Thank you guys! The patient did come in for a routine exam, but the dr found medical diagnoses. If we changed the diagnosis and re-submitted it, would that be breaking any rules/laws?
I went to my personal physician the other day. He was trying to come to the room I was in. An angry senior citizen was blocking his way, yelling and screaming at the top of his lungs. he ws accusing the doctor of fraud. He said his insurance company told him if the doctor changed his diagnosis, his insurance company would pay the bill. He must have said he would sue about 10 times. My doctor was excellent, he kept his cool. He took the patient into a private room, asked me if I could help. He asked the patient if I could see his chart. He explained to the patient about my credentials. I looked and explained that the doctor used the right code. I showed the patient what the code was. I showed the code tat the insurance company wanted The patient calmed down, admitted he used the internet to do some investigation. He said he went to an internet site and someone responded saying the doctor was committing fraud. I asked, was this person a coder? Nope! Just someone who was anonymous. I explained that we cannot change what is documented just because an insurance company wants something change. I also explained if we changed the code, we might be committing fraud. The patient apologized and left saying he would give the insurance company a call. The doctor thanked me. I was impressed. He said he was used to it when he did his intership and residency in Brooklyn.