Wiki Fraud concern

[brightpea]

Scenario: Pt is put on both the physician's & nurse practitioner's schedule in error. Physician sees the pt. Somehow the NP signs the note. I point this out to my superior and am told that it's fine and bill it out anyway. This is raising red flags with me as being fraudulent.

I have searched for a while this morning for CMS documentation to back me up, but I have yet to come across anything that specifically states the rendering physician must also be the signing physician. I mean, that seems like it should be common knowledge, but before I argue this with my superior, I need to have legit documentation on this matter.

Please advise!!

 

[thomas7331]

I wouldn't call something like this fraudulent - that is a term usually applied to matters of a much more serious magnitude. But it is sloppy work and documentation and I'm not sure why your supervisor would want to bill this out as is and not just fix it and do it correctly. If you're using an electronic medical record, there is usually an audit trail in the system that would show which user actually documented the services that you could fall back on in the event this were questioned, but to do things the right way, a correction should be made so that the patient's record is accurate. It should be an easy fix to amend the record and have the physician authenticate the note and if they don't know how to do this, your system vendor's help desk should be able to direct them.

 

[brightpea]

Oh, I see. Thank you for explaining that to me!