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Re-submitting as routine?

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Anand:

--- Quote from: Steve Verno CMBS, CEMCS on December 19, 2009, 01:40:15 AM ---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.   

--- End quote ---
..Steve: Is it only the Doctor??I think you must have had issues mostly everday.. :)..haha..Merry Chirstmas..

wildcat1842:
Thank you all again. We will not be re-submitting. Loved your stories Steve, my family is from Brooklyn  :D

PMRNC:
Steve it's so odd all this stuff only happens to you. I think you over-work yourself. If I get an irate patient upset because their payment was applied to their deductible, I'm not there to teach the patient their insurance contracts or rules. I'm not jumping through hoops for them, that's not my job. I explain it once and if they really want to fight I tell them to contact their carrier, union rep or administrator.  I've never let a conversation with any patient go to the level where I am treated poorly, there is not enough money in the world to be treated like that. I apply my customer service skills I learned while working at the insurance company at the first vulgar word the patient uses I inform them that I do NOT have to continue the conversation, they get one warning and if they continue they get a dial tone. I work with mostly mental health providers so I have had to do this a few times. I make it clear to my clients I am not a punching bag nor will I be verbally abused. 
In the situation with the doctor asking you to review the irate patient's chart.. to me that's completely crossing a line and very unprofessional. The proper way for that doctor to have acted was to take the patient in another room and discuss this with them or try to make an appointment for another time or guide him to the billing staff that works for him. If a doctor did that to me while I was waiting to have him see me.. I'd get another doctor! Did you have patient sign any form of release before you looked at her chart?  Sorry but today the legal system has our hands tied and we have to follow the letter of the law all the way around.

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