General Category > General Questions

Recourse for negligent billing service costing our practice thousands!?

<< < (9/13) > >>

PMRNC:
At this point..I wouldn't want that billing company touching anything.. the doctor has just cause to exit the contract and should be doing so right now.. also again.. where the "fraud" is considered.. cover all your butts and report it before it's too late, the more you try to "fix" it or hold them accountable to "fix" it the worse it's going to be.
If I were you I would send a letter to the billing company certified mail and I would contact all the carriers and try to rectify this situation within your office.. Don't let that billing company touch anything.. you could be looking at an even bigger mess if they go back and cook the books to cover their own asses.

Michele:
I was thinking the same thing Linda, but she had said they don't have any records, so they have no way of handling what the billing service has billed.  Personally I would have pulled it several weeks ago, but if they have no access to any previous billing I'm not sure how they will handle it.

Michele

PMRNC:
I STRONGLY advise the practice to get an attorney to handle this, this is way too much to be put on an employee of the practice, a lawyer can step in and take the necessary steps to obtain the info needed. BUT if the provider is sweating over getting caught with something.. and it were me.. I'd be quickly looking for another job.
JMO

thatcuteblonde:
And that is exactly what I'm doing. They are not taking any corrective measures here outside of expecting me to find all of these mistakes and notify the billing company. We don't have anyway to take it back ourselves which is unfortunate and I got brought into this mess at the very end of things, a month before their contract with the billing company was scheduled to end. The 'office manager' has no billing experience whatsoever and was to be monitoring what was going on.

In the two months that I've been here I've found everything from misposted payments; $61.00 posted as $610.00, bills for services not rendered, patients billed for mutually exclusive codes, MMSE (mini mental status exams) billed using an 96116 (hour long neurological exam) despite the disclaimer in the CPT book at the begining of that section and so much more. It seems the more I bring these problems to light the more the office manager hassles me for little things like arriving at 7:31 when start time is 7:30. Unfortunately there seems to be no real concern for the issues here other than the 'don't get caught' mentality Linda mentioned and the woman who should have picked up on half of these things months ago getting catty because I am making her look bad.

At this point there isn't much more I can do. I have written letters to the insurance carriers for the fraudent charges I have come across and notified them of these errors. In addition, I've kept copies of my attempts to notify the billing company and the doctor. It's so frustrating when it seems like it's getting harder and harder to find an office where the doctor's actually care and the other employees are capable of doing their jobs instead of resenting the people who do.  :( :( Anyone know of a position available in Arizona? LOL.

PMRNC:
I have had a few clients like that.. the "word" audit seems to provoke an interesting response... sort of like yelling "FIRE"..

keep documenting things and do what you can do. The carriers you notified of errors.. that might come back to bite them enough to take responsibility..you did right thing, some of those carriers if it's fraud (not error) are not going to just.. OH Ok.. oopsie..just cut us a check and we're good.. some of them might put a red flag in there which will affect future reimbursements, others will take payments from future claims and you are going to have yet another mess when the requests come in for overpayments or even.. du dum dum.. an audit or two.

These offices eventually either get shut down or see the errors of their ways.. one or the other.  I'm sure you are also dealing with some irate patients? 

Navigation

[0] Message Index

[#] Next page

[*] Previous page