I need a place to vent and probably some advice....
I've been a MDS Coordinator for 2 years now, and I do just about every thing.. all portions of the MDS for 70 beds including Med A residents. (Which every bed is lisenced to be a Med A bed.)
I also do insurance claim forms for varies insurance companies. I got one in today and did it, which this particular one asked for specific MDS related information, which just so happened to be section G. So I coded the insurance form exactly how section G was coded when I did the assessment, which is how your suppose to do code the insurance form.
My administrator came off the deep end today stating, "Thats not how you do it, I know inusrance claim forms and this isn't it." First off, I wanted to say, if you know the insurance claim forms, then by all means do it yourself.. but I minded my Ps&Qs. I refused to change the form, and he huffed off and said he was going to call the insurance company to make sure it was the correct way to do it.
The Med A biller and I work as a team, so I went up there and asked what happened about the claim form...
My administrator, who is NOT a nurse of ANY kind, added information onto the insurance claim form that MY signature and creditials are on and I did NOT approve him to do so...
Could he get in trouble for altering a document that I signed and placed my nursing creditals on?
Apr 5, '12
if it hasn't been submitted yet, yank it and redo. on the question asked, i haven't a clue, did he write it in or type it?
Apr 15, '12
Attach a copy of the most current MDS to the Insurance Form.
I don't know why your Administrator was sticking his nose in this situation.
Perhaps he was afraid that the Insurance Company would not pay on the policy due to "not meeting skilled care criteria" or something along that line.
Don't wait for the Administrator to contact the Insurance Company; contact them yourself.