, and the page you've scanned here is very unprofessional and does not even identify the name or credentials of whoever has sent you this information, so I would not give it any weight. I also wouldn't take a phone rep's word for anything - they are notorious for giving out incorrect information. If it were me, I would push back on this with the payer and not just falsify or otherwise change the claim based on such limited information just for expedience of getting payment. If you're claim is correct, they have no business asking you to change anything. But of course your supervisor may have his or her own rationale for taking a different approach.
 
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