General Category > General Questions
Legal Basis for Claiming Ownership of Billing Data?
RichardP:
Linda - thanks for that. I'll be interested in your follow-up if you find out anything more.
Re. going to court: My curiousity doesn't really extend that far at the moment. Because winning in court is one thing. Being able to collect or enforce what was won is an entirely different matter.
In most instances when we've needed data from the old billing company, and they refuse to provide it, it is up to the doctor to insist. Our experience is they don't want to bother. And building a database from scratch as the patients see the doctor isn't that big of a deal. Certainly nothing that has risen to the level of thinking that spending time in court is preferred over working the business and earning money.
PMRNC:
--- Quote ---In most instances when we've needed data from the old billing company, and they refuse to provide it, it is up to the doctor to insist. Our experience is they don't want to bother. And building a database from scratch as the patients see the doctor isn't that big of a deal. Certainly nothing that has risen to the level of thinking that spending time in court is preferred over working the business and earning money.
--- End quote ---
I hope you don't mind a little experience on this.. I learned a long long time ago.. stay OUT of contractual issues between a provider and a former billing company.
this is just another reason why I changed my business model so that the provider is responsible for PM software, support, clearinghouse, etc.. Since I've changed this, I've not had a single problem like this. WHY do billing companies mess with "DATA" at the end?? I don't know?? I don't want to know.. I don't care to know and I'm so glad I don't HAVE to know. There are so many ways to avoid this type of situation.
RichardP:
Agreed. We don't get involved in contractual issues between doctors and former billers. For all the reasons you've specified.
Merry:
I agree with Linda. Exit policy in your contract is important. You can always say that you will give them an electronic copy but hey...they wont usually be able to read it but you are doing what you promised. I would NEVER give up source documents and actually just helped someone with a contract and made sure that they had in their contract that they would be keeping source documents for 7 years. If CMS comes calling or any insurance company, they WILL go to the billing service. Nothing like the provider saying that he or she gave the billing service the correct info and that the billing service changed it. Just dealt with this with a dr that is being sued by CMS for $17 million. Thank goodness the billing service had their source docs.
RichardP:
--- Quote from: Merry on April 04, 2015, 05:41:43 PM ---If CMS comes calling or any insurance company, they WILL go to the billing service.
--- End quote ---
Assume paper charts and paper EOBs. The legal record is the chart, not the electronic data in the billing software. For a given patient and a given date of service, one can match what is in the chart with what is on the EOB for that date of service. That would demonstrate whether the billing service billed appropriately. If the physician has both the chart and the EOB, why would anybody need to come after the billing service? Other than maybe it would be easier to check the ledger of the billing software rather than find the appropriate paper EOB. But - since the billing software is not a legal record - how could that electronic ledger be used in any legal proceding in place of the actual EOB for that date of service?
And - rhetorical question for now - how does that scenario translate to the physician who is totally electronic and has no paper records?
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