Author Topic: Very specific question  (Read 1062 times)

advance11

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Very specific question
« on: June 03, 2009, 08:15:22 AM »
A patient came into the chiro's office with Medicare.
The doctor completed his sheet indicating what he did, and I billed what he said he did.
Later he realized that the patient had Medicare, and that what I billed for was a non-covered service, so he told me to bill Medicare for the same date of service for a Medicare covered procedure so that he could get paid.
I told him I wouldn't, that I would not bill for something he didn't do, that it sounded like Medicare fraud.
Who was right?  And since Medicare denied the charges, as did the secondary, what do I do with the balance?  (We do not accept Medicare assignment.)

PMRNC

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Re: Very specific question
« Reply #1 on: June 03, 2009, 11:25:55 AM »
You already did the right thing and refused to bill for something that wasn't done. Stand firm with your position because regardless if you are an employee or not you can still be accountable since especially you know it's wrong. Tell him it's simply "Fraud to bill for services NOT rendered" you might want to make a note of it somewhere that you told him this. Hopefully also you log on/ log off with your own login so in case he decides to bill it out you have an audit trail. 
Linda Walker
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