General Category > General Questions
NY based billing company billing for NJ Provider?
QueenAlicia:
I ask for a schedule with my clients. I know that it is not always foolproof ::) but it does help me to determine whether or not the patient was seen. If I am using the clients software I compare the patient visits to the schedule and I ask them for access to it but I tell them that I do not touch it and that it is just for reference. Sometimes there is no way of knowing at all times but by taking extra measures you can avoid an incident.
Also, for those that do no believe as a medical billing company you can be held responsible, I encourage you to go to the OIG website to do some research. There are plenty of examples there.
Christy:
yes, but how do you recieve the actual CPT codes/charges?
QueenAlicia:
The same way as you stated, by day sheet or super bill. Some send by fax and I have clients that email them to me to a specific email.
PMRNC:
OF course with certain claims it will come down to the doctors documentation.. AS medical billers (and I hate using that term) we are expected to KNOW certain things and if things DO come to question it is UP to us to find the error and even if suspecting an error, fraud, or abuse we are supposed to take action. IF indeed there is a compliance plan in place it tells you that along with the OIG's regs. I had a client one time that went on vacation.. he left his biofeedback tech there to send me superbills. Only problem is, that MY client was to OVERSEE all services (biofeedback) rendered and was required to be ON site. When I looked at my clients email that he was going "on vacation" it was MY job to KNOW that the biofeedback tech was NOT to perform services while he was off site. When superbills were sent to me.. that was my cue. IT WAS MY JOB TO KNOW!! long story short. I dismissed client as per my clause in my contract and I also collected a whistle blowers fee from Medicare. I did NOT automatically make the complaint, I first contacted my client, told him the law, and his response.. "Oh no one has to know" just bill it. had it not been for that I would have HELD the charges and with my knowledge let the provider know that I could NOT knowingly submit these charges. Maybe a complaint could have been avoided. Bottom line. .it was MY job to know it.
Christy:
This question is not specifically for you, Queen Alicia ;D, but just in general to those of us who recieve logs/superbills.....how do you KNOW if a code is fradulent?...it seems like you do need to trust the doc, unless you require notes.....
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