Wiki Protecting my certification

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Bethy4444

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Hi all,
We have a physician who wants me to send through and bill for office visit codes that he is not making the requirements for, documentation OR medical necessity. He has been told and shown the deficient areas, yet he still wants me to mark what he marks.

Isn't there something I should be doing to protect myself against anything and that happens if an audit ever comes around? Like making him sign a letter or something? Is there something I can do to help this situation? Thanks for any responses.:(
 
re; protecting your certification

1--RUN...don't walk from this situation. If he has been educated on proper documentation and refuses.....I would be getting OUT of that position/office ASAP! :mad:

2--get E&O insurance to protect yourself!
 
I agree with Tex. YOU are liable for his fraud since you know about it (and are his coder). I would tell him if he keeps trying to push the wrong codes that it is fraud and he will be turned in for it and I would escalate it to the highest person you can get because you can do jail time and pay fines for this. If that gets no results I would do the whistle blowing myself as I don't have up to $50,000 and prefer not to do hard time.
 
Why do you need Errors and Omissions insurance?

If you have a professional services business, having errors and omissions insurance coverage can be an integral part of protecting your business. Accusations of negligence or the failure to perform your professional services are things that any professional services business can be sued for, even if it hasn't made a mistake.

You should seriously consider this coverage if your business:
provides a professional service.
regularly gives advice.
 
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