Author Topic: Back up those files!  (Read 1619 times)

ste

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Back up those files!
« on: March 26, 2011, 04:03:14 PM »
I've been diligent with maintaining hardcopies of all the superbills that come into the office. However, with MVA claims the chart notes that come with the superbills get mailed with the claim forms to their respective insurance. Additionally, there was about a month and a half period where fax records were not maintained due to a change in fax plans. Consequently, 45 days elapsed where copies of submitted soap notes were not maintained.
An attorney representing a patient with his or her MVA claim mailed a letter to the provider asking for copies of all of the chart notes, and I have been doing the billing for the latter 4 months of the 10 month period in which the patient was being seen. The provider faxed a copy of the letter to me and said, "take care of this". Unfortunately, the 45 day glitch mentioned above fell within this same 4 month period and of the 44 soap notes that I should be able to produce I can only cough up 20.
My contract with the provider specifically states, "Any and all information supplied to the billing center from the client is considered to be copies of the originals that have been retained by the client. Client also agrees to maintain these originals."
So my question is, aside from vexing my client which is never a good thing, have I done anything against the law?   

PMRNC

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Re: Back up those files!
« Reply #1 on: March 26, 2011, 07:55:35 PM »
OUCH.  :( 

Well..  by law you are required to keep source documents of what YOU get from him.. and he is responsible for his source documents.  Right now I would be thinking of ways to fix it and not about who broke law, push comes to shove you could both be equally responsible, him for losing his and you because your to retain what he gives you. IF he never sent any of that stuff to you..then your completely off the hook.  I do not get copies of clinical notes unless I need to clarify a code or submit an appeal and then it's a copy, not the original. For mainly that reason alone. I feel the provider needs to be 100% responsible for any and all clinical information. If coding or if I'm reviewing coding.. I will go to the office and review the charts there, if I'm not close to do it.. I don't do it period.
JMO.

Either way..you may have to either find these or have provider release full liability of payment (yes it can be done, it's called PRO Bono)
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

ste

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Re: Back up those files!
« Reply #2 on: March 27, 2011, 07:48:29 PM »
The provider sent me copies of the original soap notes. I am sure he has the originals. After giving it some more thought the major problem here is that I am embarrassed to say to the provider, "I cannot retreive nearly half of them." I am also a bit bent out of shape for doing all of this extra work without pay.
You mentioned that you never have to submit chart notes to insurance? MVA claims always require them and lately other insurance companies are requiring them in certain cicumstances, like whenever an extended office visit code is used.

ste

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Re: Back up those files!
« Reply #3 on: April 08, 2011, 07:15:43 PM »
But I do get paid for it (Thanks for telling me).
Each state has their own regulations as to what will be and what won't be paid. If I am a biller in state x and an insurance company in state y requests information do I follow the regulations in state x or state y when it comes to determining my copying fees? 

PMRNC

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Re: Back up those files!
« Reply #4 on: April 08, 2011, 07:45:35 PM »
Quote
The provider sent me copies of the original soap notes. I am sure he has the originals. After giving it some more thought the major problem here is that I am embarrassed to say to the provider, "I cannot retreive nearly half of them." I am also a bit bent out of shape for doing all of this extra work without pay.
You mentioned that you never have to submit chart notes to insurance? MVA claims always require them and lately other insurance companies are requiring them in certain cicumstances, like whenever an extended office visit code is used.

No, what I said was that my clients are all required to submit any/all cllinical information. It's outlined as a provider responsibility in my contract. I don't want any clinical info here at my office. If I have to check on a code the provider will give me a copy of the chart notes and that's only time. If notes are requested the provider / office sends them.

Quote
But I do get paid for it (Thanks for telling me).
Each state has their own regulations as to what will be and what won't be paid. If I am a biller in state x and an insurance company in state y requests information do I follow the regulations in state x or state y when it comes to determining my copying fees? 

The carrier will reimburse you copying fees up to their state requirement if any.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

ste

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Re: Back up those files!
« Reply #5 on: April 19, 2011, 12:59:49 PM »
The insurance company was kind enough to send me copies of the chart notes that I had sent them. I was pleasantly surprised, and very much relieved.