mitchellde
True Blue
To all fellow coders,
I have a situation that has me extremely bothered and I want to know what you would do.
A really close acquantance of mine works for a billing service that it is well known I have no respect for their work ethic. (a story for another time)
The background you need here is she is untrained as a coder and has no medical experience at all. They have put her in the position of "coder". They usually just take whatever codes are given by the physician office and pass them thru to the payer with no review at all.
So she is relaying to me how she is bored with her job, and I said that it did not surprise me being as how it is a data entry type of function they have her doing with no decision making on her part, who wouldn't be bored. But then she said no that is not true she makes coding decisions every day, such as if a claim comes thru and she knows the diagnosis is not payable then she changes it to something on the "list" with no med record review, AND if the codes come thru as a global encounter and she sees it is even one day past the global then she changes it to a 99213, again with no record review. The physician office is never told of these changes either. When I tried to tell her that she cannot do that she just shrugged her shoulders and said "well, I do it."
I am just appalled by this attitude and she is not the only one in this office that does this. It bothers me greatly when our profession is trivialized in this manner, and it makes it very hard for providers in general to trust us to do what is correct.
So honestly am I upset over nothing ? How do you feel about this and should something be done?
I have a situation that has me extremely bothered and I want to know what you would do.
A really close acquantance of mine works for a billing service that it is well known I have no respect for their work ethic. (a story for another time)
The background you need here is she is untrained as a coder and has no medical experience at all. They have put her in the position of "coder". They usually just take whatever codes are given by the physician office and pass them thru to the payer with no review at all.
So she is relaying to me how she is bored with her job, and I said that it did not surprise me being as how it is a data entry type of function they have her doing with no decision making on her part, who wouldn't be bored. But then she said no that is not true she makes coding decisions every day, such as if a claim comes thru and she knows the diagnosis is not payable then she changes it to something on the "list" with no med record review, AND if the codes come thru as a global encounter and she sees it is even one day past the global then she changes it to a 99213, again with no record review. The physician office is never told of these changes either. When I tried to tell her that she cannot do that she just shrugged her shoulders and said "well, I do it."
I am just appalled by this attitude and she is not the only one in this office that does this. It bothers me greatly when our profession is trivialized in this manner, and it makes it very hard for providers in general to trust us to do what is correct.
So honestly am I upset over nothing ? How do you feel about this and should something be done?
